Early Help Offer in Sheffield: 2017

December 2017

Author: Sally Willoughby

Version Final V 1.5

Table of Contents

1.Introduction

2.Why Early Help in Sheffield

3.Barriers to Reaching Potential

4.Development of the Early Help Framework

5.Key Principles of the Early Help Framework

6.Principles of delivering Early Help through Locality Working

7.Early Help Governance

8.Early Help Framework Meetings

9.Refreshing of Sheffield’s Thresholds of Needs

10.Next Steps

Early Help Offer in Sheffield: 2017

  1. Introduction

Sheffield is committed to enabling and supporting all of its children, young people and families to be safe, healthy and successful now and in the future. We can best do this by identifying any additional needs as early as possible and providing the right support at the right time and in the right place. The Early Help Offer serves as a framework that can enable all partners and services to see where we are now and where we need to be in the future, and what is set out below does not duplicate but consolidates existing offers and strategies.

Our vision is for every child, young person and family to recognise their strengths and to be supported to build capacity and resilience resulting in sustained independence that enables them to reach their potential now and in the future in spite of any disadvantages that they may face. As a city we must help everyone to overcome any poverty of opportunity by tackling the causes of multiple disadvantage, reducing health inequalities and complex needs and not just address the symptoms; we must be proactive and not reactive in providing the environment, help and advice that families and young people need to thrive.

  1. Why Early Help in Sheffield

As a city we have a responsibility to identify and provide support to any child, young person or carer whenever the need arises. The Children’s Act 2004 mandates the local authority to make arrangements to promote cooperation between all relevant partners with a view to improving the well-being of all children, as does the Children and Families Act 2014. Working Together to Safeguard Children builds on the 2004 Act with an emphasis on the importance of identifying children and families who would benefit from early help and Ofsted has included early help provision in its inspections since January 2012.[1] Sheffield’s Public Health Strategy 2015 also emphasises the need for a comprehensive prevention plan endorsed by all its partners including the Clinical Commissioning Group and that all the city’s providers support the health and wellbeing of children and families in Sheffield.

To achieve our vision, the Council and its partners need to continue to forge strong partnerships with those agencies that help to shape the lives of children, teenagers and young adults including health services, the police the voluntary and community sectors.

The demand for preventative and early help services continues to increase the city. This is evidenced in the number of children being referred to the prevention and early intervention service, with a rise from 13957 in 2014/2015 to 15,554 in 2016/17. The range of partners that accessed the prevention and intervention is broad and the reasons for requests are diverse:

Early Help is focused on identifying needs and providing support when they first appear at any point in a child, young person or family’s journey and effective prevention removes barriers that hinder access to universal services. There is much evidence that recognises that effective prevention and early help can improve future outcomes for children, young people and families to a higher degree than specialist intervention and at a lower cost whilst also reducing the risk of significant harm to children.[2] Through providing a robust early help offer, we can as a city reduce the demands on children’s social care allowing this service to concentrate its resources on the most complex and challenging cases. The local authority has a key role to play, again working with other statutory and VCF partners, to where possible prevent young people getting involved in crime and antisocial behaviour, to protect them from the harms of drugs and alcohol, and give them advice and support to make the right career and education choices.

Fundamental to our method is a whole family approach that acknowledges that a problem with one person in a family cannot be isolated from affecting other family members or interacting with other problems in the family. Multiple issues within a family can interact and exacerbate each other, leading to more negative outcomes and increasingly costly outcomes, especially for children in a family.[3] The whole family ways of working approach begins at assessment, is reviewed and interventions are planned through Team Around the Family Meetings, and enables an agreed Family action plan to be developed to help show the progress made through the families support journey.

Early help not only reduces negative impacts on children, families and communities now, but also mitigates the need for access to specialist and acute services in the future by breaking the cycle of intergenerational disadvantage. Prevention and early help enables a positive future for children and families with improved outcomes, and a fiscal dividend now and in the future by reducing the dependency on expensive acute and specialist services. Not enabling families to support themselves carries significant costs both now and in the future.

As a city we need to reduce the duplication of providing multiple services to children, young people and families that arise from ineffective multi-agency working and lack of data sharing. Continued budget reductions, and central government reforms acting as drivers for the transformation of services delivered by Local Authorities, make it imperative that the Council and its partners work together and identify synergies through sharing resources to support young people and families to become more independent, resilient, self-reliant and less dependent on public services. The reduction of central government funding and the rising proportion of funding from locally raised council tax and business rates makes it all the more important to have a thriving city with resilient individuals, families and communities.

As stated in the public health prevention plan this approach to working is designed to align with and contribute to existing priorities and strategies including those set out in Sheffield City Council’s Corporate plan, the Health and Wellbeing strategy, Tackling Poverty Strategy, Best start strategy, the Children’s Health and Wellbeing Transformation Board and re-commissioning of young people’s services.

