Presentation on theme: "Welcome to Integrated Processes Training. Welcome and housekeeping Fire Toilets Refreshments Telephone Messages Smoking."— Presentation transcript:
Welcome to Integrated Processes Training
Welcome and housekeeping Fire Toilets Refreshments Telephone Messages Smoking
What is integrated working? Integrated working is when everyone supporting children, young people and families works together effectively to put them at the centre, meet their needs and improve their lives. Integrated working aims to help identify needs early and provide support so that any problems do not become more serious.
Working together to improve outcomes for children and young people Make a positive contribution Achieve economic wellbeing Be healthyEnjoy and achieveStay safe
The policy context for integrated working Every Child Matters and the 5 outcomes. Childrens Trusts. The National Service Framework for Children, Young People and Maternity Services (2004). Youth Matters (2005) and Targeted Youth Support (2007). The Children's Plan (2007). 21st Century Schools: A World-Class Education for Every Child (2008). Think Family (2008) Children and Young Peoples Workforce Strategy (2008). Recent policy updates.
Improved outcomes: Be healthy. Stay safe. Enjoy and achieve. Make a positive contribution. Achieve economic well-being. Integrated working processes and tools Tools and processes that support integrated working Lead professional and TAC CAF and National eCAF Information sharing Common coreContact Point Multi-agency working
A continuum of needs and services
The benefits of integrated working Earlier, holistic identification of needs Earlier, more effective intervention Improved information sharing across agencies Better service experience for children, young people and families More effective practice for practitioners and organisations It is what is best for the children that counts and we feel this new way forward is absolutely the best for our children and young people You cant be an expert in everything. We now have a tool to consult others – this saves huge amounts of time trying to become an expert in every subject Everything is so exciting, but what is most exciting is that all our new pieces of work are now linked
Guiding principles for the workforce Everyone in the children and young peoples workforce should: Work in partnership with children, young people and families. Work in partnership with other practitioners. Work in a child and young person centred way. Share information appropriately and effectively. Use a holistic approach. Focus on strength as well as need. Consider all potential sources of support. Be proactive and accountable. Promote the well-being of children and young people and safeguard them from harm.
Common assessment Framework
The CAF as part of integrated working Improved outcomes: Be healthy. Stay safe. Enjoy and achieve. Make a positive contribution. Achieve economic well-being. Tools and processes that support integrated working Lead professional and TAF CAF and National eCAF Information sharing Common core Multi-agency working
What is CAF? Using the CAF will help us develop a common understanding of strengths, as well as needs and how to work together to meet them. The CAF will help us assess children and young peoples additional needs for services, earlier and more effectively. The CAF is a shared assessment and planning framework to help us in our work with children, young people and families.
The CAF principles Holistic Child and young person centred Voluntary and only undertaken with consent Focused on strength as well as needs Coordinated (only ever one active CAF episode per individual) A standardised process supported by a form Able to improve links to specialist assessments Not something services can require before access to provision – but is able to inform better referrals
Who will use CAF and when? Do not use the CAF when: Progress is good. Needs are identified and already being met. Needs are clear and all can be met by one service. There is no consent. If, at any time, there are concerns that a child may be at risk of harm, then follow LSCB procedures without delay Use the CAF when: There are concerns about progress or wellbeing. Needs are unclear and not being met. Needs are broader than your service can address. Any practitioner can use the CAF with an individual child or young person
Identify initial concerns regarding family outcomes – consider need for pre-assessment or signpost to other services Holistic Family Assessments - REFERRAL Undertake a holistic family assessment to identify family needs and services required to support better family outcomes Team around the family (TAF) meeting to agree action plans and agree roles, responsibilities and timescales, agree Lead Professional Produce a multi-agency action plan to ensure a shared approach to information sharing and improving outcomes Review the action plan to measure outcomes for the family until they are back to universal services
ACTIVITY TO CAF OR NOT TO CAF!
