Launch Briefing Meeting Children’s Needs model ‘Right Services Right Time’

1. Launch Briefing Meeting Children’s Needs model ‘Right Services Right Time’ Catherine Parry Assistant Director Children Young People & Families Directorate 16th May 2013 Paul Marshall Assistant Director Children Young People & Families Directorate 22nd May 2013 Lorna Scarlett Assistant Director Children Young People & Families Directorate 23rd May 2013 Kay Child Assistant Director Children Young People & Families Directorate 4th June 2013

4. The need to manage across the system • “It is not possible to separate the protection of children from wider support to families. Indeed, often the best protection for a child is achieved by the timely intervention of family support services.” (Lord Laming 2003) • “Providing early help is more effective in promoting the welfare of children than reacting later” (Working Together 2013) • “The provision of early help is vital to keeping children safe” (Munro 2011)

7. Early Help Strategy • Providing support and assistance to children and families so that they are able to remain at home safely. • Early support will prevent the need for some children to come into public care. • The provision of better early support and use of the Strengthening Families approach will reduce the need for children to be on formal child protection plans.

8. Features of Early Help • No child or family asking for help will ever be turned away. There will be no wrong door into support.  If a service cannot help, they will connect them into a service which can. • Strong, trusting relationships across professions and between professionals and families will achieve better outcomes. • Bureaucracy will be less of a burden, allowing professionals to focus on their work with families. • Interventions with children and their families will be evidence based and informed by ‘what works’

9. Examples of Early Help • Support in the ante natal period for parents to be • New Birth Visits for all children in the first eight weeks of life • Persistent targeted out reach to our most vulnerable and disadvantaged young children • Parenting and relationship support • Training and employment support for parents to raise aspirations for themselves and their children

10. Examples of Early Help • Engaging parents in their children learning and raising aspirations • Working with partners to deliver universal early education, child care and health services • Provide early interventions to prevent escalation of issues • Working with partners to deliver and Team Around the Child/Family approach • Targeted interventions such as Incredible Years Parenting

11. Securing Early Help Services • Effective procurement • Pooling resources • Communication / Publicity / Awareness

12. Timetable for delivery • Partnership Agreement to early help strategy – December / January – done. • Identified funding – Health and Wellbeing Board, Troubled Families, others? • Procurement of additional support services -ongoing • Additional services available by September 2013 • Front line colleagues aware of what is available – by September 2013

13. Right Services Right Time - Meeting Children’s Needs My Agency’s Responsibilities

14. Ofsted Inspection 2012 Set out a requirement for BSCB to review the needs assessment documents and ensure that: Delays are avoided when responding to concerns about children and young people. All agencies understand their roles & responsibilities in referral practices and managing risk, Inconsistencies in practice are addressed

15. Working Together to Safeguard Children 2013 LSCBs to publish a threshold document that includes: The process for early help assessment The criteria for assessment, including the level of need for when a case should be referred to the Local Authority Children’s Social Care and statutory services

16. Process • Multi–agency task and finish group • Reporting to OEG • Wide consultation • BSCB endorsement March 2013 • Launch May 13 • Implementation plan

17. Right Services Right Time Meeting Children’s Needs • Focused on NEED • Child at the Centre • Support offered to the family • Birmingham’s model • All agencies use same indicators

18. Principles • Needs led approach • Changes the language, services for children not process (e.g. threshold, needs a CAF, IA, s47) • No wrong door • Acute and complex not only a SC response • Encourages a conversation that helps find a solution rather than a ‘stand off’ • Avoids the reframing of a concern into a child protection matter

19. Birmingham Basics • Always see the child first • Never do nothing • Do with, not to, others • Do the simple things better • Have conversations, build relationships • Outcomes not inputs

20. Benefit to children • Metaphorically holds the child’s hand throughout • Avoids multiple assessments • Provides advice and support to professionals • Provides additional services, shared ownership and responsibility

