Supporting Families Pathway Toolkit Event November 22nd 2012 Chris McLoughlin Service Director, Children’s Safeguarding & Prevention What is the Supporting Families Pathway? • Transformational process that has changed the way we identify need and offer support to children and families. • A way of working that ensures services are coordinated as early as possible to support children and families in Stockport • Operates from the ‘front door’ of the Contact Centre • CAF & Universal Recommendations made when issues first emerge How has this work been developed? • Intensive research and analysis at the Contact Centre to understand how we could better identify issues earlier • Data collection • Consultation with range of internal and external services • Gap analysis • The production of a set of recommendations to transform practice How do CAF recommendations work? 1. Practitioner contacting the Contact Centre. If decision- no role for social care - case screened in SFP and CAF recommendation made direct to practitioner and monitored 2. If written notification eg police/ A&E submitted to contact centre following response to an incident where concerns about a child or family raised. Case screened and CAF recommendation made to appropriate service 3. Parent rings contact centre for support: case screened and CAF recommendation made to appropriate service • All followed up after 20 working days What has changed? • All cases presented at the contact centre, are screened using a multi agency screening tool • Structured Step up/down processes via CAF • Full time Social Care managers based at Contact Centre • Senior Practitioner- CAF Expert at Contact Centre • Families are offered tangible support, early in the development of a problem • CAF & Universal recommendations made and monitored after 20 working days • Chronologies now started as soon as issues emerge. Enables more effective targeting of vulnerable families to reduce escalation Benefits • Families offered early help support as soon as issues are identified • Reduced ‘waste’ and duplication • Enhanced interface between Tier 2 agencies and Childrens Social Care • Enhanced multi agency working with GMP, Health Visitors & School Nurses, PVI Sector • 12 month period 1500 families screened for early help needs that previously wouldn’t have been ‘on the radar’ • Validated nationally as effective emerging practice by Centre for Excellence & Outcomes (C4EO) Toolkit • Share learning and resources with other areas • Inform social work and educational degree programmes to enable students to explore current, ‘real life’ practice • Funded by Greater Manchester Health Innovation and Education Cluster Next Steps • Build on strong foundation of the Supporting Families Pathway to widen ‘front door’ at Contact Centre • Use the pathway to underpin our Troubled Families work (Stockport Supporting Families Programme) • Enhance the Universal recommendation aspect of the pathway • Ensure child and family voice informs evaluation Troubled Families- Stockport’s Supporting Families Programme Steve Skelton GM Community Budgets Lead for Troubled Families Troubled Families: National & GM Focus • National TF programme - Three years of additional funding; PbR; identifies families by looking for symptoms – Crime / Anti-Social Behaviour - School attendance / Truancy – Adults