Partners in Integrated working Serving children and their families Central government Third sector Local Authorities
Early intervention What is working? How do we know? What are we trying to achieve? Early Intervention: The Next Steps An Independent Report to Her Majesty’s Government Graham Allen MP, Jan 2011
Different models of service Integrated Services Multi-agency teams Teams around the child Hackney model of service Families involved in service design and delivery – Swindon model Health visitor role to be expanded in early intervention
STAY START STOP At your tables think about what is working for the vulnerable people you serve? What would you like to be able to start doing for the vulnerable people you serve? What would you like to stop that is impacting negatively on the vulnerable people you serve?
Mary ? ? ? Lucy Tommy 3 years Amy Initial Response Team Police received information that he was being left alone for long periods of time and could be heard crying through the walls. Police attended the home which was found to be in very poor home conditions. Tommy located and was found fit and well. The home was photographed by scenes of crime officers. Evidence of some basic care, food in the fridge, clean washing drying in one of the rooms and cleaning fluids on kitchen top. A notification was made to Social Care under the Children’s Act 1989 and to the Fire Brigade to check safety
On surface appears as cluttered and chaotic living environment. Dangerous areas which posed an immediate risk. Dark, dingy and little room for Tommy to grow and develop in his environment. The state of the home raised concern about the level of care that Lucy was able to give to Tommy. What the social worker saw
The child coming into the system At your table discussion Tommy’s situation. How could your organisation support Tommy? What are the differences between the response in Australia and the response in the UK?
Problem 8 months Lucy visited social care office – money for gas, electricity & food. Month later Lucy threw bottle at Tommy ’ s head but stated it was an accident. 3 months later Lucy visited social care office again – money for gas, electricity & food. Health Visitor concerns over Tommy ’ s development as delayed with toilet training and has hearing problems. Lucy reluctant to accept help for her son. Will soon be starting school. Family Support Worker reported that house was cluttered. Tommy ’ s bedroom was sparse and Lucy not accepting support for her son. 4 months later Lucy again requested financial assistance stating loans were taking all of her benefits. No food or nappies for Tommy. 5 months later Family Support Worker contacted Duty Office on behalf of Lucy to request money as no food, gas or electricity. 6 months later Lucy visited Social work Office for financial assistance – advised that her window ’ s had been smashed and had no money for gas, electricity or nappies. Local Primary School advised that a parent had shared information that Tommy was being left alone and heard crying after a door had closed. Intervention Involved Children Centres, waiting for nursery place, money given, referral made for budgeting course. Lucy took Tommy to hospital following incident and a few days later. Health Visitor addressed issue with her. Money given for amenities and food parcel arranged. Referral to Educational Psychology made by Health Visitor Help provided to get rid of rubbish. Bed, curtains and wardrobe provided by Children ’ s Centre for Tommy ’ s room. Support Worker advised she would complete a CAF Form and refer Lucy to MIND to see the debt solicitor to look at loans. Money provided but put onto key cards. Advice given around toileting and money provided for the rest. Support Worker addressed the issue.
Cluttered and neglectful home conditions, some organisation of items as Lucy knew where everything was. High risk of fire. Lucy hated the home, spent all day out of it and was desperate to move however needed to improve home conditions before council would consider moving them. Lack of trust and high paranoia – not letting people in and feeling everyone was out to get her. Support Worker and Health Visitor had visited on a regular basis try to encourage home improvements. Would take way rubbish, however would provide more items increasing level of clutter in house. Emotionally abusive and lack of patience with quick reaction towards Tommy. Family and wider environment
Depended on by many other people and would spend all day either doing jobs for others or walking round the town to keep out of the home. Constant phone activity during home visits by professionals which meant very limited attention to either Tommy or professionals. Tommy has very poor speech. Still in nappies, drinking from bottle, displayed attention seeking behaviour and some anxious behaviours (rocking and spitting out juice when Lucy shouted at him). Lucy shared that she trusted nobody. Tommy’s father had left her. They previously lived in the Army base in Germany where she had suffered domestic abuse and financial control from him. He would give her a small amount of money which she would use to buy for Tommy and often go without for herself. This left her feeling very vulnerable and she tended to hoard food. Lucy
Resiliencies Lucy did allow for assessment to take place and told that changes must be made for Tommy. Agreed for service support if help could be provided in getting her moved. Lucy has mother and sister however contact is limited and Lucy helps out her mother who has chronic illness. Tommy was in clean clothes and was tidy Tommy attends his nursery Lucy admitted that she was hoarding and could see it was a problem.
The system’s response to the risk of harm to Tommy How are the risks perceived? What are the different types of responses that could occur at this point? What might be happening for Tommy? What might be happening for Lucy?
