HERTFORDSHIRE COUNTY COUNCIL
CHILDREN’S SERVICES AND CORPORATE PARENTING
CABINET PANEL
FRIDAY 6 FEBRUARY 2009 AT 10.00AM
INTEGRATED PRACTICE UPDATE
Report of the Director of Children, Schools and Families
[Author: Gill Gibson, Head of District Partnership Services Tel:01992 588203]
Executive Member: Jane Pitman (Children’s Services)
- Purpose of report
1.1.The purpose of this report is to update members on the progress of integrated practice within Hertfordshire children’s services, including an update on schools engagement. The report also provides an update on changes to the programme structure and the current areas of worksoon to be launched, as well as future targeted work which aims to further advance and embed integrated practice and the Common Assessment Framework.
- Summary
2.1.All children, young people and families will be supported most effectively when the Common Assessment Framework, the lead professional and information sharing procedures, are planned and delivered in an integrated way to offer a continuum of support for families. Integrated Practice aims to bring together the whole spectrum of children’s services, to identify needs at an early stageand to prevent the escalation of needs by way of a timely and preventative response.
2.2.A sustainability review of integrated practice took place in August/September 2008 which included a survey of arrangements including common assessments, teams around the child, lead professionals and information sharing experiences. The review provided important learning and led to thedevelopment of a plan for 2009/2010. Priorities have been identified to support the transition of integrated practice from an implementation stage towards embedding integrated practice as ‘the day job’. The findings from the survey and priority areashave been publicised across the partnership (“Integrated Practice - Next Steps” - November 2008).
3.Recommendations
3.1.The Children’s Services and Corporate Parenting Panel is invited to note the progress and comment on the priorities as identified.
4.Background
4.1.The Hertfordshire Framework
4.1.1Integrated Practice is co-ordinated through the Hertfordshire Children’s Trust Partnership (HCTP) to ensure an effective multi-agency approach to supporting children and young people with additional needs across the county. At a district level, arrangements are supported via 10 Multi Agency Support Teams (MASTs), 5 District CAF Managers and 38 Multi-Agency Teams (MATs) aligned with the children’s centre communities and extended schools.
4.1.2The Integrated Processes Team and District Partnership Teams provide central co-ordination and support at a local level to ensure multi-agency arrangements are in place to address additional needs, including the support to deliver the Lead Professional functions and Team Around the Child.
5.Programme Structure
5.1.Each district has a Multi-Agency Support Team (MAST), which manages and co-ordinates the frontline staff who carry out CAFs and the lead professional role. MASTs play a critical role in reviewing and ‘unblocking’ CAFs.In response to findings of the integrated practice sustainability review, the IP Programme has been re-structured where MASTs will no longer report through District Children’s Trust Partnerships but will be accountable to the HCTP outcome lead for Integrated Practice (Alan Dinning). The detailed arrangements to support this change are currently being formalised.
5.2.MASTs have moved through the ‘start up’ phase, having developed and matured at varying stages. All report successful unblocking of issues in relation to individual Action Plans for children and young people. Much of this ‘unblocking’ is reported as happening outside of MAST meetings where simply ‘picking up the ‘phone’ and discussing problems most often provides the solutions. Work is in progress to further develop MASTs towards the next phase of integrated practice, where Terms of Reference is subject to review.
5.3.During the IP development programme, it became apparent that agency ownership was required in order to effect the necessary changes in processes and behaviours, towards cultural change in how we support children and families. A HCTP Integrated PracticeTask Group has been established at a senior level in order to share an understanding of, and commit to the necessary changes within set timescales.
5.4.The HCTP IP Task Group is addressing the vision and considering their level of engagement and arrangements for success with the integrated practice requirements. Agencies are being asked to consider how their service can align their processes to the Common Assessment Framework and where a self-audit function aims to identify levels of IP engagement and any remedial actions that might follow. The Task Group membership includes heads of primary, secondary and special schools (Membership: Appendix 1).
5.5.A Processes Strand Group has been established where membership includes those identified by members of the HCTP IP Task Group. The Processes Group provides a multi-agency, operational reference and action group as part of aligning agencies to integrated practice.
5.6.As the programme for ContactPoint and National e-CAF advances with expected implementation at the end of 2009/beginning of 2010, it has been important to combine these work programmes with the embedding of integrated practice as a whole. The programme structure has been developed, to include the formation of an Integrated Practice/ContactPoint Project Board, Chaired by the Outcome Lead, Alan Dinning. The structure allows for the escalation of issues, as appropriate, in order to reach resolutions in a timely way.
