Family Recovery Project From Pathfinder to Service Transformation: lessons and recommendations

Tanya Kemp Service Manager Kelly McSherry Substance Misuse Consultant

Building a team Bid to the DCSF One City funding Beg, steal or borrow – MET Police, Housing, Mental Health, Education, DAT – Childrens Social Work, Community Protection, Action for Children

Page 4 Family Recovery Project – The Process May 2010

Who are we? FRP is a co-located multi agency team..

What do we do..? FRP persistently support and intervene with families who are at risk of losing their children, home and/or liberty… FRP work in a targeted and phased way to support a familys capacity for change and to embed and sustain changes within the family… FRP work with families who have a history of non-engagement with services, or where, even with multi-agency support, positive change has been limited or not sustained…. FRP work to improve the experience of both the family and the communities in which they live…

The Team: Family Perspective We work with around 80 families at any one time Families are referred to us from across the borough, existing panels such as ASBAG, MARAC etc tend to generate most referrals We aim to work intensively with a Family for around 12 months

How do we work with Families.. Consent..? Consent based model… Consent is a two step process – 1 - Initial explicit informed consent from the family for FRP to share information 2 - Post TAF, the family consent to the Careplan contract This facilitates a positive, transparent working relationship with families.. Not required for statutory cases, but sought regardless

Family referred to project – do they meet threshold? Overview of process Consent (for information sharing) gained from family Information Gathering - Information desk provides detailed overview of family TAF - Multi agency meeting of all involved with family – information shared Contract with consequences (Careplan) – agreed by family Regular TAF reviews – Highlighting any risk, performance against Careplan, worker supervision, information sharing and Family Involvement Intensive working 3-4 visits a week outcome focussed, gets things moving quickly Closure – Hand off to lower tier or community services

Information desk Training and work ProbationImmigrationSchools Adult Services Health Community protection Childrens services Police The Information Desk: Senior Analyst Analyst Police officer x 2 ASB case worker The Information Desk Intelligence Report - Provides an accurate and up to date summary of all relevant family information, highlighting presenting issues or risks, flagging any intelligence gaps. Initially used to inform the TAF meeting and Careplan. Following this to provide up to date information as and when required. The information desk draws information from a number of sources through either direct access or contacts within partner agencies, providing a rounded view of the family unique to FRP.

What is the purpose of the Intelligence Report..? Providing accurate information on: Who the family are? Where they live, the family composition, a detailed breakdown of all immediate and significant family members / friends. Specifically highlighting any risks to workers. What are the presenting issues / risks? What are the information gaps? What do we not know about this family that is either a presenting issue, a risk or a potential barrier to change Who is already working with the family? What has worked and what hasnt, to avoid duplication of costly interventions. The information desk can draw information from a number of sources, providing a rounded view of the family unique to FRP. Information gathering, collating and sharing is key to ensuring safe, accurate and efficient decision making.

Presenting multi agency information in a new way..

Timelines..

How do we store / share this information..? Used to store a variety of information, including; Individual family caseload sites (access is restricted to team members working with the family only) Team information sites (such as leave calendars, training information, announcements etc) Information can be uploaded (by individual team members) and disseminated quickly and efficiently. Sharepoint represents the change in working cultures in relation to sharing information The teams use of Sharepoint is phenomenal, dont underestimate what an achievement this is Trish Kearney SCIE SharePoint Online Data repository, accessed on a permission led basis by all team members and partner agencies working with FRP.

Case Study.. Family A Background: 14 year history of serious DV; poor school attendance, mothers depression/low mood; teenage pregnancy; overcrowding, debt/rent arrears; poor parenting; single parent; father convictions for violence, ASB by child and rent arrears leading to Notice of eviction

What we will do: Intensive intervention with mother, regarding parenting and routines to improve boundaries and school attendance for younger children. Individualised benefits/debt advice ASB caseworker to coordinate with safer neighbourhood team Eldest engaged with youth services; mentor Address housing and overcrowding issues Address experience of DV with mother and provide support around impact Offer family therapy Work with father around contact with children Father to be offered DV risk assessment Health Visitor to check new babys progress Case Study - Careplan..

