Integrating Children and Young Peoples Services Will Greenhow - Home Affairs David Killip - Health and Social Security John Cain - Department of Education We have seen a considerable change programme around children's services in England, motivated in 2003 by the Green Paper Every Child Matters which was published alongside the formal response to the report into the death of Victoria Climbie. This prompted an unprecedented debate into the services for children, young people and their families. Since that time a considerable amount of work as been done around developing services that work in a more preventative, proactive way. A key component of the Commission of Inquiry's recommendations here on the Island and indeed the Governments Children and Young Peoples Strategy which is aimed at all children, was the need to work in a more proactive way, what was proposed was a more integrated approach to the way in which services are delivered to children. This reflects some of the changes brought about by Every Child Matters therefore you will see common themes throughout this presentation, however what is important is that what is introduced here meets with the needs of practitioners, children and young people living in the Isle of Man. July 2007

Introduction Why we are here What do we mean by integrated working Why integrated working matters Common processes to support integrated working How it will happen We are here today because of our commitment to improving the lives of children and young people. We have listened to what you have said to us and as a consequence of those views would like to ask you all to consider the proposed changes, presented today, which will compliment and enhance the work you do. The focus of this presentation is to introduce integrated working and the processes that will be implemented to support this change programme. The government has already shown its commitment to stronger lines of leadership and accountability. The Chief Executive Officers would like to add their support to what has been proposed and are keen that the children's workforce are supported in the implementation of such. Integrated, by definition, means to include or incorporate. What we put before you are processes that we feel will better support the work you do, incorporating good practice that is already there by including colleagues, children, young people and families in the way in which those services are delivered. Integration will take place at all levels of service delivery from those directing agency agendas to those delivering services. What is proposed is a framework of processes that supports multi agency working, building on areas of good practice around the island, strengthening the links between Government and the children's workforce whilst ensuring the focus is around the needs of the child. NEXT SLIDE

Our commitment is to: To ensure all children and young people reach their full potential in the five positive outcomes: Being healthy Staying safe Enjoying life and achieving Making a positive contribution Prospering As described in the Strategy for Children and Young People 2005-2010, these five positive outcomes are what we, as service providers, should be ensuring for ALL children and young people on the Island. Our ambition is to improve those outcomes for all children and to narrow the gap in outcomes between those who do well and those who do not. In order to realise this ambition, it was recognised there needed to be improvements and a shifting of emphasis within our services. Our vision therefore is to Integrate Children's Services: NEXT SLIDE

The vision Integrate Children’s Services Joint, child centred delivery Joint processes Accountability Involving and supporting Workforce reform We want to increase consistency of integrated working by implementing practices and processes that better support this model of working. The planned changes would ensure that the focus remains on the needs of the child in partnership with parents and carers. Early, proactive intervention will help reduce the numbers of children either slipping through the net or requiring emergency intervention measures. Previous consultations have shown the need for more accountability so that everyone knows what they are responsible for at all levels. We also want to have a focus on children, young people and their families or carers, making sure that they are involved in the services and increase the effectiveness of support for those in care and those leaving care. The Children's workforce has many skills and is dedicated and caring. The Government wants to make sure that those skills are used in the best possible way. I want to look firstly at some of the benefits of integrated working which can come from joint processes. NEXT SLIDE

Benefits of integrated working Tools and processes Benefits Information Sharing Index Earlier, holistic identification of needs Common Assessment Framework Earlier, more effective intervention Improved information sharing across agencies Lead Professional Certain tools and processes will help support a more integrated approach to the work undertaken with children, young people and families. The initial benefits will be a more coordinated approach to service provision for children and families, a robust framework to support staff in the work they do, a clear system of accountability at a high level and ultimately, following audit, a more targeted service based on need. The greatest benefit, and why we are all here today, is that implementation of these tools and processes will improve outcomes for all children and young people. Lets look at the tools and processes in more detail: NEXT SLIDE Multi Agency Service Teams Better service experience for children and families

Information Sharing Index….. Store core data on all children Enable `flags` to be put onto a child's details when more than one agency is involved with a child Encourage dialogue between practitioners Reduce an overlap of services Ensure a seamless transfer of details from one area to another Firstly we are going to look in more detail at some of the joint processes. Sharing information is vital for early intervention, recurrent themes in Inquiries has been an inability across agencies to share information and be aware of other practitioner involvement with a child. The Government has already introduced an Information Sharing Protocol which all relevant Departments have agreed to and some of you may have attended the training for that Protocol. The Government is planning to build on that good work and provide in due course a system for supporting better sharing of information. An Index will act as a first point of contact to those working with children enabling `flags` to be added when additional data to the core detail held is added. NEXT SLIDE