21. Chantelle - 3yrs old • Chantelle aged 3 moved to the area a month ago with her mum, Karen, and her younger brother. They moved to be closer to Karen’s mum who now looks after the children when Karen is at work. • They do not have a lot of money and are currently living in a small, one bedroom flat which is a little damp. Chantelle hasn’t yet started at a new nursery but Karen says she’s really keen for her to go to nursery once she’s found one. • She seems rather small for her age and has a rash on her arm which she scratches a lot. Mum says she’s concerned about it but hasn’t yet managed to register at a new GP . She says she’ll take Chantelle to the GP as soon as she is signed up. • Chantelle seems quiet and doesn’t talk much

22. Chantelle – Universal Plus • While Chantelle does have some obvious needs it would seem that mum has a plan in place to address them. Therefore the appropriate intervention for her would be Universal Plus as she may just need the worker to support her and signpost her to the appropriate help such as GP and children’s centre. • If no progress was made or mum identified that she was struggling to find her way, further discussion might mean that additional needs help might be required.

23. Pravin - 8yrs Old • Pravin is having a few difficulties at school: he is not keeping up with his peers, he seems unhappy and he says he is being bullied. • Although his school work is at an acceptable standard the Classroom Assistant has noticed that he seems to be on ‘the fringe’ of activity in group times and the Playground Supervisor has noticed that he seems to be isolated in the break times. • His home situation seems loving & supportive, and his parents are keen to work together to address his needs.

24. Pravin – Universal Plus • Although there are concerns about the bullying experienced by Pravin his school can address these needs by utilising their existing anti-bullying policy. • Pravin has agreed to taking part in a classroom based ‘peer support’ group, and the Form Tutor has allocated him a classroom role to help him feel more engaged. • His form tutor is meeting with Pravin and his parents and is providing him with the support and guidance via their interventions. The parents are happy with the school’s approach and are meeting again in 3 weeks to review the situation, but they know they can speak to school by phone if they are worried in the interim.

25. Erin - 16yrs Old • Erin is 16 and is currently 4 months pregnant. Ever since she had her pregnancy confirmed her attendance at school has started to be very sporadic. Prior to the pregnancy, it was predicted that she would gain around 8 GCSEs at C or above. Erin feels that one of the reasons her attendance has slipped is due to her feeling uncertain about the future. • She lacks support from her father who does not even talk to her and does not want her in the house once the baby is born. Her mother is more supportive but the situation has caused arguments at home. Erin wants the baby but does not want to live in the current atmosphere. The father of Erin’s baby has also decided that he cannot cope with the prospect of fatherhood at his age and has broken off their relationship. • Her midwife became concerned about her and has signposted the family to family counselling and mediation.

26. Erin – Universal Plus • After initial reluctance and much prompting, Erin’s father agreed to attend family mediation and has gradually became more reconciled to the situation. He still has strong feelings of concern about Erin’s situation but has decided that it is his place, along with his wife to support and accept her and the baby into the family home. • The family are now speaking again and although the father of the baby is no longer a significant presence; Erin is feeling much more supported by her own parents and feels more able to cope with her situation and to look forward to the birth of her baby. She is starting to attend classes again as she is very conscious that at some time in the future she will need to be independent of her parents and to support her baby on her own. • Although Erin’s situation is difficult it has improved significantly because her father has now revised his view and has decided to accept it. She therefore has strong family support.

27. Child at the Centre • General needs met • Right to a wide range of services Universal Need

28. Child at the Centre • Response required • Support offered Universal Plus

30. Kaneisha - 3yrs Old • Kaneisha aged 3½ yrs moved to the area 6 months ago. She is the youngest of 7 children. The oldest 2 boys are involved in some anti social behaviour and gang activity locally. • The mum, Sharon has registered all the children with the GP and the health visitor has visited the house because of the age of the 2 youngest children. She has urged Sharon to take Kaneisha to the doctor as she has severe asthma. • The new house appears damp, smells badly and there is mould on the walls. Sharon is very worried about how much worse it will be in winter. She is also very stressed as she has mounting debts because of borrowing from a doorstep lender. • A new nursery place has been found for Kaneisha but she does not regularly attend because of her health. She is due to start school soon and the nursery staff are very concerned that she will not establish a pattern of regular attendance. • The health visitor is concerned and has arranged for Kaneisha to be referred to the local Children’s Development Centre.

