Supporting Families Pathway Toolkit Event November 22 nd 2012 Chris McLoughlin Service Director, Children’s Safeguarding & Prevention.

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 monitored2. 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 SkeltonGM 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 - Substance misuse – Mental wellbeing - Chronic limiting illness / disability– Low income - Poor educational attainment– Child safety issues - 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 Housing Probation Debt A&E GP

Child Psycholo

gyKITE COT Jigsaw

ASBAT GMP Victim crime Family B

Cprotection Hvisitor Snurse Substance Tier 2 HomelessSpecialist Health

Legal County Court

PRU SENSchool Action

+FIP MFH

Mother

CSCare CSCare CSCare CSCare Homeless CSCare CSCare CSCare Debt Debt Debt Debt Debt Cprotection CSCare CSCare Debt Tier 2 Tier 2 Debt CSCare CSCare CSCare CSCare CSCare CSCare GMP GMP CSCare Tier 2Specialist Health Tier 2 Tier 2 CSCare CSCare CSCare Substance

Housing CSCare Debt Substance Housing Debt CSCare CSCare CSCare CSCare CSCare Debt CSCare CSCare

Specialist Health

Legal County Court

Specialist Health

Debt Probation

Debt SubstanceSubstance Tier 2 CSCare DebtSpecialist Health

Debt Debt Cprotection Cprotection CSCare GMP GMP

CSCare Cprotection GMP Housing GMP

GMP GMP

GMP

victim victim GMP victimGMP

GMP

GMP

Year 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr3 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4

Partner 1CSCare CSCare CSCare CSCare Homeless CSCare CSCare Substance Substance Housing Substance Died

CSCare CSCare CSCare Substance Relationship endedCprotection

victim victim victim victim

Year 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr3 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4

Daughter 1

CSCare A&E A&E A&E Homeless CSCare CSCare CSCare CSCare CprotectionCprotectionCprotection CSCare CSCare CSCare CSCare CSCare Tier 2 CSCare

Child Psycholo

gy CSCare CSCare CSCare CSCare GMP Cprotection

Legal County Court

Legal County Court CSCare CSCare

Legal County Court CSCare CSCare Adult

A&E A&E CSCare A&E CSCare GMP CSCare GMP Hvisitor CSCare CSCare GMP CSCare CSCare CSCare

A&E A&E GMP Hvisitor CSCare CSCare

Specialist Health

CSCare CSCare GP Housing Cprotection victim

victim victim victim victim

Year 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr3 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4

Daughter 2

Born CSCare CprotectionCprotectionCprotection CSCare CSCare CSCare CSCare

Child Psycholo

gy Tier 2

Child Psycholo

gy

Child Psycholo

gy

Child Psycholo

gy Hvisitor GP CSCare GMP Cprotection

Legal County Court

Legal County Court CSCare CSCare

Legal County Court CSCare CSCare

GMP

Specialist Health

Child Psycholo

gy

Child Psycholo

gy CSCare

Child Psycholo

gy CSCare

Child Psycholo

gySpecialist Health GP CSCare GMP CSCare CSCare

SEN SENCSCare

CSCare

Child Psycholo

gy Hvisitor

Child Psycholo

gy GP CSCare

Specialist Health

Specialist Health

Housing CSCare CSCare CSCare GP Cprotection

CSCare

School Action Plus

victim

Year 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr3 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4

Partner 2Relationship started Substance Tier 2 GMP GMP

Tier 2Victim victim victim victim

Year 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr3 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4

Daughter 3

born Hvisitor CSCare CSCare CSCare CSCare CSCare

Child Psycholo

gy CSCare CSCare CSCare CSCare GMP Cprotection

Legal County Court

Legal County Court CSCare CSCare

Legal County Court CSCare A&E KITE

TAC level 3

School Action +

PRU PRU PRU

CSCare Hvisitor CSCare CSCare GMP CSCare CSCare KITE KITE 1x FTECOT

KITE 3 x FTETAC level 3

TAC level 3

Cprotection CSCare CSCare CSCareCOT

TAC level 3

ASBAT MFH

MFH MFH MFH MFH ASBAT MFH 2nd ABC ASBATMFH MFH ABC MFH MFH MFH

NACRO FIP MFH MFH MFH

MFH MFH MFH MFH MFH MFH

Year 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr3 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4

Son 1

born CSCare CSCare CSCare

Child Psycholo

gy CSCare CSCare CSCare CSCare GMP Cprotection

Legal County Court

Legal County Court CSCare

Specialist Health

Legal County Court CSCare CSCare

School Action +

KITE KITE KITE

CSCare CSCare CSCare GMP CSCare CSCare

School Action + CSCare

KITETAC level 3

COT COT

Cprotection CSCare

School Action +

CSCare

TAC level 3

victim Jigsaw

victim

Year 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr3 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4 qtr 1-2 qtr 3-4

Children’s ProbationRSL / ALMO NHS Commissioners

Colleges

Social Care

Mental Health

JCP Foundation Trust

Schools

Police

MoJ / CJS

Partnership Working

Government expectations-evaluation 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

The new NHS in England

& Workforce is the key

Gillian McLauchlanGreater Manchester Public Health workforce

[email protected]

Implications of the Health and Social Care Act

Structure Accountabilities

The pivotal role of workforce Who they are? Develop and support

2 Themes

Better Care

Better Treatment

No decision about me without me

Clinicians at the heart

Health and Social Act 2012

The NHS before the reforms

New structure

New arrangements

Currently state of flux

Data

Health and Wellbeing Board

Health - part of Local Authority functions

Implications

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

The critical role of the Workforce

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

Develop and Support the workforce