Health Visitor involved since March 2010 on request from family. Referral made to SALT, couldn’t speak and drinking from bottle. Considered whether Tommy could respond to his mother's instructions. No routines, boisterous behaviour and referred to nursery. Still in nappies. Health Visitor was asked about negative interaction between mother and son. She replied that she had not observed this but had seen Lucy being ‘sharp and shouting’ at Tommy. Community Paediatrician completed a development check who advised of global development delay. A referral was made to Education Psychology. Lucy reported that her son was clumsy and has poor concentration. Nursery stated that Tommy had good attendance, he enjoys nursery and plays with other children. Tommy’s speech was starting to improve a small amount. Nursery did not feel that his level of development was anything different to that of similar children from similar backgrounds and home circumstances. Asking about the relationship, they remembered observing Lucy being ‘short with Tommy and shouting at him’. Also witnessed Tommy flinching from adults in nursery. At Christmas Lucy was observed to be rooting around the bins for food – thought that she had nothing so provided bags of toys, clothes, bedding and hamper or food. Educational Psychology stated that they had been speaking with nursery and they felt there were no major concerns compared to any other child of his age in the nursery. They did feel that there are no teachers in the nursery who would be looking at the next stage of development. There is more than likely going to be major issues with transition into school as Tommy has had no experience other than nursery as yet. It was suggested due to collated concerns from Initial Assessment and observations from family home, that a development assessment would be beneficial to see the baseline of Tommy’s needs. To be planned at a multi agency meeting. Lucy did not want to move Tommy on from day nursery as she felt that she could not trust the school, which was again holding back his development. Reminded of her responsibilities and also necessity to improve things from him. School admission form completed. Home conditions were of immediate and serious concern. Looking back at the picture noticed hoarding behaviours rather than neglectful. Food in the fridge, piles of toys for years to come, bedding etc. Fire Brigade to complete fire safety check and advise of level of risk from fire loading. Finding an ‘in road’ with Lucy but also how to reduce the risk around Tommy. Plan for a short intense intervention to see if Lucy responded under the guide of Child in Need. If not look at the most appropriate support plan for Tommy as circle needed to be broken, Addressed how her current way of living was impacting upon Tommy and that he was not growing up as he should be. Due to paranoia and low self esteem of mum, focused on Tommy. Solution Focused – asking mum what she wanted? Lucy wanted to be out of the house, but needed rubbish moving. Asked for a skip. Arranged and went out to help. Amazing how she threw things out and reported feeling better. Seeing something done.
Many universal services were trying to make improvements for Tommy and were able to pick up on concerns however not communicating together which left him in a state where he was not having the right intervention. Address the home, address his development, address parenting. Focus of intervention looking at Lucy’s attachment behaviours. Case transferred to long term social work support with a plan to look at moving Tommy on and improving his home and welfare.
Children in the care one of the most vulnerable groups in society. The majority of children in care are there because they have suffered abuse or neglect. At any one time around 60,000 children are looked after in England (of whom some 59 per cent are subject to care orders). Some 90,000 children are looked after at some point in any one year. The Government wants every child in care to grow up safe, happy, healthy, secure and loved. This is the only way they will be able to fulfill their potential.
The term 'looked after children' includes: Those children who are in care through a care order under section 31 of the Children Act 1989 Those accommodated on a voluntary basis through an agreement with their parents under section 20 of that Act, or agreement with of the child if they are over 16. Children placed away from home under an emergency protection order Children on police protection/remand/detention (section 21 of the Children Act)
How are they cared for? Most looked after children are in foster care (73 per cent) Some 10 per cent are in children's homes The rest are cared for in a number of different settings including residential schools and placement with parents.
Placements as % of total Child Looked After population 4% placed for adoption (2,300) 11% placed in Family/friend foster carers 20% placed in IFP foster placements 42% placed with Local Authority foster carers 6.5% “Placement with Parents” Accurate Jan 2011
Numbers of children adopted Looked After Children placed for Adoption since Adoption Act 2002 in force is on average 4% of the Looked After population 20062007200820092010 3,0002,7002,9002,7002,300
What do children say? (source: Dr R Morgan, Children’s Rights Director, reports 2006) Don’t leave us too long where we’re being harmed Speed up adoption/permanent placement: it takes too long Give us more information and a say in what happens If we can’t live with brothers/sisters, make sure we keep in touch Moving us around before adoption makes it hard to believe anyone wants us Don’t push us into adoption if we want to stay fostered Best thing about adoption is joining a real family, feeling good about it and having a positive future Worst thing about adoption is leaving our old family
A child who needs looking after Different ways to meet children’s care needs: Kinship care Foster care Adoption Special Guardianship Residential Care
Discussion If Tommy had to be cared for outside of the home how could your organisation respond? What factors would you take into account? How could you respond to Lucy as a vulnerable adult?
A relational task Creating visibility in the relationships rather than on the paper Enabling workers to stay with children and families during the journey.
Building skills in the workforce SWTF competencies framework CWDC Common Core Competencies Research In Practice to build evidence base Supervision as critical to the on-going process Chief Social worker College of Social Work
Challenges in the UK Larger number of looked after children Unaccompanied asylum seeking children Changing role of education Funding for all non statutory activities under threat in Local Authorities Very tight economic climate creating more marginalised children and families. Developing Local Performance Framework and Pay by outcome frameworks Investing in workforce development
How the economic situation is impacting on the third sector Key findings Most participants (71 per cent) are experiencing cuts to their budgets in 2011/12 Of those organisations in receipt of local government funding 80 per cent are experiencing cuts Two thirds of organisations were still awaiting funding decisions from LAs for 2011/12, many not knowing whether services would still be running on 1 April and with staff on notice of redundancy 40 per cent of organisations anticipating staff cuts in the first 6 months of 2011, rising to 66 per cent over the whole year Over a third of organisations who receive funding from charitable trusts, individual giving and corporates are anticipating an increase in funding from these sources There are 14 instances of service closures reported Children’s Centres, Sure Start services, youthwork, family support services and play services are amongst the hardest hit
Services affected by current economic climate A third of services such as Sure Start Children’s Centres and related services, play services, family intervention services, short breaks for disabled children and youth work services report a reduction in capacity. Advocacy and leaving care services are also affected Counting the Cuts: The impact of public sector spending cuts on children’s charities, March 2011
The most notable anticipated increase in capacity seems to be in relation to adoption and fostering services with 40 per cent of organisations who provide them reporting an expected rise.
Discussion Name three themes that has come out of this mornings discussion that it would be useful to take further in either your own organisations/larger forums? What has been left as a ‘burning issue’ you would have liked to explore further.