31. Kaneisha – Additional Needs • Kaneisha clearly has some additional needs notably health and school attendance. • Also the two older boys in the family have identified needs as does mum herself. • Support from several agencies will be needed to address these issues. • The most appropriate response would be multi agency support to engage with the family via the fCAF process.

32. Hassan - 9yrs Old • Father of the child, Mohammed, is a single parent following his wife leaving the family home 3 months ago. He is working but is struggling to keep his job and look after Hassan and his sibling, Aisha and get them to school. • Hassan is autistic and can exhibit some challenging behaviour at home and at school and this has worsened since his mother left the family home. • Mohammed does not find it easy to feed the children as he has never really learned to cook and look after the house so he and the children eat junk food. He has no family locally to help him out as they are all abroad. • He had found it very difficult to accept his wife’s departure and his mood is getting lower and he reports that he has started smoking khat. • The children’s attendance has suffered as it used to be excellent but they are often late for school and can look unkempt and scruffy. The children seem to have a loving relationship with their father.

33. Hassan - Additional Needs • It is clear that the family circumstances have undergone a significant change recently and Dad is clearly struggling to cope despite trying his best. • He and the children need some support from several agencies to help them so this is best coordinated by a family CAF assessment with support at additional needs. • Support is needed from Children’s and Adult agencies to support the family

34. Katerina - 15yrs Old • Katerina 15yrs, moved to the UK from Latvia 2 years ago with her parents. The parents are out all day working long hours in the hospitality industry so Katerina is often alone and unsupervised. • She has developed friendships with a group of local girls who hang round the local shopping centre and has started truanting from school. She has been picked up by the police for some petty shoplifting and they have been to see her parents to discuss her behaviour. • They were very shocked and tried to ground her but are not in often enough to enforce it. • Parents have noticed her behaviour has changed at home, she is dressing provocatively and has started smoking. School has also noticed that her attendance has deteriorated. • She is a bright girl but her school work has begun to suffer and her teachers suspect that she is drinking too. She was recently picked up by the police again in a big gang of girls and was found to be in possession of some cannabis. • Police will not be prosecuting her but will be issuing her with a formal caution.

35. Katerina – Additional Needs • Katerina undoubtedly has needs which need to be addressed but she is not yet at risk of significant harm. • A multi-agency response is required to bring together support for Katerina and her family. • She and her parents can be supported at additional needs by the Youth Offending Team and other agencies coordinated via a family CAF.

36. Callum & Declan - Early Support • Callum and Declan are twins aged 3 years. They live with their mother, Anne, in a private rented house that is very damp and needs many repairs. She has asked the landlord about repairs and his response is to threaten eviction. • Anne goes to her local Children’s Centre and speaks to the Family Support team. • Anne explains to the Family Support Worker that she is also very worried about the twins. She finds their behaviour hard to manage and she has asked the Health Visitor for advice. The Health Visitor has identified other developmental concerns relating to delayed communication and play skills, and referred both children to the Consultant Community Paediatrician. • Anne has taken the boys for their first appointment with the Paediatrician. The Paediatrician explained to Anne that she would like the boys to go the Child Development Centre for a multi-disciplinary assessment as she feels both boys may have autism. With Anne’s consent, she has also made a referral to the pre-school teaching and support services for children with special educational needs and/or disabilities (the Early Years Inclusion Support teams: the Early Support Service and Area SENCOs).

37. Callum & Declan - Early Support • Children’s needs are assessed as ‘Additional’. There are also wider family needs to consider a coordinated long term multi-agency plan is required. • Because of their age and disability an Early Support Family Service Plan is the appropriate assessment tool to use. • Early Support is the approach of choice for children with special educational needs and/or disabilities. Whereas the fCAF is intended to coordinate a short to medium term episode of support, Early Support is designed to provide children and their families with long-term coordinated support to meet their complex education, health and care needs. This includes addressing wider support needs a family may have. • The Early Support Family Service Plan is used as the boys may have autism and Anne feels she will need longer term support to help her understand and meet the additional needs of her children. The other needs she identifies relating to housing can also be addressed through this plan. • The Green Paper Support and Aspiration – a new approach to Special Educational Needs is leading towards a new Code of Practice for Special Educational Needs and legislation where, from September 2014, Statements of Educational Needs will be replaced by the Single Education, Health and Care Plans. Single Education, Health and Care Plans are based on the Early Support model. • Both the fCAF and the Early Support approach be able to support children and families appropriately as part of multi agency ‘team around the child/family’.

