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Integrated Family Support Services: A Catalyst for Change in the Provision of Family Focused Services in Wales Neelam Bhardwaja, President, ADSS Cymru Andrew Figiel, Joint Policy Lead, Older People, PSI and Health, ADSS Cymru. Aims of the Workshop.
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Integrated Family Support Services:A Catalyst for Change in the Provision of Family Focused Services in WalesNeelam Bhardwaja, President, ADSS CymruAndrew Figiel, Joint Policy Lead, Older People, PSI and Health, ADSS Cymru
Aims of the Workshop • Outline the background to the Integrated Family Support Service (IFSS) Programme. • Provide some context to the three pioneer areas currently implementing the IFSS model in Wales. • Discuss some of the emerging issues arising from the work of the pioneer areas. • Offer you the opportunity to discuss and explore: • Would a model like IFSS work in your country / area? • Are there other good practice models that could be used to respond to the complex family issues that IFSS is designed to respond to?
The IFSS Model • A new way of working not just a new service – cultural and systemic changes • Reform and invigorate health and social services delivery for vulnerable children and their families in Wales. • Principle of safeguarding children paramount to the model. • Focus on helping high need families where there is evidence of parental substance misuse combined with an increased risk to the child. • IFST’s – multiagency teams • Long term aim – roll out to families where there is domestic abuse, mental illness and/or learning disabilities.
Policy Mandate for Change • Restating our values on the importance of families. • Applying Welsh solutions to local circumstances. • Supportive environment for change where managed risk is the norm. • National approach to transform services that enhance the wellbeing of children and families. • Focus on Outcomes as opposed to Outputs. • Core challenges remain; increased demand for services, financial squeeze, need for modern services that are effective, efficient, citizen centred, meet increased expectations.
Aims of the IFSS Programme • To create a positive change in the way families function, enabling children to remain safely at home wherever possible. • To improve the quality of service experience (and outcomes) for children and families when they meet professionals. • Address concerns that existing services don’t meet needs of most complex families. • Improve safeguards through earlier decision of child’s future • To bridge the gap between adult and children’s social services.
Aims of the IFSS Programme • Strengthen collaborative working across Health and Local Government as well as the third sector. • Influence and support practise in the wider workforce – build capacity within the workforce when dealing with complex families.
Family Focussed ServicesIntegrating Health and Social Care Children’s Services AdultServices Transparent Intensive Family Service Build on strengths Engage, build trust, Enhance motivation
IFSS: Multi-Resourced Team • Adult & Child Social Workers • Health Visitors • Community Psychiatric/Nurses • Substance Misuse Specialists • Social work assistants/family support workers
A Skilled & Focused Workforce A ‘Learning Team’ removing barriers to information sharing between adults and children’s services and between health and social care. Sharing: • Ideology • Skills & models • Systems & procedures Having: • Increased autonomy & accountability
IFSS Governance Board • Multi agency strategic partnership acting as the governing body. • A Welsh Assembly Government requirement for the IFSS. • Has responsibility for the governance of IFSS and other family support services. • Has power and responsibility to influence change in the service environment.
Anticipated Outcomes of IFSS • Fewer children on the child protection register. • Fast tracking of cases where change is not achievable in a timescale suitable for the child. • More children are able to stay at home and be safe in families that have been considered very vulnerable. • Fewer children looked after. • Fewer children acting as young carers. • Fewer relapses and fewer crises in children’s lives • Greater success in establishing and maintaining ‘safe enough’ parenting with improvements in home routines. • Improvements of parenting capacity to be sustained.
The Pioneer Areas • Three pioneer areas in Wales: • Wrexham • Newport • Rhondda Cynon Taff / Merthyr Tydfil (as consortia) • Pioneer areas launched spring 2010. • Testing and adapting legislation. • Sharing ideas and good practice. • Opportunity to influence the direction of legislative change. • £600k funding per year to each pioneer area for a period of 3 years. • Full implementation of IFSS over 2013 – 2015.
Wales UK
Wrexham • Population of approx. 130,000 (at 2001 census). • Worklessness disproportionately affects children with 18% of children in Wrexham living in families where no-one works. • Local concentrations of families facing complex difficulties linked to deprivation. • Wrexham is the 7th highest in Wales for drug referrals through the Community Safety Partnerships. • Wrexham has the highest rate in Wales of women admitted to hospital for drug related conditions. • 2000 estimated number of problematic drug users: heroine remains the main drug of choice. • Alcohol is seen by all service providers as a major issue - estimated 4,368 dependent drinkers. • Substance misuse was the pre-dominant factor in children entering the care system and in approx. 34% of all cases on the Child Protection register. • Parental substance misuse also featured in approx. 82 of 348 child in need cases (08/09).
Newport • Increased incidence of substance misuse and domestic violence typical of inner city environment (population 137,000 at 2001 census). • At May 30th 2009, 228 children identified as being affected by parental substance misuse and another 120 affected by parental mental health problems. • The number of Children and Families cases being dealt with per year where parental substance misuse, mental health or domestic abuse is an issue far exceeds 100 cases. • Increased instance of co-occurrence of substance misuse with mental health and/or domestic abuse impacting on parenting capacity. • At May 30th 2009, 61 children were in the Care System due to parental substance misuse and 39 due to parental mental health. • Newport looking to use IFSS to reshape its family support services.
Merthyr Tydfil / RCT • Areas categorised by high levels of social and economic deprivation - sets a challenging context for local services (population 287,927 at 2001 Census). • Substance misuse (drug and alcohol) is a significant local issue impacting on the lives of children and young people: • Substance misuse has become an inter-generational issue. • Highest amount of alcohol related deaths in Wales • Predominant co-occurrence of substance misuse with mental health and/or domestic abuse impacting on parenting capacity = complex needs. • RCT – substance misuse present in • 37% of Children in Need cases (2007 – 2009) • 41% of Requests for Placements (2007 – 2008) • 61% of Care Orders (2007/2008) • RCT – 138 families with substance misuse issues referred for support 2008/2009. • Merthyr Tydfil – 51% of children on the child protection register (Jan 09) lived with parents where there were serious concerns over parental substance misuse.
Operational • Where IFSS sits and its relationship with existing services and practice - communicating the IFSS message to other teams. • Engaging with hard to reach clients. • Recruitment difficulties. • Inspection framework. • Budget management. • Long term funding – sustainability of the model. • Physical location of the IFST. • Untested model in rural areas.
Governance • Prescriptive regulations, processes and procedures put in place by IFSS. • Finding the right level of involvement and lead from the local IFSS Boards.
Discussion Questions • How do the demographic, cultural and wellbeing challenges of the IFSS pioneer areas compare to those in your country/area? (15 minutes) • Would a programme like IFSS work in your country/area? (15 minutes) • Discuss and identify 1 model of good practice per group that responds to the challenges in the IFSS pioneer areas.(15 minutes)
Useful Information Links • www.adsscymru.org.uk • http://wales.gov.uk/topics/childrenyoungpeople/parenting/help/ifst/?lang=en • http://www.ssiacymru.org.uk • http://www.rip.org.uk