Areas for consideration….. Training for staff – when, why and how should we share information Who will have what level of access to the index How will it fit with other systems i.e. Integrated Children's System Data protection issues Information sharing guidance Information sharing at all levels, either through IT or verbal communication can often cause concern amongst staff. Knowing when, where and how to share information need to be considered. I have already referred to the positive work done in this area with the introduction of an information sharing protocol, this could be developed further to include these specific information sharing tools. With a number of developments in relation to Information Technology Systems on the Island, the Information Sharing Index is just one, it is important, where possible that these systems have an interface with one another. NEXT SLIDE

The Common Assessment Framework What is it? A process of dialogue and development amongst agencies A catalyst for integrated working A standardised early assessment of a child or young person's needs across all services A basis for initiating proactive, early intervention A tool for collating data to ensure a more targeted approach to service provision The Government is planning to introduce a Common Assessment Framework. This will be the first time that an assessment has been given joint, equal ownership to all agencies who work with children. To identify additional needs early, and with the involvement of children and carers actively plan support and interventions that improve the outcome for that child or young person. The emphasis of the assessment is to identify strengths and needs. NEXT SLIDE

What does it do… Engages and empowers children, young people and carers Reduces the number and duration of assessments Improves the quality and consistency of referrals between agencies by making them more evidence based Helps embed a common language about the needs of children Breaks down professional barriers Promote the appropriate sharing of information Enable information to follow the child Supports the role of the Lead Professional It is believed that the Common Assessment Framework will promote more effective, earlier identification of children's additional needs and improve multi-agency working. It is intended to provide a simple, non-bureaucratic process for an holistic assessment of a child's needs, taking account of the individual, family and community. It is important here to point out that it does not replace specialist assessments, or replace any interventions required when there is a child protection concern. Specialist assessment would build on this initial, common assessment. A key element of the Common Assessment Process is that of the Lead Professional: NEXT SLIDE

Lead Professional The Lead professional is a single practitioner who can help children who require an integrated package of support It is not a new job title or new role, but a set of functions essential to delivering integrated support. These are to: Be a single point of contact Co-ordinate services Reduce overlap and inconsistency The Lead Professional is not accountable for the work of others. The role of the Lead professional is to act as a single point of contact, who children, young people and families can trust, and who are able to support them in making choices and navigating their way through the system. They ensure that children and families get appropriate interventions when needed, which are well planned, regularly reviewed and effectively delivered, this helps to reduce overlap and inconsistency from other practitioners When a common assessment suggests that a child has needs that require input from more than one service, the practitioner identifying the need would, in agreement with the family, call a meeting for all those working with that child. At this meeting a Lead professional would be appointed. NEXT SLIDE

Areas for consideration……… Who will use the Common Assessment What format should the form take The role of the Lead Professional Training Policies and procedures to support implementation Quality assurance Every practitioner working with children, young people and families should understand the positive outcomes for children and know about the Common Assessment Framework, when and how to have one completed. Every agency offering services to children and young people and their families (whether from statutory, community or voluntary sectors) will train at least some of its staff to complete common assessments. Training will be offered to all those who would be expected to use the Common Assessment Framework. The role of the lead professional will need to be clarified and support given to those who undertake this function. NEXT SLIDE

Joint working at the local level A clear structure will need to be identified to support staff which could be: Multi Agency Service Teams (MASTs) made up of a multi professional team, working together to meet the needs of the child and/or young person Working with individuals, schools and communities Joint working at the local level has been shown to be an effective way of managing the delivery of services to children, and all we are planning to do here is build upon much of the good practice that is already in place. There are a number of different models that can be looked at to drive forward improved joint working utilising the practice that currently works well but with the introduction of a framework to further enhance and support the work you do. This will encourage greater communication between practitioners, children and families and less duplication of assessment and services. It reduces the risk of children slipping through the net and having their needs unmet. This way of working will assist in the production of a local needs assessment, identifying areas of strength and weakness in services, enabling targeted service provision for that community in the future. The following will need to be considered: NEXT SLIDE

Areas for consideration…… Model to be used Location Roles and responsibilities Relationship of individuals within the team with their own agency Accountability Joint training Whilst these areas for consideration have been identified it is anticipated that a multi-agency working party will be established to consider these in more detail. We recognise the importance of getting the structure and function of joint working right and during implementation it will be evaluated enabling issues to be addressed quickly and efficiently. NEXT SLIDE