Scenario 1 – Chantelle Chantelle moved to the area a month ago, with her brother and her mum, Karen. They moved closer to Karen's mum, who now looks after the children when Karen is at work. They do not have much money and are currently living in a small one bedroom, 8 th floor flat that Karen says is a little damp. Chantelle has not yet started at a new education provider since the move. Chantelle seems small for her age and has a rash on her arm that she scratches a lot. Karen says it has been there a few weeks and she will take her to the doctors once they register with one. Chantelle is quiet and does not talk much.
Scenario 2 – Carlos Carlos has a serious stutter that sometimes makes it hard for others to understand him, but he is working with a language therapist. Other than that, he is healthy, intelligent and popular – but a little shy. He lives with his mum and dad and 2 siblings in a 4 bedroom detached house.
Scenario 3 – Tammy and her baby Tammy is 15 and lives with her Grandmother. She has recently given birth to a baby girl. She says she wants to go back to school as soon as possible so she can get an education and a good job to support her baby. Her Grandmother is supportive, but Tammy says she is considering applying to move into a flat once she is 16 so she and the baby can begin life as a proper family.
Scenario 4 - Pravin Pravin is having a few difficulties in education. He is not keeping up with his peers and says he is being bullied. The home situation seems loving and supportive. Both Pravin and his parents say they do not want a common assessment to take place
Scenario 5 – Paulette and Mickey Paulette (14) and Mickey (3) live with their mum and her boyfriend. Both Mum and her boyfriend are regular heroin users and deal from the flat to support their habit. Mickey has signs of bruising on his back and Paulette has what appears to be a cigarette burn on her arm. Both seem undernourished and are dirty.
Basic/background information. Consent, at various stages. Assessment in three domains (see below). Initial action plan. Delivery plan and review. What does the CAF consist of? Through the process standard information will be gathered and recorded: Development of the child or young person Parents and carers Family and the environment Assessment domains
A good CAF discussion should… Lead to a better understanding of strengths and needs, and what can be done to help Build on effective engagement and communication Not be too formal or a big event Build on existing information to avoid repetition Fully involve the child or young person and their family Cover relevant areas but look beyond the surface
An assessment that is: Focused on strengths as well as needs. Valid and accurate. Clear and uses appropriate language. Inclusive. Unbiased. Authentic. Professional. Solution focused. Practical. Evidence based with opinion recorded as such. What makes a good CAF assessment? Using an approach that is: Empowering. Accessible. Developmental. Transparent. Leading to…
Identify initial concerns regarding family outcomes – consider need for pre-assessment or signpost to other services Holistic Family Assessments - ASSESS Undertake a holistic family assessment to identify family needs and services required to support better family outcomes Team around the family (TAF) meeting to agree action plans and agree roles, responsibilities and timescales, agree Lead Professional Produce a multi-agency action plan to ensure a shared approach to information sharing and improving outcomes Review the action plan to measure outcomes for the family until they are back to universal services
Activity Completing A CAF
Family risk factors for assessment Economic well being Communities & staying safe Health and family structures Most Excluded Families Poverty and debt Worklessness Education and skills Crime and ASB Alcohol and drugs Poor housing and homelessness Domestic violence Relationship conflict Mental and physical health
What makes a good CAF plan? Good action planning is: Comprehensive. Efficient. Inclusive. Informative. Focused. Logical. SMART. Transparent. CAF initial plan and delivery plan should: Build on strengths and help meet needs identified through the assessment. Not promise support on behalf of others. Agree who will do what by when and when review will happen. State anticipated outcomes and how progress will be measured. Record consent to record and share. Gather information Undertake assessment AnalysePlan
The CAF review The CAF review should gather and record: Who is present. Progress against each of the actions in the CAF delivery plan. Next steps. Review notes. Child/young person and parent comments and where necessary, additional consent. Outcomes of the review could be one of the following: New assessment needed New actions agreed and review date set CAF closed
Activity The CAF Plan
Closing a CAF A CAF can be closed for many reasons, including: Additional needs met. Child or young person has moved to another area. Child or young person has made the transition into adult services. CAF assessment superseded by specialist assessment. Consent withdrawn. Others?
