Multi Agency Allocation Meetings (prevention and early intervention support through multi agency support teams), Sheffield

Themes this local practice example relates to:

  • General resources
  • Local area early intervention strategies

Basic details

Organisation submitting example

Prevention and Intervention Services & Children and Families Services 

Local authority/local area:

Sheffield City Council

The context and rationale

There are around 120,000 children and young people between the ages of 0-19 in Sheffield (23.3% of the total population). We would estimate that 35,000 of these children will at some point in their lives need some form of additional support. The challenge is to provide support so that every child achieves their potential, no matter what the barriers may be. To do that, the City must work in new and effective ways across services, and prevention and intervention services were developed for this reason.
Successful early identification of children and young people with additional needs reduces the numbers of children who need additional support and which may escalate into expensive targeted and treatment services. 
In 2007, an internal review was carried out to assess progress and found three areas of priority for future development.

These were:

• defining the service delivery model for children, young people and families 
• defining the governance and partnership model that supports community engagement 
• developing and implementing a performance management framework that assesses impact. 

Out of this, the Prevention and Early Intervention Project (2009-2010) provided a defined model for delivering multi-agency front line services and packages of support to children and families in local communities. The model and its associated structures for delivery has embedded new ways of working that have increased early identification of potential risk and developed a system for assessment, planning, implementation and review. 

The model has become known as the Multi Agency Allocation Meetings (MAAM) process. This is a framework of shared principles based on the Common Assessment Framework (CAF) which creates consistency in approach with universal and partner agencies delivering services in conjunction with Local Authority and Health Services.

The MAAMs model was developed in collaboration with a focus group of headteachers, health representatives and representatives from Social Care. They were introduced by Multi Agency Support Teams (MAST) in 2009 with the aim of co-ordinating and performance managing integrated working throughout the City.

The practice

Multi Agency Allocation Meetings (MAAM) take place throughout the city, and they create an opportunity for MAST and Children’s Specialist Service Team Managers to share assessments and agree support. These are cases worked on jointly and which are existing in Children’s Specialist Services to be supported back into universal services. During these meetings, professionals also discuss a Common Assessment Framework (CAF) form which has been completed with a member of the family.

A wide range of agencies attend the meeting including:

• Action for Children
• Health Visitors
• Children’s Centres
• Multi Agency Support Teams
• Children’s Specialist Services
• Primary Mental Health
• Community Midwifes 
• Police
• Child Adolescent Mental Health Service
• Safeguarding Services
• Early Years
• Sheffield Futures
• Family Action
• Sheffield Homes
• Family Aid Services
• Youth/Youth Offending 

These agencies jointly agree which of them can offer the most appropriate support and also joint working packages that will be of most help to the families’ needs. A Lead Agency/Professional is appointed to co-ordinate the families’ packages of support and monitor how the work is progressing. This person will work closely with other professionals to ensure all the services are delivered. 

The MAAM is designed to be solution-focused and to ensure families get the right help as soon as possible and also to agree an action plan with the family. These plans are designed so that the whole household is able to work through their challenging circumstances together.

The MAAMs model provides the process for ensuring a continuum of support to families. This is achieved by unblocking barriers to offer personalised support packages and also preventing risks escalating. It empowers multi-agency teams to direct resources when and where they are most needed. It has created a safe and seamless approach where partnership working is embedded and the traditional practice of passing families around agencies has been removed, thereby encouraging ownership and accountability.

The additional support, guidance and encouragement given by the MASTs has led to universal services increasing the use of CAF as an early assessment tool. This has led to better information sharing between partners, and an increase in the broader understanding of individual children and families’ needs. This early identification process has enabled us to reduce the duplication of services and number of professionals involved directly with families.

The intended measurable outcomes were:

• a rise in attainment
• a reduction in the number of children requiring a higher end social care service
• to provide support to families existing in social care services
• to see a measurable rise in the use of CAF. 

We have been set several challenges in the development of this service and they have been the focus for demonstrating improved outcomes. 

Challenge 1 > Providing support to children with additional needs. 
Challenge 2 > Developing a pathway for families to access multi agency support.
Challenge 3 > Enabling fast access to responsive services. 
Challenge 4 > Children and families’ voices should contribute to the development of services. 
Challenge 5 > Improving outcomes for children and their families. 
Challenge 6 > Communication and strengthening partnerships and links within communities. 
Challenge 7 > Modernisation of the workforce to deliver integrated services. 
Challenge 8 > Maintaining and increasing resources into preventative services.

Evidence and evaluation - making a difference to children, young people and families

Multi Agency Allocation Meetings were introduced by Multi Agency Support Teams (MASTs) last year as a means of co-ordinating integrated work, supporting children and families in Sheffield. Since this time, MASTs have screened and processed over 7,500 requests for support. We have seen an increase of 46% of Common Assessment Frameworks (CAFs) and an increase of 33% of other assessments being sent to MAST requesting support.

Challenge 1: Providing support to children with additional needs
• 46% increase of Common Assessment Frameworks (CAFs) being sent to MASTs.
• Reduction in inappropriate referrals to social care (going into assessment) at 90% (target 73%).
Challenge 2: Developing a pathway for families to access multi agency support
• Raised the number of cases that have a lead agency/professional to over 6,500 cases.
Challenge 3: Enabling fast access to responsive services
• MASTs have screened and processed over 7,500 requests for support and seen a 33% increase in other assessments requesting support.
Challenge 4: Children and families voices should contribute to the development of services
• Introduced a customer charter and customer focus questionnaire, with an overall satisfaction of the outcome of the support at 83%.
Challenge 5: Improving outcomes for children and their families
• Delivered 53 parenting programmes for 466 parents.
• Introduced difficulties and disabilities early years panel. 
• Integrated support for MAAMs to provide wraparound support as well as childcare places for vulnerable two years olds.
• Introduced primary mental health workers at MASTs.
Challenge 6: Communication and strengthening partnerships and links within communities
• Created a MAST brand.
• Engaged schools (including governors) for services and publicising events.
• Developed local reports at community level.
Challenge 7: Modernisation of the workforce to deliver integrated services
• Trained 150 staff in the use of SDQs.
• Trained 150 practitioners in using parenting programmes.
Challenge 8: Maintaining and increasing resources into preventative services
• We have made use of SDQs.
• We have conducted customer focused questionnaires.
• Continuing to engage with local and citywide services.