38. Child at the Centre • Coordinated response required • Multi-agency support offered • via fCAF Additional Need

40. Eve – 5 month Old • Eve is a 5 month old baby girl. At a recent baby check up, the Health Visitor notices that her mother, Clare, has a bruise to her head and asks Clare what happened. Clare explains that it was an accident; she has been stressed and had a row with her partner. He didn’t push her; she accidentally tripped and fell, hitting her head. This had never happened before. • At the next appointment, the Health Visitor notices grip bruises on Clare’s arms and is concerned about Clare. She refers her to a local Children’s centre so that Clare can get some support. • The Children’s centre staff develop a relationship with Clare and as she relaxes, she talks more about the circumstances at home; she describes her partner as a very lovely person who sometimes becomes volatile and insists that Eve is never in the room when these rows and incidents occur. • Some weeks later, Clare tells her sister about a near miss, she was holding Eve when she had an altercation with her partner and nearly dropped her. Eve was distressed and screaming. Her sister reports the incident to the Children’s centre.

41. Eve – Complex/Significant • The build up of evidence here suggests to the children’s centre worker that Eve is at risk of significant harm. • The children’s centre worker will make a referral to IASS using any supporting evidence such as a family CAF if one had been completed earlier.

42. Mickey – 7yrs Old • A mother who is a regular heroin user, has attended her first appointment with an intervention service. At the appointment she brought her child Mickey with her. • Mum’s lifestyle is chaotic and as a result both she and her child looked unkempt and dirty. Mickey has a rash on his arm that mum says has been there for weeks, but has not sought any medical advice. • It appears that there is a hand shaped bruise on his leg that mum can’t account for. • At the meeting Mum had a cup of coffee but Mickey ate all the biscuits and mum reported that money is tight and so the family aren’t eating much food.

43. Mickey – Complex/Significant Needs • It is clear there are concerns for Mickey, Mum’s initial engagement is encouraging and ongoing monitoring by the Substance Misuse Service is still required. • However there are several concerns about Mickey that require investigation. • His safety due to Mum’s substance misuse • His general appearance • His health needs • His access to suitable food • Mum’s chaotic lifestyle impacting on her parenting role • Mum’s substance misuse • A referral needs to be made to the Integrated Advice Support Service and consideration be given to an assessment taking place by a social worker. • Agencies will still need to work together to deliver a package of care to Mickey and his mother, but this will be coordinated through a statutory process with a specialist lead

44. Raj – 13yrs Old • Raj aged 13 has just changed schools and his parents are concerned that he is not making friends and not fitting in at his new school. • His parents raise this with the school and through discussions with them it becomes apparent that he is also isolated at home. An uncle, to whom he was very close, died recently and suddenly of leukaemia. • His school work deteriorates and there are attendance issues, the school finds out that he is not going off with his peers; instead he is hanging around quiet places by himself. He is caught trespassing on the nearby railway lines. • He then takes a significant overdose at home, is found quickly by his parents and rushed to hospital. When his computer is checked, his parents find articles and websites about suicide and a draft letter explaining why he had taken the overdose.

45. Raj – Complex/Significant • Raj’s attempted overdose and his emotional health are clearly an indication of complex and significant needs. So immediate and urgent support needs to be sought from the appropriate agency. • In the first instance this is provided by the local hospital with a referral to the CAMHS service. • Once this support is in place and Raj’s suicidal ideation is no longer a concern his family’s needs may be able to be met via a family CAF. • However, if further complex and significant needs become identified, may be identified particularly around the parent’s capacity to meet his needs and provide a safe environment he may need specialist social work support

47. Child at the Centre • Specialist response required • Multi-agency support offered • via specialist services Complex/Significant Need

48. Right Services Right Time Meeting Children’s Needs • Focused on NEED • Child at the Centre • Support offered to the family • Birmingham’s model • All agencies use same indicators

50. What Happens When you make A Referral? Children & Young Peoples: Information Advice Support Service What Constitutes A Good Referral Supporting Documents Download from www.lscbbirmingham.org.uk/