1. Altogether Better: Cheshire West and Chester Whole Place Community Budget Area Carly Brown Head of Ellesmere Port and Strategic Lead for Troubled Families CWAC

2. CONTEXT Integration around customers and communities Whole systems change From symptoms to root causes Responsiveness Open Public Services The Economy Rising demand Disparity in opportunity The drivers Altogether Better New delivery models New financial models Collaborative leadership Better with less The result Reducing resources

3. Starting Well Families Together Early Support : -9 months – 5 years Living Well Community empowerment Community delivery Safer Communities Sustainable Communities Affordable Housing Quick Wins: ASB integration Local delivery vanguards Working Well Work ready individuals Skills for sustainable growth Supporting Enterprise Quick Wins Opportunity Centres Social Value Procurement Ageing Well Integrated prevention Team around the community Quick Wins: Reablement Assistive technology Investment agreements Smarter services Customer Insight New Delivery Models Strategic Commissioning Assets

4. The Projects Families together: New approach to supporting families who have the most needs resulting in greatest demand on public services (Project Lead – Carly Brown) Early support: Developing the case for joined up early support primarily at levels 2 & 3 on the continuum of need. Priority emerging for focus on -9 months to 5 years (Project Lead - Val Sturgess)

5. Getting there Jan-Feb 2012 Scope development and programme set up March- April 2012 Assess: -As is -Discovery workshops -Opportunity definition May-July 2012 -New delivery Model -Customer Insight -Stakeholder Engagement August- October 2012 Draft specifications & operational plan November- December 2012 Approval (Local and National) OBC FBC Ownership

6. The Case for Change Emphasis on Early Support, Foundation 0-5 (Marmot, Allen, Tickell, Field) Troubled Families Transformed Service Models e.g. Health Visitors Sustainability in context of contracting budgets

7. The Case for Change Latest Health profile for CW&C (March 2012) indicates a number of issues where performance is significantly below the England average e.g. –Children achieving a good rate of development aged 5 (with respect to the Early Years Foundation Stage Profile) –Teenage mothers (age under 18 years) –Hospital admissions due to alcohol specific conditions Estimated 525 Troubled Families in West Cheshire footprint (CLG) with direct costs to the public purse of £39.4 million

8. Where do we want to be? (October) Route map for improvement to priority outcomes: As-is analysis (cost, quality, customer experience) Integrated delivery models tackling root causes New approaches to delivery Evidence based interventions at scale Cashable savings route map/Joint Investment Agreement Decommissioning plan Clear pathways for levels 1 to 4 on Continuum of Need (step up, step down) Effective multi-agency governance and commissioning arrangements

9. ‘Families Together’ Consolidate approaches and governance - DCLG Troubled Families - ESF /DWP Complex Families - DOH Multi Systemic Therapy (MST) Advocate the need for whole system reform Integrate the myriad of ‘People’ initiatives to improve service delivery Develop a ‘core offer’ of support and unlock potential within families

10. Families Together - Concept The development of a ‘Families Together’ pledge Partners who commit services as part of the pledge – prioritisation & responsiveness A core offer of services with the agility to tailor 24/7 provision to meet customer need Personalisation A family assessment rather than individual or multiple assessments

11. What does ‘success’ look like… Families know how to access appropriate services at the right time Families live a housing of ‘good’ condition Families demonstrate and respect neighbourly qualities – participation in the community Families make positive lifestyle choices Children brought up in a warm, stable supportive parental environment Children meet age appropriate development indicators Strong financial literacy, awareness and not dependent on benefits Adults are work ready for local industries/markets Minimal interventions from agencies outside of the core offer

12. What constitutes an eligible ‘family’… A household that has dependent(s) up to the age of 19 (subject to exceptional circumstances) A family that is experiencing difficulties in achieving 3 or more of the determinants of success and; A family that is referred through partnership channels that cause disruption to their communities

13. How can we identify families that require help… DCLG Troubled Families Unit Figures correlated with ‘local’ analysis ‘Bottom Up’ referrals generated from ESF / DWP Families process and other existing referral processes A Partner Conference Local discretion

15. Families Together - the offer A menu of support options / interventions for our Key Workers and Families to ‘contract’ to One Key Worker: One Family A customised, 6 month, Family Action Plan Five key areas they want to improve with inspired targets A Celebration of Achievement designed by the Family for the Family

16. Families Together – delivery Integrated and co-located teams in the 4 new localities supported by the Area Head of Service Performance, intelligence and support centrally provided A strong, unique Team Identity A single assessment and referral process appropriately branded

17. So where do we start???

18. Families Together – what are we trying to answer? Which Families? ‘shared cohort ’ How are we working with them now? What impact is this having? What and who is it costing? Costs /benefits of a new delivery model? Which agencies spend and gain? Distribution? ‘Whole system’ view Planned services? Reactive response? Assessments? Coordination? 1 year timeline/ usage pattern? Outputs? Outcomes? Behavioural change? Neighbourhood effects? Impact on services/staff? Planned Service costs? Reactive Service costs? Wider system/support costs? Wider/Long term costs? Distribution? Outputs? Outcomes? Behavioural change? Neighbourhood effects? Impact on services/staff? Building the evidence base for Joint Investment Who are our families? - Service data - Local knowledge - Cross matching

19. Families Together – A whole system approach 3.Assessments & baselines 2. Family I/D & Referral 5. Joint Investment and service redesign 1. Partner Engagement 4. Family plans & coordination 6. Performance, Evaluation and Cost Benefit Analysis Detailed programme delivery plan. CLG agreement on PbR. Ongoing evaluation Detailed programme delivery plan. CLG agreement on PbR. Ongoing evaluation

20. Mobilisation Plan One single action plan to enable the programme to be effective One ‘route map’ referencing collective and key milestones One assessment process One evidence base One ambition to do something different

21. Programme Governance Public Services Board Operational Steering Group Families Together Board Multi Systemic Therapy ESF Complex Families Early Support Work stream 1 Work stream 2 Work stream 3 Starting Well Thematic Group

22. Families Together – Next Steps Continue to develop the Families Together Concept Conduct planning session (20 April) and continue weekly sessions with ABC team Deliver the actions required for DCLG by 30 April Produce options for Services and Partners to discuss regarding an integrated delivery team Deliver ESF / DWP Families Targets