Results: Dramatic reduction in ASB Improved school attendance Father DV assessed and intervention in place Alcohol treatment for father in place Oldest child and her baby re-housed Debt addressed Victim support for mum Case Study - Outcomes..

Whole view of the family Team around the family Two lead professionals for adults and children Integrated Family Care Plan – adult and childrens needs – focused on key areas Quick information through Information Desk Capacity building Focus on adults needs – DV Worker, substance misuse worker Intensive outreach – fast, intensive, targeted Outcomes and consequences – speedy decision making – relevant professionals in the team All in one project The Model: whats different about FRP..?

Page 19 Family Recovery Project – Learning so far and Evaluation May 2010

Formal evaluation – the who and the what University of East Anglia – led by Prof. June Thornburn. DCSF / York consulting. WCC Cost Avoidance FIP – Natcen evaluation Plus separate measures for NHS and Police

Findings : Child Protection Table 6: Summary of outcomes for FRP and Control Group FRP/CP Outcome/ProgressOutcome progressControl CP FRP ANo progress and managed under PLO CP A FRP BProgress and heading to being removed from plan Progress and no longer subject to CP plan CP B FRP CProgress and heading to being removed from plan No progress and in care proceedings CP C FRP DProgress and heading to being removed from plan Little progress and Child Likely to come into care – high cost placement CP D FRP EChild Removed from CP PlanCP Plan continued – Risk being managed CP E FRP FProgress and heading to being removed from plan Child no longer subject to CP plan but had CP F to go through proceedings to get there FRP GNo Progress and Long term CP registration No Progress and managed under PLO CP G FRP HManaged under PLO following long period of superficial engagement. Now engaging very well. No longer CP plan in placeCP H FRP ICP Plan in place but engaging very well and heading for de-plan No progress and in care proceedings CP I FRP J No Progress and Long term CP registrationNo control case available

Capacity building in families seem clearer and more of a priority DV support for parents have helped them – empowered and equipped to cope Practical support for parents who had never been parented invaluable IOW/DV provides support these parents dont have friends Parents feel contained and so can focus on issues pertaining to children Better, quicker, and more effective information sharing between SW and FRP saves time – no need to chase multiple agencies as all services in house under one roof Time saved by not having to try to consult on issues SW dont really know about – e.g. chasing housing, benefits, etc Serious case reviews show that often SW too focused on adult needs rather than focusing on childs needs and this approach shows SW can come back to focusing on child Need to address less in monthly visits – visit content more manageable De-stress – knowing work is manageable and cases are safe and under control 2 people available to deal with crises – Lead professional for child AND adult SW doesnt necessarily need to drop everything for every crisis as Lead Prof/IOW available to support family in difficult times and contain risks Findings : Child Protection themes

Page 23 Family Recovery Project – Cost avoidance May 2010

Cost avoidance An over-riding objective for the Council was to measure the cost avoidance of this new way of working, to understand how much this intensive type of work would cost and how could this preventative work help avoid future costs to Westminster, its partners and public purse. Three costs to consider: What could the family cost in a do nothing scenario Actual cost of FRP intervention – based on unit cost or time spent with each family–£15-20k per family Avoidance of future cost to public purse

Cost avoidance: existing costs to services Challenging, some agencies do not collect data at service user level, costs of interventions unknown Short term v long term costs – e.g. long term and secondary impacts not measurable Childrens Social Care - a child in care costs £50k annually Criminal justice – annual costs for a male prisoner = £27k/female prisoner = £48k An unemployed family of four in rented accommodation costs £30k annually NHS: Obesity Mental illness Substance misuse - £47k pa per user Early death

Cost avoidance: the model This model is based on: nationally available figures on the cost of various negative outcomes projecting the likely cost for each family based on our assessment of their needs the actual cost of the FRP intervention using the recommended DCSF FIP success rates to forecast outcomes and hence produce an estimate of the probable avoided costs

Cost avoidance: the numbers