Safeguarding Board Creation of Safeguarding Board Policies and procedures for safeguarding and promoting the welfare of children Communicating the need to safeguard Responses to unexpected deaths Collecting and analysing information about child deaths Children can only be safeguarded properly if the key agencies work effectively together. The Government already has an Island Child Protection Committee but this has a narrow remit focused around child protection and is not set up as a statutory body. The Government is planning to establish a Safeguarding Board which will be on a statutory footing and whose remit will be focused around the ‘staying safe’ outcome. The role of the Safeguarding Board will include coordinating and ensuring the effectiveness of what their member Divisions and agencies do to safeguard and promote the welfare of vulnerable children, ensuring that children grow up in circumstances consistent with the provision of safe and effective care. NEXT SLIDE

Workforce Development Develop and train more people within the children's workforce Strengthen inter agency and multi disciplinary working by workforce re modelling Identify a common core of skills required by all who work with children Implement a framework that enables professional development of skills that enable transition across services. The Children’s workforce plays an absolutely vital role in supporting parents, carers , children and young people. They also have the potential to play a vital role in closing the gap between the what we want to achieve for children and what we do achieve. Its essential that the Government provides the tools to support the work of integrating practices but these will not be enough in themselves to tackle the issues. The Government is planning to help to support the changes at all levels from Senior Managers like myself learning new skills through Middle managers and to front line staff. Improving our team working skills, having common cores of skills to provide a consistent approach to the delivery of care services for children. NEXT SLIDE

Accountability Minister for Education and Children Commissioner for Children External Inspections of Services Joint Commissioning and Performance Management Unit Each Minister in Government has responsibility for his or her Department and the services of that Department - but Children’s needs don’t always come neatly packaged but instead are spread across services. The Government is planning to extend the responsibilities of the Minister of Education so that she is also making sure that children’s services work together and are contributing towards the five outcomes for children. This cannot happen without the Government making legislation which will happen in the next year. The Island is signed up to the United Nations Convention on the Rights of the Child. This is a set of promises to make life better for children and young people. We are planning to appoint a Commissioner for Children to ensure that these promises are kept. The Commissioner will work on behalf of Children and young people to promote and protect their rights. The External Inspection of services will be a very important part of ensuring that practices are integrating. The Government’s Children’s services will be assessed in the short term by an assessor looking at progress on Inquiry recommendations. In the long term there will be a programme of external inspections through Joint area Reviews which will involve greater depth and range across all children’s services. In addition to the new processes that we talked about earlier the Government is also planning to improve multi agency working across services at the centre of Government. No single service can deliver any one of the five outcomes for children by working in isolation. The Departments will work more closely together to plan and commission work sometimes sharing budgets. NEXT SLIDE

Keeping the child as our focus This is what the model we propose will look like, keeping the child at the centre.

How will all this happen? Raising awareness amongst those who work with children Seminars Pamphlet on Integrating Children's Services Web site with further information on developments around integrating children's services www.childrensservices.gov.im Collation of feedback from seminars and questionnaires to inform a paper for the Council of Ministers in September Working parties to be convened to consider the changes in more depth I hope that you are not sitting here today and thinking this is just part of a tortuous plan by out of touch politicians and civil servants to make life difficult, we do not want to re-invent the wheel but want to build upon much of what is already in place. It is easy to get lost in the detail of the planned changes and lose sight of why we are doing this. The Minister made reference in her introduction to the Government’s commitment of improving the lives of all children and young people. That is why we are here and that is why it is so important to have you here to be able to use your experience and knowledge to make sure that we have got the outline right. The Government has agreed the integrated processes that now need developing further and implementing. For this to happen we need to discuss each process individually and consider the elements that require further development. For this to happen we need your support. We are now going to divide into workshops to let you consider in small groups what is planned. You will see that you have a number on your name labels. Please can Number 1 go ….Number 2 go…… Number 3 go……. INTO WORKSHOPS

Questions used in the workshops ……

Question 1 Using your own experiences what Integrated Working is in use on the Island and works well?

Question 2 What do you see as the strengths and weaknesses around what is proposed?

Question 3 What could be done to overcome the weaknesses?

Question 4 What methods of communicating the progress on Integrating Services for Children would work best for you?

Question 5 What support do you feel would help you during the implementation of the proposed changes?

Any questions ?

Keeping the Child as our focus C hange in how children's services are delivered H olistic approach to needs to safeguard & promote welfare I ntegration of service provision L istening to children, young people and families D evelopment of accountability and inspection framework Before we leave I just want to bring the Seminar to a close by reminding ourselves of the focus for our Children’s services which is of course the child. The Government has started on a journey of improving children’s services. Your views and feedback today are a crucial part of that journey. They will be carefully considered and will help to shape the vehicles that carry us on that journey. Thank you all for coming along today, we hope that you will encourage work colleagues to attend other Seminars and to complete the questionnaires in the back of the pamphlets that you all received.