not in employment - High cost / high demand • GM TF programme - 3-5 years to ‘re-wire’ public services; reform the mainstream to deliver sustainable inter-generational improvements for families; and focus on the causes! – – – – Domestic abuse / violence Mental wellbeing Low income Child safety issues - Substance misuse Chronic limiting illness / disability Poor educational attainment Inadequate living arrangements • Both programmes – limited cohort of high-cost / high-demand families; impact on whole-public sector; need to address whole families issues and relationships in a sequenced way Stockport Data and Evidence • 38 Stockport families meet 3 government criteria • 291 Stockport families meet 2 government criteria (+13 out of area attending Stockport Schools) • Conservative costings reveal 38 families have cost 1.1 million • Domestic Violence: 24% of families meeting 3 criteria have been involved in a domestic abuse (DA) incident within last 6 months and 42% within last 18 mths. Of those families meeting 2 criteria, 10% have been involved in a DA incident in last 6 months and 18% within last 18 mths. • Missing From Home: 24% of families meeting 3 criteria have had at least one child go missing from home in the past 6 months and 42% within the last 18 mths. Of those families meeting 2 criteria, 6 % have had at least one child go missing from home in the past 6 months and 15% within the last 18 mths. KEY GMP CSCare Cprotection Hvisitor Housing Probation Debt Snurse Substance Tier 2 Debt Debt Debt A&E GP Child Psycholo gy Legal Specialist County Homeless Health Court KITE COT Jigsaw PRU SEN School Action + ASBAT FIP Family B GMP Victim crime MFH Mother CSCare CSCare CSCare CSCare Homeless CSCare Housing CSCare CSCare Debt Debt CSCare Debt Cprotection CSCare Substance Housing Debt Debt CSCare Debt Debt Tier 2 Tier 2 Debt CSCare CSCare CSCare CSCare CSCare CSCare CSCare CSCare CSCare CSCare GMP GMP CSCare Debt Substance Substance Debt Cprotection CSCare Tier 2 CSCare Specialist Health Tier 2 Tier 2 Legal Specialist County Court CSCare CSCare Substance CSCare Specialist Health CSCare Health Tier 2 CSCare Cprotection Debt Probation Specialist Health Debt CSCare GMP CSCare Cprotection GMP GMP Housing GMP GMP GMP GMP victim victim victim GMP GMP GMP GMP Year 1990 qtr 1-2 qtr 3-4 1991 qtr 1-2 qtr 3-4 1992 qtr 1-2 qtr 3-4 CSCare CSCare CSCare CSCare Homeless CSCare 1993 qtr 1-2 qtr 3-4 1994 qtr 1-2 qtr 3-4 1995 qtr 1-2 1996 qtr 1-2 qtr 3-4 qtr 3-4 1997 qtr 1-2 qtr 3-4 1998 qtr 1-2 qtr3 3-4 1999 qtr 1-2 qtr 3-4 2000 qtr 1-2 qtr 3-4 2001 qtr 1-2 qtr 3-4 2002 qtr 1-2 qtr 3-4 2003 qtr 1-2 qtr 3-4 2004 qtr 1-2 qtr 3-4 2005 qtr 1-2 qtr 3-4 2006 qtr 1-2 2007 qtr 3-4 qtr 1-2 qtr 3-4 2008 qtr 1-2 qtr 3-4 2009 qtr 1-2 qtr 3-4 2010 qtr 1-2 qtr 3-4 2011 qtr 1-2 qtr 3-4 2012 qtr 1-2 qtr 3-4 qtr 3-4 2001 qtr 1-2 qtr 3-4 2002 qtr 1-2 qtr 3-4 2003 qtr 1-2 qtr 3-4 2004 qtr 1-2 qtr 3-4 2005 qtr 1-2 qtr 3-4 2006 qtr 1-2 2007 qtr 3-4 qtr 1-2 qtr 3-4 2008 qtr 1-2 qtr 3-4 2009 qtr 1-2 qtr 3-4 2010 qtr 1-2 qtr 3-4 2011 qtr 1-2 qtr 3-4 2012 qtr 1-2 qtr 3-4 Child Psycholo gy CSCare CSCare CSCare CSCare GMP CSCare CSCare Court Partner 1 CSCare Substance CSCare Substance Housing Substance CSCare Substance Relationship ended CSCare Died Cprotection victim Year 1990 qtr 1-2 qtr 3-4 1991 qtr 1-2 qtr 3-4 1992 qtr 1-2 qtr 3-4 