We have evaluated our project against national key performance indicators and introduced our own local performance indicators to monitor outputs from the project.

We have also conducted an evaluation of customer satisfaction with the services they received. During April 2010, the MASTs introduced the use of customer satisfaction questionnaires to be sent to families following the end of an intervention by a Multi Agency Support Team Worker. During April –September, 1,170 questionnaires were sent to families on cases that were recently closed. The cumulative response rate was 13.3%. 
Standard questions 1-8 continue to score very positively for the way the worker has interacted with the family, with 88% of respondents answering YES to questions of ‘did our worker…’
Customer satisfaction is linked strongly to customer focused practice, the building of working relationships and the ability to give personal attention to the individual needs of the customer. The overall city scores show that 83% of customers rated the services as 3 or above.
Customers were asked what difference they thought our team had made to their child. This question is directly linked to the previous question on customer satisfaction and the rating is comparable on both. Citywide, 75% of customers thought that MAST services had made ‘some’ to ‘lots’ of difference in a positive way to their child. This correlates to whether the services were statutory or not and comments made by the respondent about the type of relationship that was built up between the worker and the customer.

Two case studies highlight the work of the Prevention and Early intervention project:

Case study A
Case study B

Other outcomes:

Our Multi Agency Support Teams (MASTs) have been working with colleagues on raising the aspiration and attainment of pupils both inside and outside of school (including at home within the family setting). The Prevention project has supported an increase of Learning Mentors which has led to the creation of much stronger links with some schools. We have also provided additional targeted support to the cohort of children identified in schools under the World Class Primary Programme. This support work has directly contributed to the marked improvement in performance seen in 2010 (NI 76).

Despite the overall rise of referrals into children’s social care recently in Sheffield, Social Care Fieldwork Services have changed practice in respect of Initial Assessments. There is now a policy of carrying out Initial Assessments on all third party referrals and the improved relationships with partners created by the development of MAAMs has meant that, where agreement is for a social work assessment, this occurs without further referral. These factors have been partially responsible for a yearly increase in Initial Assessments of 37%.

However, with the introduction of the new Domestic Violence Service, completion of Initial Assessment on all third party referrals and MAAMs has led to more streamlined services and service users receiving more timely interventions at the right level by the right agency. It has impacted significantly on the efficiency of social care referral processes. It also ensures that decisions are made on more complete information thereby strengthening the child protection aspect of the service. The impact of changing practice, improved quality assurance and management oversight, improvement in prevention strategies and the development of more integrated provision has been seen on the numbers of LAC in the care of Sheffield City Council. The number of LAC has also fallen slightly over the past two years.

Early prevention services also support children often subject to Child Protection (CP) Plans or returning home from section 20 accommodation. This work has also had an impact on the number of children on CP Plans seeing a further reduction in 2010. This has shown Sheffield to produce better results in the past two years than local or statistical neighbours. 

Through the MAAM, agencies come together to agree who can offer the most appropriate support and joint working programmes that will be of most help to the families needs. The person representing the lead agency will work closely with other professionals to ensure all the services are co-ordinated and delivered. As part of this process the number of lead agencies/professionals linked to a case has risen significantly.

We have developed our local reporting significantly over the past year and all the changes we have made have led to faster access to services and better management of cases.

The levels of need across the city vary greatly, depending on factors relating to individual family social and economic circumstances. However, having jointly aligned Prevention and Social Care services with Community Assemblies, we have managed to create service areas that share the responsibilities of care across our teams.

Sustaining and replicating your practice

£3.2million has been invested into prevention and early intervention services over the past two years. The main sources of funding for this have been the Sure Start Grant and the former Area Based Grant. This funding has supported the implementation of the MAAM delivery model, enabled an increase in front line workers and provided support to partner agencies to enable us to work more closely together, support each other’s interventions and share information quickly and more easily. 

We have invested money in-house on training our frontline support staff on newly introduced processes and ways of working such as: 

• Integrated file management and action plans
• Strengths and Difficulties Questionnaires 
• Triple P (solution focused training) 
• Integrated Management events (jointly with Social Care)
• Introduction of a joint performance management framework (with Social Care)
• Refresher training on EMS (ONE) and CS Profile website

We have also set-up and/or funded a number of new projects and initiatives such as:

• Primary Mental Health Workers (offering clinics, drop-ins ,advice and referral to Tier 3 services).
• Family Aid (contract with Crossroads Care, a charitable organisation providing practical support to families in their homes).
• Homeless Prevention Team (joint working between MAST, Housing and Social Care for homeless 16 and 17 year olds).
• Aspire for Life (preventing teenage pregnancy advocacy support).
• Family Group Conferencing (mediation of social care – care proceeding cases).
• Set-up costs to support Domestic Abuse Helpline.
• Police Screening Teams supporting MAAMs.
• Funding of post within the Joint Investigation Team (JIT).

In our opinion this service can be easily replicated, the barriers that were encountered were similar to those in every day working life around resistance to change, implementation of new ways of working, communication, which was key, getting partners on board and agreeing protocols for working relationships.

 

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