6.Progress Commentary
6.1.Progress from the ‘Start Up Phase’ (April to September 2008) shows the following achievements:
- A developed multi-agency project structure combining Integrated Practice, ContactPoint and National e-CAF;
- The establishment of 10 Multi Agency Support Teams where ‘start up’ actions have been completed;
- 38 Multi Agency Teams aligned with extended schools/children’s centres supported by a MAT List available ‘on-line’;
- Integrated Practice awareness and training for 3,000 practitioners across agencies;
- Development of an Integrated Practice learning and development modular programme to build on ‘start up’ training and to promote targeted training (Appendix 2);
- Delivery of Managers’ Workshops to support front-line managers, who are in turn supporting practitioners with integrated practice (further events arranged);
- The development of district practitioner IP Networks (monthly forums) where some forums have shown attendance of some 50+ practitioners across Hertfordshire children’s services;
- Roll-out of ‘train the trainers’ programme across the services;
- Recruitment and induction of Children and Young People Support Workers and Parenting Support Workers to further support integrated practice across each consortia;
- An increasing trend in the number of common assessments (CAFs);
- Case examples demonstrating effective integrated working, positive feedback from families and practitioners as well as some early examples of effective change for children.
7. School Engagement
7.1.Schools engagement with integrated practice has been good, with examples of positive outcomes for children and young people.
7.2.The IP data shows that the majority of CAFs are carried out by schools. In mid December this was 161 out of 280 CAFs. While Hertfordshire has better engagement with schools in IP than most local authorities (a finding at the Local Authority Research Consortium), engagement differs across the County and within districts where some schools are starting their engagement with the framework. Schools generally have concerns about capacity issues and how much work IP and the lead practitioner role will mean for them. Extended Schools Co-ordinators are engaged with integrated practice and the new Children and Young People’s Support Workers are expected to make a difference.
7.3.Teachers and other staff from nursery, primary and secondary schools took part in the Integrated Practice sustainability survey (June- September 2008) and gave their views. Their main issues were pressures on time and capacity and they asked for support and changes to training.
7.4.Children and Young People’s Support Workers (CYPSW) are new posts, introduced from September 09 to support schools with Integrated Practice. Schools are already reporting the difference that this support makes to their capacity to engage with IP. Of the 38 extended schools consortia:
- 17 Hub Schools have a CYPSW or joint CYPSW/Parent Support Worker in post.
- 7 Hub Schools have appointed to the CYPSW or a joint CYPSW/PSW post or equivalent, due to start in Jan 09.
- 8 Hub Schools report that recruitment is underway.
- Other consortia are recruiting in the near future or exploring options.
- The impact of CYPSWs will be evaluated and fed back to improve practice.
8. Integrated Practice – Work in Progress
8.1.Currently, there is significant work taking place in order to push forward the integrated practice agenda and increase momentum. February to April 09 will see the following actions taking place:
8.2.Referral forms to be replaced by a revised Common Assessment Form where practitioners are expected to complete a common assessment to access a multi-agency support plan – rather than ‘referring’ to others to assess. This is expected to be a significant move towards cultural change.
8.3.In order to separate multi-agency support plans (Teams Around the Child) from those cases where children/young people have a single service need, a Single Service Request form has been developed. This Form is based on the pre-CAF Assessment Checklist and therefore requires practitioners to consider the 5 ECM outcomes, a holistic consideration of needs where the practitioner is guided to consider “why not a CAF”?
8.4.The CAF and Single Service Request Form will be used by schools and Youth Connexions following half term (23 February 2009). By 1 April 2009, it is expected that all Hertfordshire children’s services will use these forms to replace existing referral forms.
8.5.An updated, easy to follow, Common Assessment and Team Around the Child Flowchart and guidance will be widely distributed in February to accompany the new forms.
8.6.The revised ‘Meeting the Needs of Children and Young People in Hertfordshire’ document will be launched in February. The re-launch follows a consultation period with agencies and services and has provided a development to the initial tool
8.7.A Hertfordshire Integrated Practice Practitioner Toolkit will be launched in February/March 09. This toolkit will be provided to work bases across the partnership both in hardcopy (folders) and on-line. It is planned that updates and additions can be added to the toolkit as the IP programme develops.