1993 qtr 1-2 qtr 3-4 Homeless CSCare CSCare CSCare 1994 qtr 1-2 victim qtr 3-4 1995 qtr 1-2 victim victim 1997 qtr 1-2 qtr 3-4 1998 qtr 1-2 qtr3 3-4 1999 qtr 1-2 qtr 3-4 2000 qtr 1-2 CSCare Cprotection Cprotection Cprotection CSCare CSCare CSCare CSCare CSCare Tier 2 CSCare qtr 3-4 1996 qtr 1-2 qtr 3-4 Daughter 1 CSCare A&E A&E A&E A&E CSCare A&E A&E A&E A&E CSCare CSCare CSCare GMP GMP CSCare GMP Hvisitor CSCare GP Housing victim Year 1990 qtr 1-2 qtr 3-4 1991 qtr 1-2 qtr 3-4 1992 qtr 1-2 qtr 3-4 1993 qtr 1-2 qtr 3-4 1994 qtr 1-2 qtr 3-4 1995 qtr 1-2 Hvisitor CSCare CSCare GMP CSCare Legal County Court Legal County CSCare CSCare Adult CSCare CSCare Specialist Health CSCare victim Cprotection victim 1996 qtr 1-2 victim 1997 qtr 1-2 qtr 3-4 1998 qtr 1-2 qtr3 3-4 CSCare Cprotection Cprotection Cprotection CSCare CSCare CSCare CSCare qtr 3-4 Legal County CprotectionCourt qtr 3-4 1999 qtr 1-2 qtr 3-4 2000 qtr 1-2 qtr 3-4 2001 qtr 1-2 qtr 3-4 2002 qtr 1-2 qtr 3-4 2003 qtr 1-2 qtr 3-4 2004 qtr 1-2 qtr 3-4 victim 2005 qtr 1-2 qtr 3-4 2006 qtr 1-2 CSCare CSCare Court 2007 qtr 3-4 qtr 1-2 qtr 3-4 2008 qtr 1-2 qtr 3-4 2009 qtr 1-2 qtr 3-4 2010 qtr 1-2 qtr 3-4 2011 qtr 1-2 qtr 3-4 2012 qtr 1-2 qtr 3-4 qtr 3-4 2008 qtr 1-2 qtr 3-4 2009 qtr 1-2 qtr 3-4 2010 qtr 1-2 qtr 3-4 2011 qtr 1-2 qtr 3-4 2012 qtr 1-2 qtr 3-4 qtr 3-4 2010 qtr 1-2 qtr 3-4 2011 qtr 1-2 qtr 3-4 2012 qtr 1-2 qtr 3-4 Daughter 2 Born GMP Specialist Health CSCare Housing Child Child Child Child Legal Legal Psycholo Psycholo Psycholo Psycholo County County gy Tier 2 gy gy gy Hvisitor GP CSCare GMP CprotectionCourt Court Child Child Child Child Psycholo Psycholo Psycholo Psycholo Specialist gy gy CSCare gy CSCare gy Health GP CSCare GMP CSCare CSCare Child Child Psycholo Psycholo Specialist Specialist gy Hvisitor gy GP CSCare Health Health CSCare CSCare CSCare GP Cprotection Legal County SEN CSCare CSCare SEN CSCare CSCare School Action Plus victim Year 1990 qtr 1-2 qtr 3-4 1991 qtr 1-2 qtr 3-4 1992 qtr 1-2 qtr 3-4 1993 qtr 1-2 qtr 3-4 1994 qtr 1-2 qtr 3-4 1995 qtr 1-2 qtr 3-4 1996 qtr 1-2 qtr 3-4 1997 qtr 1-2 qtr 3-4 1998 qtr 1-2 qtr3 3-4 1999 qtr 1-2 qtr 3-4 2000 qtr 1-2 qtr 3-4 2001 qtr 1-2 qtr 3-4 2002 qtr 1-2 qtr 3-4 2003 qtr 1-2 qtr 3-4 GMP GMP 2004 qtr 1-2 qtr 3-4 2005 qtr 1-2 qtr 3-4 2006 qtr 1-2 2007 qtr 3-4 qtr 1-2 Partner 2 Relationship started Substance Tier 2 Victim Year 1990 qtr 1-2 qtr 3-4 1991 qtr 1-2 qtr 3-4 1992 qtr 1-2 qtr 3-4 1993 qtr 1-2 qtr 3-4 1994 qtr 1-2 qtr 3-4 1995 qtr 1-2 qtr 3-4 1996 qtr 1-2 Tier 2 victim qtr 3-4 1997 qtr 1-2 victim qtr 3-4 1998 qtr 1-2 qtr3 3-4 1999 qtr 1-2 qtr 3-4 2000 qtr 1-2 Hvisitor CSCare CSCare CSCare CSCare CSCare 2001 qtr 1-2 qtr 3-4 2002 qtr 1-2 qtr 3-4 2003 qtr 1-2 Child Psycholo gy CSCare CSCare CSCare CSCare GMP qtr 3-4 qtr 3-4 2004 qtr 1-2 qtr 3-4 2005 qtr 1-2 qtr 3-4 2006 qtr 1-2 CSCare CSCare Court victim 2007 qtr 3-4 qtr 1-2 qtr 3-4 2008 qtr 1-2 qtr 3-4 2009 qtr 1-2 Daughter 3 born CSCare Hvisitor Legal County CSCare CprotectionCourt CSCare GMP CSCare Legal County Court Legal County CSCare KITE CSCare Cprotection A&E KITE KITE CSCare 1x FTE CSCare COT School TAC level Action + 3 KITE COT CSCare PRU PRU ASBAT MFH MFH MFH MFH MFH 1990 qtr 1-2 qtr 3-4 1991 qtr 1-2 qtr 3-4 1992 qtr 1-2 qtr 3-4 1993 qtr 1-2 qtr 3-4 1994 qtr 1-2 qtr 3-4 1995 qtr 1-2 qtr 3-4 1996 qtr 1-2 qtr 3-4 1997 