The team around the family (TAF) and the lead professional
Identify initial concerns regarding family outcomes – consider need for pre-assessment or signpost to other services Holistic Family Assessments - TAF Undertake a holistic family assessment to identify family needs and services required to support better family outcomes Team around the family (TAF) meeting to agree action plans and agree roles, responsibilities and timescales, agree Lead Professional Produce a multi-agency action plan to ensure a shared approach to information sharing and improving outcomes Review the action plan to measure outcomes for the family until they are back to universal services
Lead professional and team around the child as part of integrated working Improved outcomes: Be healthy. Stay safe. Enjoy and achieve. Make a positive contribution. Achieve economic well-being. Tools and processes that support integrated working Lead professional and TAF CAF and National eCAF Information sharing Common core Multi-agency working
The Team around the family (TAF) The TAF is a multi disciplinary team of practitioners established on a case by case basis to support a child or young person and their family. Practitioners in the TAF can come from across the workforce and will focus on strength as well as need. The model does not imply a team that is located together or who work together all the time.
Forming the TAF Where a multi-agency response to the CAF assessment is required, a TAF should be arranged by the person who initiated the CAF assessment. The child or young person and/or their parent/carer must be a full and active part of the TAF at all stages and be invited and encouraged to attend meetings. Invite relevant practitioners, as identified through the CAF assessment. TAF practitioners might include those from statutory as well as voluntary/third sector organisations and include: Universal services. Targeted services. Specialist statutory services, if appropriate.
TAF meetings Initial meeting Share information to gain a fuller picture Initial meeting Agree a lead professional Agree achievable goals Agree and record actions to meet goals Set date for review meeting (within three months is recommended) Review meetings Discuss progress Share any new information Update plan Agree achievable goals Agree new actions, OR close, stating reasons
Activity Convening an initial TAF Meeting
Identify initial concerns regarding family outcomes – consider need for pre-assessment or signpost to other services Holistic Family Assessments - PLAN Undertake a holistic family assessment to identify family needs and services required to support better family outcomes Team around the family (TAF) meeting to agree action plans and agree roles, responsibilities and timescales, agree Lead Professional Produce a multi-agency action plan to ensure a shared approach to information sharing and improving outcomes Review the action plan to measure outcomes for the family until they are back to universal services
TAF practitioner responsibilities The lead professional coordinates delivery of the plan. Each practitioner in the TAF is responsible/accountable to their home agency for the services they deliver. Jointly responsible for developing/delivering the CAF delivery and review plan Responsible for delivering the planned activities Responsible for monitoring and keeping TAF informed about their progress Attend TAF meetings and contribute to taking minutes, chairing and other tasks Support the lead professional, including providing information and offering guidance and advice Contribute actively and positively to problem solving and resolving difficulties in a child centred way Remember the T in TAF stands for team
Identify initial concerns regarding family outcomes – consider need for pre-assessment or signpost to other services Holistic Family Assessments - REVIEW Undertake a holistic family assessment to identify family needs and services required to support better family outcomes Team around the family (TAF) meeting to agree action plans and agree roles, responsibilities and timescales Produce a multi-agency action plan to ensure a shared approach to information sharing and improving outcomes Review the action plan to measure outcomes for the family until they are back to universal services
The role of the lead professional The lead professional is a set of functions to be carried out as part of the delivery of effective integrated support, when a range of services is involved with a child or young person following a common assessment. The lead professional will: Coordinate the delivery of the actions agreed by the practitioners involved. Act as a single point of contact for the child, young person or family. Reduce overlap and inconsistency in the services received.