8.8.The implementation of an integrated practice policy for Children’s Centres
8.9.Developing IP expectations and targets as part of the Extended Schools Core Offer (Swift and Easy Access)
- Further Targeted Work
9.1.Work will continue in order to streamline and strengthen systems and processes, including the replacement of all assessment systems, streamlining transitions between services, incorporating review processes into the Common Assessment Framework and developing quality assurance and performance management systems.
9.2.We continue to work with engagingpractitioners and services to support embedding of integrated practice. For example:
- Targeted work is taking place with GP surgery’s where Practice Managers have signed up for IP Training;
- New youth projects, led by the police, will be supported by integrated practice and the common assessment framework;
- Engagement and training with the Voluntary and Community Sector is underway;
- Working with Early Years and Children’s Centres aims to increase early intervention with children and families;
- Building IP into Extended Schools Core Offer (Swift & Easy Access);
- Working with social care to ensure smooth transition of cases between the specialist services and the Common Assessment Framework (passing the baton).
10.Performance Management
10.1Appendix 3sets out CAF activity arranged by agency, district and extended school consortia. 37 of the 38 extended schools consortia have entered into integrated practice, as shown by completed CAFs. The data provides trend information and assists in targeting IP development work.
10.2The data is provided by way of practitioners manually logging CAF activity with the CAF Administrator. It appears that not all CAF activity is being reported and this is being addressed by MASTs, District CAF Managers and the central IP Team. It is considered that this situation will be improved once National e-CAF is in place.
10.3The interim database provides information on the number of completed Common Assessments, as well as Team Around the Child and Lead Professional information. The data does not include or count completed Common Assessments where a single service response is the outcome.
10.4Work is in place to align Team Around the Child activity already in place within Early Support (Children with additional needs/disability), and those supported by Youth Connexions.Indications are that there are some 100+ children currently receiving a multi-agency service via Early Support. The majority of young people supported by Youth Connexions result in a single service response. However, some young people are supported by Teams Around the Young Person and should be accounted for in line with CAF reporting. Alignment will be taking place during February 2009.
10.5Quality Assurance Audits were held in August and December 2008 and the learning is being applied to improve the processes, and to inform learning and developmentneeds. As part of a qualitative evaluation of integrated practice, we have been collating case studies, comments about the process by children, young people and parents/carers and views of practitioners on the benefits they found by using the common assessment and team around the child approach. These studies, comments and views are soon to be publicised via the website, DVD and briefings/bulletins.
11Financial implications
11.1The implementation of Integrated Practice 2008/09 was funded through HCTP with multi-agency partner contributions. HCTP has agreed a budget for integrated practice for 2009-10.
Background Papers
Integrated Practice in Hertfordshire: Next Steps November 2008
Children’s Partnership News Special September 2008 and Winter 2008
Integrated Practice Sustainability Survey summary Summer 2008
Background information can be found at
Appendices:
Appendix 1-HCTP Integrated Practice Task Group Membership
Appendix 2-Integrated Practice Learning and Development Programme
Appendix 3-CAF forms broken down by district and month
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090206 Children’s Services & Corporate Parenting Cabinet Panel
Item 3 – Integrated Practice Update
APPENDIX 1
HCTP Integrated Practice Task Group Membership:
Alan Dinning
Deputy Director (Integrated Children’s Services)
Andrew Simmons
Head of Youth Connexions Hertfordshire
Jessica Linskill,
Assistant Direct Children’s Services
East & North Herts PCT
Catherine Pelley
Assistant Director, Childrens Commissioning
West Herts PCT
Chris Miller
Assistant Chief Constable,
Hertfordshire Constabulary
Ros Cooper
Head of Primary School Effectiveness, CSF
Lucy Leith
Chair of SpecialSchool Heads’ Forum,
KnightsfieldSchool
Nick Binder
Head teacher, The SeleSchool
(and East Herts MAST Chair)
Anne Gorolini
Head teacher,
BonneygrovePrimary School
David Ring
Head of Access to Education, CSF
Debbie Orton
Head of Inclusion Services, CSF
Janis Pridgeon
Child & Adolescent Mental Health
Services Manager, CAMHS
Mary Milton
Head of Fieldwork Services,
Social Care, CSF
Gill Gibson
Head of District Partnership Services
Caroline Cook
ICS Strategy Manager (Integrated Practice)
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090206 Children’s Services & Corporate Parenting Cabinet Panel
Item 3 – Integrated Practice Update
APPENDIX 2
Integrated Practice Learning and Development Programme
Integrated Practice / CAF / Information Sharing / Lead Professional and Team Around the Child / Line Management SupportIn place:
- Training programme ( half day)
- E learning
- IP Networks
- Training programme (half day as part of IP)
- E learning
- Networks – supporting the practical aspects
- Modular 2 hr session purely on CAF for delivery in agencies