qtr 1-2 qtr 3-4 1998 qtr 1-2 qtr3 3-4 1999 qtr 1-2 qtr 3-4 2000 qtr 1-2 CSCare CSCare CSCare 2001 qtr 1-2 Child Psycholo gy CSCare qtr 3-4 qtr 3-4 2002 qtr 1-2 qtr 3-4 2003 qtr 1-2 CSCare CSCare CSCare GMP qtr 3-4 2004 qtr 1-2 qtr 3-4 2005 qtr 1-2 qtr 3-4 2006 qtr 1-2 2007 qtr 3-4 qtr 1-2 qtr 3-4 2008 qtr 1-2 qtr 3-4 2009 qtr 1-2 qtr 3-4 MFH MFH ASBAT ABC NACRO FIP MFH Year MFH 2010 qtr 1-2 qtr 3-4 PRU TAC level TAC level 3 x FTE 3 3 TAC level 3 MFH MFH 2nd ABC ASBAT MFH MFH MFH MFH MFH MFH MFH MFH MFH 2011 qtr 1-2 qtr 3-4 2012 qtr 1-2 qtr 3-4 2011 qtr 1-2 qtr 3-4 2012 qtr 1-2 qtr 3-4 Son 1 born CSCare Legal County CSCare CprotectionCourt CSCare GMP CSCare Legal County Court CSCare Legal Specialist County Court CSCare Health School Action + CSCare Cprotection CSCare CSCare School Action + KITE TAC level 3 KITE KITE School Action + CSCare KITE COT COT TAC level CSCare 3 victim Jigsaw victim Year 1990 qtr 1-2 qtr 3-4 1991 qtr 1-2 qtr 3-4 1992 qtr 1-2 qtr 3-4 1993 qtr 1-2 qtr 3-4 1994 qtr 1-2 qtr 3-4 1995 qtr 1-2 qtr 3-4 1996 qtr 1-2 qtr 3-4 1997 qtr 1-2 qtr 3-4 1998 qtr 1-2 qtr3 3-4 1999 qtr 1-2 qtr 3-4 2000 qtr 1-2 qtr 3-4 2001 qtr 1-2 qtr 3-4 2002 qtr 1-2 qtr 3-4 2003 qtr 1-2 qtr 3-4 2004 qtr 1-2 qtr 3-4 2005 qtr 1-2 qtr 3-4 2006 qtr 1-2 2007 qtr 3-4 qtr 1-2 qtr 3-4 2008 qtr 1-2 qtr 3-4 2009 qtr 1-2 qtr 3-4 2010 qtr 1-2 qtr 3-4 Partnership Working Children’s Probation RSL / ALMO NHS Commissioners Colleges Mental Health Police Social Care Schools JCP MoJ / CJS Foundation Trust Government expectationsevaluation of health outcomes • GP/Dentist registration • Number of adults/children experiencing mental health difficulties • Number of children diagnosed with ADHD • Number of adults with long standing illness • Hospital and A&E attendances across families • Prevalence of self harm • Under 18 conceptions • Substance misuse prevalence adults/children Health agencies are crucial to success – but it’s not easy! • High level buy-in from GM HWB, CCGs and providers • But NHS reform - opportunities & challenges: – New players and (extremely!) complex commissioning arrangements – But we have some influence, through GM, on DH, and new ideas / space to reform • Crucial is a shared view of the value of deep, detailed, practical, operational integration between partners • The next presentation will provide more context, and the following exercise will give delegates the chance to discuss a more integrated future way of working Gillian McLauchlan Greater Manchester Public Health workforce Lead gillian.mclauchlan@nhs.net Implications of the Health and Social Care Act Structure Accountabilities The pivotal role of workforce Who they are? Develop and support Better Care Better Treatment No decision about me without me Clinicians at the heart Currently state of flux Data Health and Wellbeing Board Health - part of Local Authority functions 70% recurrent NHS costs relate to staffing 80% of workforce still be working for NHS in 10 years time Service changes – need workforce on board Professional grouping /silo recruitment & workforce planning Understand the workforce’s context Understand rational behind change & their enhanced role can assist and improve lives Existing and New workforces Health and social care curriculum Integrated workforce planning The multi professional approach to training and development