This articulation of prevention and early help is not a duplication of activity, but rather captures how the local authority and its partners will use their existing resources to help achieve the outcomes required, inform future investment, signal opportunities to further enhance progress against our priorities, and provoke debate on where more ambitious/radical approaches need exploring. This should include identifying areas where further resource could be levered in or where existing powers could be targeted more effectively.

  1. Barriers to Reaching Potential

There are approximately 134, 000 people aged under 19 children living in Sheffield, and by 2020 the under 19 population is projected to increase by 2.8% with the largest increase in the 10-14 subgroup.[4] Children, young people and families all over the country face difficulties that can have an impact on their immediate lives and future potential. Sheffield has its own context based on the needs of its population and our aspirations for them in the future. The wider determinants of ill health determine the extent to which a person has the right physical, social and personal resources to achieve their goals, meet their needs and build resilience to change. Acknowledging these wider determinants alongside the Indices of Deprivation Affecting Children and the potentially negative impacts that they can have on a child’s future is essential when articulating an early help offer and in understanding where services’ joint outcomes align.

To enable children and young people to reach their potential we need to acknowledge what can have a negative effect:

  • Inclusion: Attendance and Attainment

Education and training are the key enablers that allow a child to reach their potential in the future. Absence can have a detrimental impact on attainment, for example at Key Stages 2 and 4: 2012 to 2013 shows 44% of pupils with no absence in key stage 4 (normally aged 16) achieve the English Baccalaureate - the gold standard package of GCSE qualifications that includes English, maths, science, history or geography and a language - opening doors to their future.[5] But this figure falls by a quarter to just 31.7% for pupils who miss just 14 days of lessons over the 2 years that pupils study for their GCSEs, which equates to around 1 week per year, and to 16.4% for those who miss up to 28 days. The same pattern is also seen at primary school level. Preparing children for schools starts from the earliest age and Sheffield’s Best Start Strategy recognises this priority. Removing barriers to accessing education is a key tenet of Sheffield’s Inclusion Strategy.

  • Employment

There is a body of evidence that suggests the working is good and unemployment is bad for physical and mental health[6], and it has a profound impact on household and child poverty. The unemployment rate for the city is currently 6.4%, higher than the national rate and the regional rate.[7] Young people age 18-25 are 3 times more likely to be unemployed than their older peers. We have seen a significant fall in the numbers of young people Not in Education, Training and Employment (NEET) in Sheffield in the last 5 years, but further reducing this is a key goal if Sheffield is to have the social capital that it needs to continue to thrive as a city. The NEET rate is currently 5.9%. To access sustainable employment young people and adults must have the skills required by employers and the resilience to respond economic change.

  • Emotional Wellbeing and Mental Ill Health

Nationally, 850, 000 or 9.6% of the 5-16 year old population or 3 out of a school class of 30 school children will have a diagnosable mental health issue.[8] In Sheffield referrals to Child and Adolescent Mental Health Services increased by over 30% from 2012/13 to 2013/14.[9] The Sheffield Emotional Wellbeing & Mental Health Needs Assessment (2014) estimated that approximately 7, 000 children between the ages of 5-15 years have a clinically recognisable mental health disorder, and it reported that in 2014/15 16.8% of Yorkshire and Humber CAMHS bed days were for Sheffield patients. We also know that levels of Self Harm and Eating Disorders are increasing locally, which correlates with national data. The Children and Young People’s Mental Health and Wellbeing Taskforce highlighted the emotional health and wellbeing of children and young people as being imperative to their futures and focused on the importance of promoting resilience through prevention and early intervention. This is not only about tackling issues now, but also preventing their potential to damage in the future, as the over half of adult mental health problems start by the age of 14 with 75% starting by 18.[10] The national Future in Mind (2015) Transformation Programme provides the opportunity to redesign services and priorities the need to develop effective models of early help. Developing locally is a universal model of emotional wellbeing and mental health support through a school based approach, providing ‘in reach’ from CAMHS to enhance children and young people’s resilience and emotional wellbeing. The evidence presented by the Futures in Mind strategy supports the model of early help, ‘Early Intervention avoids young people falling into crisis and avoids expensive and longer term interventions in adulthood. There is a compelling moral, social and economic case for change.’[11] In addition, perinatal mental ill health can also have a negative impact on the wellbeing of children and young people increasing the risk of emotional and behavioural problems, parent child interaction and ultimately school readiness.

  • Child Poverty

1 in 5 children, and in 1 in 3 under 10s are living in poverty at an estimated cost to Sheffield of £265million.[12] In Sheffield, the proportion of primary school children entitled to free school meals is 21% compared to 18% nationally. For many families, living in poverty means more of a struggle to provide essentials such as food, suitable warm clothing or heating the home. Financial strain can place additional stress on home life, which in turn can have an impact on children’s wellbeing and thus their outcomes.