Myth Busting – the lead professional Does not have to be an expert in everything Is not automatically the person who initiated the CAF Does not need any particular qualifications Will not be expected to work outside their usual remit Is not responsible or accountable for actions by other practitioners or services in the TAF Will have support mechanisms in place to resolve any issues Does not become responsible for the needs of the entire family May use more time in one area, but save time elsewhere
Who can be a lead professional?
Core tasks of the lead professional Be a single point of contact for the child, young person and family Be a single point of contact for all practitioners working with the child Build a trusting relationship to secure engagement Continue support if appropriate, if specialist assessments are needed Convene the TAF meetings to enable integrated multi- agency support Identify where others may need to be involved and broker involvement Support the child/young person through key transition points Ensure a safe and planned handover if a different LP is agreed and more appropriate Coordinate delivery of solution focussed actions and ensure regular reviews
Knowledge and skills of a lead professional Knowledge – understand: CAF and integrated working. How to access services. The child/young persons strengths and needs. Information sharing, consent and confidentiality. Safeguarding. Boundaries of own knowledge. Skills – ability to: Establish relationships. Support, empower and challenge children and young people. Convene inter-agency meetings. Work with practitioners from a range of services. Knowledge and skills underpinned by: Effective communication. Planning, organisation and coordination. Critical and innovative thinking.
Activity Exploring the Lead Professional task, knowledge and skills
Criteria for selecting a lead professional Criteria for selection could consider: The wishes of the child or young person, and their family. Any statutory responsibility to lead on the work. The level of trust built up. Any previous or potential ongoing relationship. Who has primary responsibility for addressing the needs. The main needs (as assessed through the CAF). The skills, ability and capacity to provide leadership and coordination in relation to other practitioners involved. The ability to draw in and influence universal and specialist services. An understanding of the surrounding support systems.
Activity Selecting a Lead Professional
Management for lead professionals and the TAF Lead professionals should expect managers to ensure: Lead professional responsibilities are taken into account when setting caseloads. Performance in delivering the lead professional functions is recognised and recorded. Clear communication between agencies to support lead professional practice. Appropriate and up to date training and supervision is provided along with coaching and mentoring where appropriate. TAF practitioners should also expect support to fulfil their responsibilities
Supervision for lead professionals Line management supervision for lead professionals: ManagerialFocused on effective delivery of services and the lead professional functions SupportFocused on reflection and evaluation of lead professional practice (could be from line manager and/or local support functions) Training and development Focused on continuously assessing strengths and identifying training and development needs for practitioners acting as the lead professional
Resolving disagreements and disputes Could arise over: Selection of the lead professional. Roles and responsibilities of TAF members. The need for action and by whom. Communication. Others? Resolve problems quickly through clear local systems: Between the parties. Line manager support and/or other local support systems. Negotiation between agencies at senior management level. Childrens Trust coordinated arrangements at strategic level. Director of Childrens Services.
Transfer and endings for the lead professional Being a lead professional is not a permanent thing: –Children and young peoples needs change (in their level, extent and focus). –Situations and relationships change. –Practitioners change. –Children and young people get older. Transfer and endings of the lead professional functions, where appropriate, need to be carefully planned and managed.
