Organisation submitting example
Local authority/local area:
The context and rationale
The Stockport Supporting Families Pathway has changed the way the Local Authority responds and offers services to children and families who are in need of early help.
In the past, the Contact Centre ‘front door’ effectively identified families that met social care thresholds of intervention.
A new system has been created that screens needs below the social care threshold and offers a multi-agency response using CAF as the common process tool.
The idea for the Supporting Families Pathway came following a discussion at the Children’s Trust Board around the national indicator NI68 (numbers of referrals to social care that go on to receive an initial assessment).
There were a number of drivers that triggered this work:
• Increasing numbers of children reaching Social Care thresholds.
• The Contact Centre highlighting high numbers of children with needs that were lower than Social Care threshold.
• Motivation to understand what was being offered to families that did not meet the social care threshold.
• A commitment from Children’s Trust to develop integrated working.
The high numbers of referrals to social care coupled with high numbers of children who were assessed as not meeting social care threshold, prompted a conversation to discuss the development of a new pathway with a view to addressing some of the issues.
The idea of the Supporting Families Pathway was:
• To improve identification of need and access to early help for children and families.
• To explore use and effectiveness of Stockport’s Contact Centre as the means by which families access Universal and Tier 2 services.
• To develop and analyse journey maps of children and families by undertaking detailed research into existing processes at the Contact Centre and examining the interface with service providers.
Stockport Council led the re-designing of services with a Service Manager in Integrated Prevention Services.
Council Services involved:
• Strategy Engagement and Commissioning
• Children’s Social Care
• Local Safeguarding Children’s Board
• Social Care Systems and Performance
• Parenting Services
• Children and Young people Disability Partnership
• Common Assessment Framework (CAF) and Common Processes
• Children’s Centres and Play Development
• Young Peoples Substance Misuse Service
• Services for Young People
• Youth Offending Service
• Corporate Information and Governance Services
• Stockport Direct Contact Centre - Corporate and Support Services
• Adult Social Care,
• Workforce Development
• Integrated Prevention Services
• Greater Manchester Police
• Stockport Women’s Aid
• Health Visitors, School Nurses and Community Midwives
• Counselling Services
• Adult Drug & Alcohol Treatment Services (Health)
The service redesign took place over three phases.
Phase 1: Intensive scoping and analysis May - August 2010
• Meetings were held with managers and staff at the Contact Centre.
• Time spent establishing an understanding of practice and processes at front line level and shaping next steps.
• Data collection and analysis of gaps in the service.
Phase 2: Service Redesign August - October 2010
• Analysis from phase 1 confirmed that the front door to Social Care was robust and met the needs of children and families at Tiers 3 and 4.;
• Families that did not meet Social Care thresholds were provided with information and advice, which would often take the form of a letter or general information on tier 2 and universal services available in the borough.
• Analysis was undertaken of the variety of referral routes to the Contact Centre requesting help.:
This analysis informed recommendations for service redesign which were presented to key stakeholders at a full day workshop.
‘End to end’ case studies, illustrating current processes for lower tier cases, were used to help stakeholders test the vision and opportunity presented by the new Supporting Families Pathway processes.
Recommendations to Senior Managers included a range of adaptations to current processes. This included a new ‘CAF recommendation process’ to ensure an increase in numbers of CAFs undertaken by services, therefore providing help to families earlier.
The decision to implement service redesign was agreed by the Children’s Trust Board.
Phase 3: Implement Service Redesign November 2010 - April 2011
Key aspects of the implementation stage were:
• Development of multi agency screening tool.
• Development of database: to assist the authority in building a picture of concerns about children and families..
• Equip colleagues at Contact Centre to implement the Supporting Families Pathway: briefing sessions on new processes and use of database were delivered. Bespoke CAF training was also delivered.
• Communication of the proposed changes to tier two and universal providers.
• Create new ways of working which changes the way services receive cases: services have access to the Supporting Families Pathway database and now receive cases that have been screened and indicate a CAF is required.
• Create a momentum that supported a change in culture: negotiation with services and discussion related to how the potential changes would impact upon them was crucial to this process.
• Integrate allocation of resources that support families: the Supporting Families Pathway ensures collaboration between services relevant to a families needs.
• Negotiate information sharing protocol with key partners.
• Negotiate step down from Social Care intervention: to create an interface between Social Care and Supporting Families Pathway to ensure CAF is embedded when social care withdraw from a case.
• Live status for the Supporting Families Pathway: achieved May 2011 and introduced with a staggered approach. Introduction of one Contact Centre worker at a time to ensure they are fully supported in implementing new way of working.