  • Crime and Antisocial Behaviour

The number of young people getting involved in crime and antisocial behaviour has fallen over the last 5 years. We need to maintain focus on this area to protect young people themselves from going down a path of crime and custody as well as to protect victims and communities.

  • Domestic Abuse

An estimated 130, 000 children nationally live in households with high-risk Domestic abuse.[13] It is estimated that 16, 000 adults and 12, 000 children are affected by Domestic or sexual abuse or violence each year.[14] Children can be affected by abuse directed at them, or at an adult in the family. The estimated yearly cost to Sheffield is £106.5 million.[15]

  • Young Carers

There are approximately 4594 young carers in Sheffield supporting family members.[16] Caring for another can have a seriously detrimental impact on the carer in terms of their ability to attend school, attain at school and prepare for their futures, and to maintain their own health.

  • SEND

Earlier identification of need and ensuring that children, young people with SEND aged 0-25 and their families get the right support at the right time to enable them to achieve their outcomes is a key priority in Sheffield. There are around 13,000 children and young people with SEN in Sheffield schools, of which approximately 2,600 have a statement or EHC Plan. Many of these children and young people experience multiple difficulties. National data shows they are significantly more likely to be permanently excluded from and less likely to achieve at school; they are more than twice as likely to be eligible for Free School Meals and they are twice as likely to not be in education, employment or training.[17]

To support children and young people with SEND, we are implementing new, locality-based ways of working that deliver personalised approaches to identifying need early and putting in place support.

  1. Development of the Early Help Framework

The Early Help Framework has been developed by the formation of key partners from citywide organisations. They have designed and agreed the key principles for the Framework of Early Help Multi Agency Working, and how this can be delivered jointly together at a local level in the communities that families live in.

The model shows how the areas of the city are broken down to allow to allow for support for unmet levels of need in family to be accessed quickly and appropriately and be met wherever possible from services based within the families own locality.

  1. Key Principles of the Early Help Framework

All partners have agreed on the following principles by which the framework will operate:

  1. Children’s wellbeing and safety are paramount, and ensuring that each child, young person and family can thrive is everyone’s responsibility.
  2. Our focus is on preventative early help: we will work together as services to meet the needs of individuals and families as soon as they emerge, on whatever level of need, in order to ensure that they are resilient, and have the potential to flourish and withstand any future challenges.
  3. We will recognise and tailor our responses based on the existing strengths of children, young people and families and will co-ordinate support around the needs of both individuals and families.
  4. At the core of our approach is an acknowledgement that in the majority of cases parents and carers are best placed to support the needs of their children and family, especially in their local community.
  5. Integrated locality working enables a focus on jointly and flexibly responding to local needs across the 7 localities.
  6. Integrated working in localities will provide a more flexible workforce that is better able to respond to the changing needs of children, young people and families.
  7. Locality working aims to ensure that children, young people and families are able to access the most appropriate type of support as rapidly as possible using the shared resources available at a locality level in a co-ordinated offer to children, young people and families.
  8. As services in a locality, we will all work to the same processes to reduce duplication and operational inefficiencies to ensure that children, young people and families receive appropriate advice, guidance and support when they need it.
  9. We will share information when relevant and according to agreed information sharing agreements.
  10. Locality working is based on all services having a shared understanding of and a consistent application of the different levels of needs of families.
  1. Principles of delivering Early Help through Locality Working

All partners in the EHF agree that to deliver services jointly within communities requires changes in working practices to build upon the relationships that already exist and expand professionals’ boundaries to new areas and ways of working. The following principles integrated multi-agency working in localities were developed as a result of this:-

  1. Locality working presents opportunities for the co-location of services and staff.
  2. Locality working is built on the premise of services working together in an integrated whole family assessment process that avoids duplication of effort and resources, and creates operational efficiencies.
  3. The assessment process is supported by an agreed levels of need document that is consistently applied.
  4. Integrated working practices will be underpinned by a commitment to work to the same processes.
  5. As services working together to improve the wellbeing of children, young people and families, we will have shared a shared outcomes framework.
  6. Locality working aims to integrate the existing services in a given area and ensure robust and effective communication and information sharing arrangements between services.
  7. Locality working provides the potential to build workforce capacity through improved opportunities for sharing best practice.
  8. Locality working allows for the Whole Family Working approach to service delivery to be embedded.
  9. Integrated working in localities will provide a more flexible workforce that is better able to respond to the changing needs of children, young people and families.
  10. Locality working provides a platform for shared learning and training opportunities.
  11. Locality working promotes staff to use their skills more effectively in a multi-disciplinary setting.
  12. Locality working provides an opportunity to share relevant information locally with professionals where appropriate and according to agreed information sharing agreements.
  1. Early Help Governance

The Early Help Board was formalised in July 2017. The following Governance and reporting arrangements were put in place: