Think Family: Strengthening collaborative working between families Caroline Prichard and Lia Borgese Department for Children, Schools and Families.

Think Family: Strengthening collaborative working between families

Caroline Prichard and Lia Borgese Department for Children, Schools

and Families

Developing the potential of parenting and family support to improve child outcomes

• We know that evidence based parenting programmes work and have lasting effects in improving behaviour even in cases where parents are initially reluctant to receive help.

• A review of evidence based parenting programmes by the National Institute of Clinical Excellence shows significant long term effects in improving children’s behaviour (of between 1-10 years).

• Despite this:

• Problems with supply and availability

• Agencies don’t refer

• Or don’t refer early enough

• Targeting & reach

• Issues about quality of practice

So what are we doing to expand parenting and family

support?

Three main strands of activity: • Supporting local authorities to develop parenting support • Developing the workforce • Increasing targeted provision

Supporting local authorities

• In 2006 LAs asked to appoint single commissioners of parenting support and to develop a parenting strategy by March 08

• Majority of LAs have strategies in place and are now moving to an implementation phase

• Parenting Implementation Project to test effective practice in developing parenting strategies to develop a national framework for all LAs

Supporting the workforce

• The National Academy for Parenting Practitioners

• Mission - To transform the quality and size of the parenting workforce across England so that parents can get the help they need to raise their children well

• Training in evidence based programmes & skills needed to work with parents – training starts this month

• Provide ongoing support to practitioners; through individual and group consultancy and online services.

• Developing the evidence base

• Plus feeding into wider workforce development e.g. Children’s Workforce Strategy for 2020

Increasing parenting and family support services across a spectrum of need

• Parenting Early Intervention Programme

• Parenting Experts

• FamilyPathfinders

• Family Intervention projects

Parenting programmes Whole Family Support High

Needs

Increasing needs

Early signs of risk

Of course some families need more than help with parenting and this needs to be one element of ‘whole family’ support

But of course some families need more than just parenting support …

Rather than waiting for the first signs of risk to emerge in children, we could do more to predict future risk by picking up signals from the family as well as a child

Too often parent’s pass their own problems onto their children, creating a never-ending cycle, generation after generation which becomes difficult to break. We are still not doing enough to interrupt inter-generational patterns of social exclusion.

• 63% of boys with convicted fathers go on to be convicted themselves

• Parental alcohol misuse is a factor in more than 50% of child protection cases (and there are 350,000 children with drug addicted parents/ 1m with alcohol addicted parents)

• 1:4 children witnessing domestic violence have serious social and behavioural problems

• Children from the 5% most disadvantaged households are more than 50 times more likely to have multiple problems at age 30 than those from the top 50% of households

Such as the 2% or 140,000 families with children experiencing 5 or more disadvantages

%

Basket of indicators of disadvantages includes:

• No parent in the family is in work

• Family lives in poor quality or overcrowded housing

• No parent has any qualifications

• Mother has mental health problems

• At least one parent has a long-standing limiting illness, disability or infirmity

• Family has low income (below 60% median)

• Family cannot afford a number of food and clothing items

Percentage of families with children experiencing 5 or more disadvantages

2.2 2.1 2 1.9 2

2001 2002 2003 2004 2005

The consistency of this figure over 2001 to 2004 suggests that improvements

such as the reduction in child poverty may not be reaching such families

Multiple disadvantage can cast a long shadow

2.81.4

6.5

1

4.9 5.44.5 4.3

8.1

2.9

7.78.9

6.27.3

9.7

5.6

7.5

11.910.4 11.1

12.5

10.2

16.318

02468

101214161820

Well belowaverage at English

(2005)

Child suspendedor excluded in last

year (2005)

Not seen friends inlast week andnever goes to

organised socialactivities (2004)

In trouble withpolice in last year

(2005)

Child spent lessthan an hour on

physical activity inlast week (2005)

Child admitsrunning away fromhome before (2004)

None 1 or 2 3 or 4 5 or more family disadvantages

Time to ‘Think Family’ ?

• Developed by the Social Exclusion Taskforce in their Families at Risk Review

• Reaching out: Think Family (June 2007)

• Think Family – Improving the life chances of Families at Risk (Jan 2008)

• Currently being tested by 15 Family Pathfinders

• Funding to help every Local authority develop the model from 2009 -10

“Every Child Matters is already transforming the way services are delivered for 0-19 year olds. ‘Think Family’ extends this model to

include adults’ services and puts families firmly at the centre”

What is ‘Think Family’

Systems change

• Changes to delivery systems and workforce culture to ensure consideration of the family context to need

• Critical to earlier and more effective intervention with families at risk

• 15 Family Pathfinders testing how this might be implemented

Whole family support

• Need for more provision to deal with risk in families and how it inter-relates

• Whole family support available at different levels

• Including very intensive support (building on the FIP model) for the most risky families

This extended the logic of collaboration from ECM to beyond children’s services

• Better co-ordination of all services to support families at risk

Improving the response of services and systems to vulnerable families

Identification Better systems for identifying and engaging families at risk (those with multiple and complex problems putting their children at risk of poor outcomes)

Whole family assessment

Building on the CAF, which looks at the needs, strengths and interrelation of problems of the whole family

Multi agency support plan

Managed by lead workers who case work families, working directly with them and co-ordinating other service involvement

Improved information sharing To enable early identification and interventions

Joined up planning & commissioning

To ensure the full range of evidence based programmes and interventions to meet family needs

Integration between adult and children’s services

At all levels of local services – such as clear accountability for families through joined-up governance to and a common vision and agreed outcomes for families across services as part of the LAA process.

