LSP Projects 2011

High Need Families Project Brief

Rationale

Ealing delivers excellent Children’s services across a broad range of local agencies. However, there are many families in Ealing who are at risk of one or more factors that can lead to social exclusion such as poor parenting skills, housing problems, substance misuse, domestic violence and benefit dependency.

There is a growing body of information which suggests that a more integrated way of working between all the various agencies which come into contact with families is more effective in both improving outcomes, avoiding future costs, and can be adapted to various service user problems. Some of this evidence is provided in Appendix 2.

This project aims to start a systematic review of the ways in which services from across the public sector in Ealing could intervene more effectively into the lives of those most at risk and those with the highest needs.

The project will be led by Ealing’s Children’s Services with support from the Policy and Performance Team. Where relevant, the project will also be integrated with other LSP and VFM projects including the project proposal to jointly market test and diversify the provision of local services, with a particular view to increasing the use of community and social enterprise.

Key Principles and Objectives

Parents and families are the main influence on a child’s development and there is compelling evidence on the importance of effective parenting for outcomes for children, and young people.[1] When looking at improving children’s services we therefore cannot ignore adults social care. With this in mind the following will be embedded in this project:

  • Whole family approach – Services need to work in a genuinely integrated manner to ensure interventions are coherent, aligned and take into account all the factors associated with the family. The fact that the poor academic record of children in the family can be directly related to inappropriate housing conditions is a matter of common sense but is not accurately reflected in traditional service responses.
  • Building on family strengths – The importance and potential strength of the family unit has often been misunderstood or underestimated by service providers. By engaging families in the care planning process and giving them a stake in their future relationship with services, they no longer become passive observers but can build their capacity to work through problems themselves.
  • No wrong door – Contact for vulnerable families with the service should open the door to a broader network of support. Public services should not seek to deflect individual issues as they arise but, instead, aim to deliver long term solutions that might be complex and involve several services and agencies but, if ignored, mean that the family will continue to present.

Benefits and Anticipated Outcomes

By tackling a whole range of negative factors projects for intensive family support achieve benefits for the children involved, their families, and for those in the local community who they come into contact with.

The impact of coordinated intensive support can be fairly immediate and help reduce the often excessive demands some families make on local services through staff time and the financial costs of failing to intervene earlier.

Recent local estimates suggest the average saving per family per year from a Family Intervention Project is £81,624.[2] Parenting programmes can also lead to significant savings for example, up to £225,000 per child with conduct disorder (including £160,000 in reduced offending)[3].

In Ealing the current Family Intervention Project (to date working with 20 families with a total of 83 children) is estimated to have worked with 32 families in total, with an estimated 135 children, by the end of March 2011. Using the Dfe Costing Tool it has been estimated that the annual saving for the public sector in Ealing for 32 families could be as high as £1, 369, 364. However, the costing tool estimates future potential savings and needs to be treated with caution. Through this project we have proposed developing a local costing tool that can be uses throughout project delivery to analyse the financial impact of intensive family support. This will be lead by Ealing’s Finance Department and will enable us to cost the delivery of interventions and outcomes.

A more detailed analysis of the costs and expected benefits will be drawn up after the costing tool has been developed.

However, in terms of anticipated outcomes we would expect:

  • Fewer families needing to access support services or a wide range of support services. For families themselves this will mean less interference with their everyday lives.
  • Remodelled social work teams
  • Greater integrated working between different agencies

More information on the evidence and benefits of intensive family support interventions can be found in Appendix 2.

Project Delivery

Project Brief
The key elements of this project will include:

  • Review and collation of information about our highest need areas: the structure of the service and the response of teams need to reflect need so it is essential that we start mapping what this need is. Different families will have different needs ranging from those who need some intervention to others who need intensive support. The service needs to reflect this.
  • Research evidence into the most effective types of intervention: with a view to developing key models for intervention and recommending the most effective types of intervention for Ealing.
  • Review of existing work to identify most prolific service users, services they are accessing, and how they are accessing these services: this will include an evaluation of cost, performance, and existing family based provision, incorporating the Think Family Approach (detailed in Appendix 1).
  • Development of a local negative costing tool to undertake a cost benefit analysis of intervention programmes: this tool should be developed from Dfe’s negative costing tool. This is a tool which will help Ealing estimate how intervention might avoid the highest potential future costs incurred by high need families. The tool uses professional judgement to establish a baseline of the risks for each family at the point of their entry to the service. The baseline calculates a ‘do nothing scenario’ cost for each family, broken down by a number of themes including housing, parenting and ASB. The % Reduction of Risk column indicates the likelihood of the negative event not occurring again due to the intervention and is calculated using results from the families who had participated in the national FIP programme. This risk reduction percentage is multiplied by the unit costs, giving the predicted cost avoidance for each family.
  • Identify alternative methods of service delivery such as key workers, family ‘wraparound’ services: this will include, for example, consideration of assessment routes and possible efficiencies in the ways services are accessed and delivered and consideration of the opportunities for geographically based service provision to target issues including e.g. alcohol and drug services.