• Set up regular Supporting Families Briefing meetings: to provide a multi-agency forum to facilitate communication and ensure that services feel supported in implementing the pathway and issues arising are addressed quickly.
Achievements so far
Measurement: Have you identified any measures of success? If so, can you explain what they are?
Robust Performance Management reports that measures:
• Numbers of families screened via the Supporting Families Pathway.
• Numbers of CAFs/ universal recommendation made.
• Successful application of 20 working day time limit for CAF Recommendations.
• Uptake by families of universal service offer and satisfaction with that service.
• Primary and secondary presenting issues (to inform commissioning/ workforce development of tier 2 and universal services).
• Referral Source.
• Successful Step Down from Social Care intervention via CAF/TAC.
• Reduction of inappropriate referrals to Social Care.
Quality Assurance Process that monitors:
• Early identification of problems: the Supporting Families Pathway has been live since May 2011 and evidence shows that it is effective in identifying need early and providing a coordinated response to families.
• Co-ordination of services to avoid escalation of intervention: evidence highlights that services are providing a true integrated approach to families as the Supporting Families Pathway facilitates communication between agencies.
• Step-up/ Step-down arrangements as exemplars of integration: the Supporting Families Pathway is becoming embedded into Social Care’s exit strategies via robust Step Down processes.
• The exercise of professional judgement.
• The role of CAF champions as mentors for integrated working.
• The efficacy of information sharing across the Children’s Trust: early evidence indicates that information sharing has become enhanced under new Supporting Families’ processes; reducing duplication and ensuring families’ experience a seamless, coordinated response.
Evidence collated so far:
87 cases were submitted to the Supporting Families Pathway in the first 4 weeks of going live and with only one (out of five) Referral and Information Officer implementing the new processes.
Of those 87 cases there were:
34 CAF recommendations
52 Universal recommendation
1 had an existing CAF in place
N.B. until all Referral Information Officers are implementing the pathway this data will be incomplete.
Parent testimony: in the first four weeks after the pathway went live a parent rang the Contact Centre to say that he was delighted with the support he received from services following his request for help with a variety of issues.
Early evidence shows transformation of processes and enhancement of the interface between Social Care and lower tier service providers.
Early evidence highlights that services are now contacting families earlier in the customer journey and soon after, for example, police notifications of attendance at a domestic incident (below social care threshold) are shared with the service. Traditionally schools may have identified problems with a child a few months after the original incident; however services are now contacting families to offer help as soon as that issue is highlighted to avoid escalation of need and requirement of much more intensive and costly services.
A cultural shift has been apparent in relation to changes in information sharing protocols and access to data and information between key partners.
Positive collaboration amongst service providers and coordination of approach to families has been apparent in the early days of the Supporting Families Pathway; this is enhanced by the fact that the database has an interface with service providers and has improved day to day communication between services.
The Supporting Families Pathway seeks to strengthen links with adult providers and has recently become aligned with Adult Drug and Alcohol Treatment Services to enhance information sharing and coordination of services, using a family orientated approach.
Families are receiving a tangible offer of early help before problems escalate.
More CAFs are now being recommended, completed and effecting positive change for families with evidence of earlier identification and intervention being achieved.
Workforce development needs have been identified to support service delivery under this new way of working. This is in relation to building resilience and confidence in the workforce to contact families much sooner in the customer journey.
Opportunities for further development of the Supporting Families Pathway have been agreed by Stockport’s Local Safeguarding Children Board. Work is currently in progress to direct all missing from family home reports through the pathway and ensure a targeted early response to children missing from family homes. This work is being developed in conjunction with Greater Manchester Police and Emotional and Mental Health colleagues in the private and voluntary independent (PVI) sector. This will increase uptake of the CAF across the voluntary sector.
There have been a number of positive unintended consequences.
• The work of the Supporting Families Pathway has contributed to a transformational programme and financial review across the Directorate which commenced after the Supporting Families Pathway had begun. Data and research from the Supporting Families Pathway is underpinning the work of the transformational programme.
• The opportunity to contribute to the development of the Children’s Trust CAF/TAC flexibilities which were also in development. The Supporting Families Pathway is part of the Integrated Working Board and this is a forum to link initiatives.
• The opportunity to take part in LARC4 (Local Authorities Research Consortium) research and to repeat use of the methodology with the Supporting Families Pathway in autumn 2011.
• The opportunity for the Supporting Families Pathway to support and inform investment in the borough via the Community Budgets initiative.
Investment of time in order to develop the Supporting Families Pathway was intensive and demanding but vital to drive the work effectively.