Information sharing as part of integrated working Note: This training is about information sharing and not data sharing Improved outcomes: Be healthy. Stay safe. Enjoy and achieve. Make a positive contribution. Achieve economic well-being. Tools and processes that support integrated working Lead professional and TAF CAF and National eCAF Information sharing Common core Multi-agency working
Sharing information as part of early intervention and preventative services Effective partnership working between universal and targeted specialist services. Active processes for identifying those at risk of poor outcomes. Sharing between adult and childrens services. Sharing to support transitions. Success depends upon… Increased emphasis on integrated working across services to better identify and meet needs
Sharing information if concerned about significant or serious harm Always consider referring concerns to childrens social care or police, following LSCB procedures Seek advice if unsure what to do Practitioners must:Issues to consider: Confidential information can be shared without consent if justified in the public interest Timely sharing is important in emergency situations Significant harm to children and young people or serious harm to adults can arise from a number of circumstances It is good practice to seek consent and/or discuss concerns, unless this would increase the risk of harm
Information sharing decisions Decisions about information sharing should be based on an assessment of benefits and risks to the child, young person or family. You must assess: What are the benefits of not sharing information? What are the risks if information is shared? You must assess: How would sharing information benefit the child, young person or family? What are the risks if information is not shared? Decision to share Decision not to share
Activity The Benefits and challenges to information sharing
Seven golden rules for information sharing Remember the Data Protection Act is not a barrier to sharing information. Be open and honest with the person from the outset. Seek advice where in doubt. Share with consent where appropriate and where possible, respect the wishes of those who do not consent to share (unless there is sufficient need to override the lack of consent). Always consider the safety and well-being of the person and others. Ensure information is accurate and up to date, necessary, shared with the appropriate people, in a timely fashion and shared securely. Record the reasons for the decision – whether it is to share or not.
Key questions to inform decision making Is there a clear & legitimate purpose to share the information? Does the information enable a living person to be identified? Is the information confidential? Do you have consent to share? Is there sufficient public interest to share? Are you sharing information appropriately and securely? Have you properly recorded your decision?
The law The common law duty of confidentiality Legislation containing express powers or which imply powers to share: The Children Act 1989 and Local Government Act Education Act 1996 and Learning and Skills Act Education (SEN) Regulations Children (Leaving Care) Act Mental Capacity Act Protection of Children Act Immigration and Asylum Act Crime and Disorder Act National Health Service Act 1977 and The Health and Social Care Act Criminal Justice Act Adoption and Children Act The Human Rights Act 1998 The Data Protection Act 1998
What is confidential information? Confidential information is… Can be shared if…. Personal and private or sensitive, and… Not already in the public domain, and… Shared in confidence. Consent is given by the person who provided the information or the person to whom it relates. OR It can be shared without consent if justified in the public interest. Reasonable cause to believe that a child is suffering or at risk of suffering significant harm In the prevention and detection of a crime Or information is subject to a court order
What constitutes consent? Consent is key to information sharing, it is good practice even where the law does not demand it. Consent: Must be informed. Should be explicit but can be implied in some circumstances. Is preferably written, but can be verbal. Must be willing and not inferred from a non response. Must be sought again if things change significantly. Can be withdrawn and have limits. Should be recorded and stored. When gaining Consent: Explain it at the start, using suitable language. Explain the limits to confidentiality. Be aware of relevant legislation. Follow local policies and procedures. Do not seek consent where it would increase risk
Whose consent should be sought? People aged 16 and over – generally presumed to have the capacity to understand and may give (or refuse) consent. Children aged 12 or over – may generally be expected to have sufficient understanding to give (or refuse) consent. Younger children may also have sufficient understanding. Sufficient understanding is indicated if they can: Understand the question. Understanding what might be shared, why and implications of sharing/not sharing. Appreciate and consider alternative actions. Weigh up aspects of the situation. Express clear, personal, consistent view. Record the decision and try to balance the wishes of the child or young person and the parent/carer
Activity To share or not to share?
What to share and how to share it Distinguish between fact and opinion Share in secure way Share only what is necessary for purpose Understand the limits of consent Check information is accurate and up-to-date Share only with those who need to know Inform person to whom it relates, and/or who provided information if safe to do so Record reasons for sharing; what shared; with who Establish whether recipient will pass to others – ensure they understand limits of consent given
Support for practitioners Practitioners need: A culture that supports sharing. Secure processes for sharing. Processes for explaining information sharing. Effective training, supervision and support. Mechanisms for monitoring, advice and conflict resolution. Organisations should: Fulfil duties under sections 10 and 11 of the Children Act Establish an information sharing governance framework.
Main web links The following national websites hold further information and overviews, as well as links through to guidance and training materials, for all of the processes and tools of integrated working: CWDC – or