Key questions we need to ask ourselves at each stage of the project are:

Activity 1: Systematic review of current evidence of high need families

  • How do we ensure that a family’s needs can be identified and met before a crisis point is reached?

Activity 2: Research evidence into the most effective types of intervention

  • What types of intervention work best?
  • What is the most effective intervention for Ealing likely to be?
  • Who should deliver this model?

Activity 3: Systematic review of current service delivery

  • What services do we offer now?
  • How are these services delivered?
  • What services are used? How many by the same individual/family?
  • How do service users find the service?
  • How long do service users access the service? Is the cycle of intervention broken? Why for some families and not others?
  • What happens when an intervention is no longer needed? Are we sure all issues are addressed within the current system?

Activity 4: Undertake negative costing tool analysis

  • How much is spent per individual, per family on interventions provided by the Council and partner agencies?
  • Where can we save money and improve outcomes?
  • Are there any quick wins?

Activity 5: Identify opportunities for efficiencies and better joined up working to deliver to these families

  • How can we introduce effective integrated working on the front-line?
  • What structures need to be in place (management and team)?
  • How can we assess performance?

The initial research stage will inform the next stage of delivery. However, at present it is anticipated that there will be three potential models of delivery:

  • Model 1: New practitioner-based delivery team e.g. as in Westminster
  • Model 2: Extending a pre-existing and tested model of working e.g. Family Intervention Project
  • Model 3: Systems change e.g. new ways of working between adult and children's services

A list of key activities, milestones, proposed measures of success and indicative timescales are detailed in table 1 on the following page.

A more detailed project plan is also attached. The timeframes are indicative at this stage however the plan sets out clear stages for the initial work programme. The project plan also sets out which organisations we need to liaise with to obtain information on need and current service delivery, which makes up a substantial part of the research stage. These include:

  • Children's social services
  • Education/schools
  • Adults social services
  • Police
  • DAAT
  • GPs
  • Hospitals
  • Housing including housing associations
  • Benefits
  • VCS organisations
  • Community safety
  • Probation
  • Youth offending service
  • Substance and Alcohol Misuse
  • Domestic Violence/Abuse
  • Youth services
  • Health visitors
  • Maternity Services
Activity / Key partners/stakeholders / Outcomes / Indicative timescale
1. Systematic review of current evidence of high need families
Collection of data and information from key agencies as to most frequent users / Management Information and Statistics Team, Children’s Services, Adults Services, Police, WLMHT, Housing, Community Safety, VCS / Contact with service areas
Data received from service areas
Data used to inform needs analysis
Ongoing communication[4] with partners and stakeholders (as highlighted in the communication plan) / January – February 2011
Map need / Management Information and Statistics Team, Children’s Services / Needs analysis complete / March 2011
2. Research evidence into the most effective types of intervention
Local and national research / Management Information and Statistics Team, Children’s Services, Adults Services, Police, WLMHT, Housing, Community Safety, VCS / Evidence on what types of interventions work best
Recommendations for the most effective type of intervention for Ealing / January 2011
3. Systematic review of current service delivery
Market testing and alternative ways of delivery (part of the vfm projects and led by the vfm sub-group) / Vfm sub-group / Contact with service areas
Potential alternative providers identified
Marketing testing project outcomes
Ongoing communication with partners and stakeholders (as highlighted in the communication plan) / March 2011
Liaison with services and providers to identify existing work (and identify possible opportunities) / Children’s Services, Adults Services, Police, WLMHT, Housing, Community Safety, VCS, education providers / Info received and researched on existing services offered
Map of existing service delivery complete / March – May 2011
Map support received by service users in Ealing / Children’s Services, Adults Services, Police, WLMHT, Housing, Community Safety, VCS, education providers / Map support received by service users against services we say we are delivering
Mapping of service delivery complete and opportunities for improved ways of working identified / May 2011
Review performance (including, results of social work health checks and views of service users) / Management Information and Statistics Team, Children’s Services and other services as above / Up-to-date performance of service area and agencies
End of year performance of service areas and agencies / May 2011
4. Development of a local negative costing tool and embed into service delivery
Map services delivered against a more integrated approach / Finance and Children’s Services and other services as above as relevant / Negative costing tool used to analyse financial impact of interventions
Negative costing tool used to measure financial impact throughout the project / March – May 2011
5. Identify opportunities for efficiencies and better joined up working to deliver to these families
Models for service delivery developed / Vfm sub-group, Finance, Legal, Children’s Services, and Adults, Police, WLMHT, Housing, Community Safety, VCS, education providers / Models for service delivery developed and agreed
Identify barriers and risks / Vfm sub-group, Finance, Legal, Children and Families / Risks, opportunities, barriers and mitigating actions identified and agreed / June 2011
Propose recommendations and action planning / Vfm sub-group, Finance, Legal, Children and Families, Police, WLMHT, Housing, Community Safety, VCS, education providers / Action plan agreed with partners and stakeholders / June – August 2011