Managing change and expectations: the Supporting Families Pathway has both short and long term objectives and communicating them effectively with partners is important to avoid confusion. Short term goals are: earlier identification of need in families, increased uptake of CAF/ TAC processes and reduction of inappropriate referrals to Social Care. Long terms goals are a reduction of children presenting for the first time to services with high end need requiring intensive and costly Social Care intervention.
Cost: £68,000 - £77,000 for a full time Service Manager and CAF Common Processes Senior Practitioner plus approximately £5,000.00 for set up and other project management costs for the year.
LARC 3 2010 highlighted:
‘…CAF process costs are mostly under £3,000, the exception being the most complex cases where multi-agency intervention is required. Even here case study data suggests an upper limit of £8,000 which is still relatively low when set against a potential saving of £100,000. The CAF process is an enhancement to capacity for early intervention and not a costly bureaucratic overhead.’
Invest to Save is key to the Supporting Families’ Pathway. By offering early help Stockport hopes to reduce potential future costs associated with the following:
• Reducing escalation to social care by intervening earlier:
Social Service family assessment: £350 (DCSF, 2010)
Family support 1hr x 10 weeks £1,250 (DCSF, 2010)
Learning support assistant/ learning mentor (10 hours per week x 36 weeks) £12,600
Child being taken into care: £36,653 (Netten & Curtis, 2006)
X x 1 hospital admission for childhood accident: £274 (Netten & Curtis, 2006)
Truancy over lifetime £44,468 (Misspent Youth, 2007)
10 x 1 hour sessions psychologist: £810 (Netten & Curtis, 2006)
• Children of substance misusing parents are more likely to go on and misuse substances themselves without intervention which could incur the following costs for one family:
Specialist Counsellor £38.50 per visit
Residential rehab (Adult/ parent) £717 per week
Residential rehab for under 18 placement p/wk £4,000
Nuisance behaviour eviction £6,872
6 months custody £51, 409
Source:(Early Intervention: securing good outcomes for all children and young people. March 2010)
Learning from experience:
The Supporting Families Pathway followed a ‘must have’ approach for pathway development.
Stockport’s Principles of Integrated Working were a key reference point for the development of this project.
Key leadership behaviour characteristics
The following core behaviours have been identified as part of successful elements of leadership (see National College for Leadership of Schools and Children’s Services/C4EO (2011). Resourceful leadership: how directors of children’s services improve outcomes for children. Full report. Nottingham: NCSL see http://www.nationalcollege.org.uk/docinfo?id=144732&filename=resourceful-leadership-dcs.pdf).
Stockport identified the following behaviours as key to the transformation of their service.
Openness to possibilities
• An open and positive approach underpinned the research stage of this work. This enhanced the building of effective relationships which helped create an in depth understanding of existing data, systems and processes across a wide range of services.
• Knowledge of available resources whilst assessing future resource requirements was vital when preparing this model of change.
• Approachability and listening to the views of partners was key in ensuring shared ownership of the redesign. This was balanced with a pragmatic approach; essential when working to effect change across a variety of services with contrasting ideas on what the ‘solution’ should be.
• Openness and flexibility assisted in the engagement of key stakeholders, which enabled the exchange of ideas and a general consensus to be reached on potential solutions
Personal resilience and tenacity
• Persistence, resilience and confidence to see this work through each stage of development, particularly in light of financial pressures across the local authority, was important in driving the Supporting Families Pathway.
• Stockport’s shared vision across the Children’s Trust was an important source of strength when working to effect change of this type. Knowing when to seek support from colleagues and the quality of the subsequent support given was invaluable.
• Ability to see and retain the ‘big picture’ whilst exploring the detail of front line practice was a significant factor in driving this work.
The ability to create and sustain commitment across a system
• Maintaining and promoting the vision of improving the child and family journey in Stockport was central to the process of change. Holding this at the heart of the work helped create cohesion across the range of services involved.
• Improving outcomes was already a shared commitment and this was used as a springboard to help the new system evolve and develop.
• Communicating incentives was helpful in sustaining commitment across services. Illustrating potential improvements to future delivery using real life case studies was key to brokering this commitment to change.
The ability to simplify
• Whilst working on this complex programme of change and system redesign it was vital to communicate a simple, consistent and clear strategy to both internal and external partners in a way that would help colleagues quickly understand the vision and end goal.
• Skill in utilising a range of communication methods, to suit different learning styles and different organisational cultures was an important part of the process.
• The vision embraced a wide range of services, each with complex systems in place and it was therefore helpful to develop a ‘shorthand’ summary of the vision using visual, written and verbal methods. This enhanced engagement of partners and supported development of a joint commitment to the vision.
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