The ECM Framework ‘Think Family’

Integrated front-line delivery

• Multi disciplinary teams: ‘team around the child’

• Lead professionals

• ‘Team around the family’

• Lead worker for the family to coordinate multi-agency plan

Integrated processes

• Information sharing across local children's services

• Common Assessment Framework

• Information sharing across children’s and adults services about family needs

• Whole family assessment

Integrated strategy

Single Children & Young People’s Plan

Pooled budgets to support joint commissioning of services for children

Single outcome framework C&YP

• C&YP and Parenting Strategy includes the contribution of adults’ services to family wellbeing

• Common vision and agreed outcomes for families

• Pooled budgets to support joint commissioning of services for families

Inter-agency governance

Director and lead member for Children’s services

Duty to create LSCB

• Nominated senior lead to ensure clear accountability for outcomes for families

• Strategic leadership of TF (on CT board?)

Think Family needs to be part of the next phase of ECM reform

Family Intervention Projects (FIPs)

A dedicated key worker with low caseloads who works intensively with the whole family.

Taking a whole family perspective to assessment and the development of support packages.

Use of a contract setting out the changes that are expected, the support that will be provided (building on strengths) and possible consequences if changes are not made.

The use of persistent and assertive working methods. Effective multi agency arrangements (referrals panel, information

sharing, agreeing the objectives of intervention etc). Accredited parenting programmes are delivered and services (such as

health) are brought in and coordinated around the family. Nominated health professional (NHP), to signpost and make appropriate

referral to health services.

Recent evaluation shows the effectiveness of the model in tackling risk factors in families

72%

65%

65%

26%

22%

20%

45%

51%

31%

10%

8%

9%

Education

Health

Poor parenting

Family breakdown

Domestic violence

Child protection issues

Start End

Base: Families who completed the intervention (337)

Expansion of Family Intervention Projects (FIPs) to reach 20,000 families by 2011

65 Projects aimed at families involved in persistent ASB

2008 budget announced new projects aimed at tackling child poverty and inter generational worklessness.

Youth Crime Action Plan announced projects to target families with C&YP at risk of offending in every local authority

2008-09: 30 new projects National roll out over 09 -11

0

50

100

150

200

250

300

2006-07 2007-08 2008-09 2010-11

Number of Family Intervention Projects 2006-11

Expansion of Family Intervention Projects to reach 20,000 families by 2011

“Child Poverty FIPS”

Announced in 2008 budget 2008-09: 10 projects started in October 2008 Further expansion over 09 -11 (around 32 in total)

New Models

Testing the model with families with multiple problems other than anti- social behaviour e.g. intergenerational poverty & worklessness, substance misuse etc

“Crime prevention FIPS”

§ Announced in Youth Crime Action Plan

§ A project in every local authority § 2008-09: 20 projects to start in January 2009.§ National roll out over 09 -11

Focus on specific types of risk in families e.g. prolific parental offending, domestic violence etc

Focus on specific age bands of children e.g. 0-5, 5-10, or 10+

In time the various ‘FIP variants’ may merge into joined up intensive whole family support for families at risk

80% of parents had poor health/mental health problems

47% of families affected by domestic violence, high number of children at risk

High proportion of children with ADHD, emotional & other problems

Over 50% of the children are obese and overweight, with very poor nutrition

Role of the Nominated Health Professional - where health works well Participation on steering group and multi-agency panel;

Effective communication between agencies & whole family assessment, including age appropriate children’s services;

Links into teenage pregnancy, DAT, school nurses, GPs, psychologists, paediatricians, CAHMS and health visitors which help to create networks, nutrition and obesity prevention.

Knowledge of commissioning and levers

FIPs-health impact in families

Where do we need to get to?

Joined up Family Intervention Project type provision sufficient to meet the needs of the most extreme families (whatever their combinations of problems)

Changes in attitudes, culture and behaviour at local level and on the front line (achieved by ‘Think Family’, workforce reform and Children's Trusts) to identify and intervene early with all families at risk

High

A integrated and appropriate service response to all families at risk

However – need to be realistic. This is a massive change process that will take significant investment and time to deliver. But the potential gains are huge

How will this be achieved ?

Medium

Low