Project group and resource required

This is a complex project that requires commitment from each organisation, and clear contributions from all organisations involved in delivering services to our families in most need. Representatives of the project steering group will needs to be present from all the key stakeholders identified in the table above and have sufficient impact and leverage to ensure that actions are fully implemented.

We would expect the representatives from the following agencies to be included in a project group:

  • Children's social services
  • Children’s Commissioning
  • Adults social services
  • Police
  • VCS organisations
  • Community safety
  • Finance
  • Housing
  • Education providers

The project group should also establish clear links to other ongoing projects and activities delivering to meet the needs of families in need across individual organisations (dependencies on other projects will be scoped more fully in detailed project plans). It will be important to link into work on other LSP projects to make use of shared data and to ensure that solutions are couched in the opportunities provided by better use of assets in the future. Links to teams, such as the GIS team, to enable the mapping of high need families and potential interventions will also be key.

Project management support will be provided from the Council’s Policy team in the initial scoping, set up and research stages of the work.

It will be possible to resource the project management of this work on an ongoing basis from within the policy team, but it is suggested that resource for ongoing project management and implementation is discussed further and the most appropriate resource allocated from any partner organisation taking into account the specific skills required for this work.

It is anticipated that managing this work will take up approximately two days a week of a single officers’ time, or less according to the numbers of staff allocated to manage this work. Timescales in the plan below are set out according to this resourcing assumption. Nevertheless, the scale and complexity of the project mean that such resourcing will be subject to review and recalculation as the work progresses.

Governance

It is proposed that a project steering group is established to oversee the overall direction of this project. It is anticipated that the project steering group will need to meet approximately monthly.

Project management will be supported through the Council’s Policy team and led by a nominated project manager from across partners in the longer term.

The project steering group will report to the DMG, who will hold projects accountable for their delivery and ensure that the overarching programme of LSP projects is delivered successfully. Regular reports will be provided to LSP Executive to ensure that progress meets the requirement of all major partner organisations.

Stakeholders

A full stakeholder engagement and communications plan will be developed outlining who we need to involve, why, when and how.

However, key stakeholders, beyond those identified as members of the steering group, will be:

  • Elected representatives – notably the Leader of the Council, portfolio holder for Finance and Performance, and other Cabinet members
  • Local residents and service users – once specific proposals have been developed, community consultation and engagement will be important to shape future strategies and goals
  • Local businesses – to consider potential input into solutions and future developments

Risk Management

An initial outline of potential risks and mitigating actions are outlined in table 2 below.

Table 2: Initial risk register and mitigating actions

Equalities Implications

Initial thoughts around potential areas of impact in terms of equalities and how we will assess these are highlighted in table 3 below.

Table 3: Potential Equality Impact[5]

Potential Equality Impact / Assessment of impact
Service users receive a reduced/limited service during re-organisation of interventions / Through robust project planning ensure smooth handover to a more integrated service e.g. by appointing a single contact for a family.
The process in which high need families are identified may favour some service users over others / Based on needs analysis develop a robust and fair process for identifying high needs families.
The structure of social work teams if re-organisation is recommended / Full consultation with any teams affected.

Appendix 1 What Ealing is already doing