- Training programme
- E learning
- Networks
- Modular 2 hr session purely on IS for delivery in agencies
- Training programme
- E learning
- Networks – sharing experiences
- Half day session on the role of the LP and TAC – skills based
- Management forum events
- Identification of skills and development of appropriate skills programmes
- Improved communications – via blog on website/Q and A slot
To support all L and D activities ( work in progress): / a)Toolkit underpinning all learning:
Case studies incl DVD
Slides for all modules
Website addresses / b)Advertise all networks widely and include linkages to the training programme / c) Include IP awareness raising as part of induction across HCTP / d) Access to appropriate safeguarding programmes
IP Learning and Development for differing groups of practitioners and managers
Practitioner unlikely to carry out a CAF / Practitioner likely to carry out a CAF, be part of TAC and become Lead Professional / Practitioners currently employed in specialist services who may be involved in TAC / Managers of staff involved with CAF/TAC and/or Lead Professional- Complete all e learning modules
- IP Awareness to be included as part of induction process in agency and /or HCTP induction events
- Complete e learning modules
- Attend half day IP training
- Attend CAF and IS 2 hour modules ( agencies to be encouraged to deliver, materials available centrally)
- Attend networks to share best practice
- Attend half day session on Lead Professional/TAC
- Complete e learning modules
- Attend half day IP training
- Attend CAF and IS 2 hour modules ( agencies to be encouraged to deliver, materials available centrally)
- Attend networks to share best practice
- Attend half day session on Lead Professional/TAC
- Complete e learning modules
- Attend half day IP training
- Attend management workshops – learn skills and share best practice(some workshops to be run as networks)
- Additional support may also be needed for managers who are MAST or MAT members pertaining to their roles on these groups
Practitioner unlikely to carry out a CAF / Practitioner likely to carry out a CAF, be part of TAC and/or become Lead Professional (universal or targeted services) / Practitioner currently employed in specialist services / Managers of staff involved with CAF/TAC and/or Lead Professional
Introduction to integrated working
Awareness of integrated working processes and tools (including information sharing, involving children and young people, common assessment and lead professional role)
Knowledge of how integrated working fits within your role
Knowledge and understanding of services provided to children and families in Hertfordshire
Information sharing:
Basic awareness of informing sharing and relevant legislation
Basic awareness of confidentiality and when and how to share information
Basic awareness of ContactPoint and how to access it
Basic knowledge of the importance of information sharing, how it can help and the dangers of not doing so
Create an environment of trust, by seeking consent appropriately
Access to appropriate safeguarding programmes applicable to all practitioners and managers / Understand the purpose of integrated working and the underpinning values & principles
Knowledge of, and skills in the processes for the delivery of integrated working
Ability to implement the process
Knowledge and skills in how to use and complete a common assessment
Knowledge of the policies and procedures required to support integrated working and able to implement them
Information sharing:
Ability to seek out and bring together relevant information about children and young people
Ability to assess the relevance and status of information and pass it on when appropriate
Knowledge of who to share information with and when, understand the difference between information sharing on individual, organisational and professional levels
Know what to record, how long to keep it and how to dispose of records correctly and when to feed back or follow up / In-depth knowledge of integrated working practice and processes
In-depth knowledge of how to incorporate common assessment into specialist assessment
Recognise how and when to involve targeted services as part of planning
Skills to support children and young people with critical needs requiring specialist interventions and to plan for transition to targeted and universal services
Information sharing:
In-depth knowledge of legislation relating to information sharing
In-depth knowledge of the complexity of information sharing for children and young people with critical needs requiring specialist interventions
Additional support
There may also be other specialist support needed for particular groups relating to their role and how Integrated practice fits with specialist services e.g. LAC/residential – further work needed to establish what the requirements would be. / Understand the purpose of integrated working and the underpinning values & principles
Knowledge of, and skills in the processes for the delivery of integrated working
Ability to implement the process
Knowledge and skills in how to use and complete a common assessment
Knowledge of the policies and procedures required to support integrated working and able to implement them – this includes information sharing
Additional support
Specific leadership skills to support practitioners in Integrated practice whether based in targeted, universal or specialist services
Linking programmes to the CWDC management and leadership standards such as those around supervision and safeguarding
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