'Passionate leadership and fewer targets' key to early help success
Gabriella Jozwiak and Joanne Parkes
Wednesday, March 20, 2019
Passionate leadership, a clear vision, and a small number of focused targets are among 16 "key enablers" identified by research looking at what makes an early help offer successful.
The advice for councils and partnership services is intended to help them make the most of resources amid increasing funding pressures and demand for children's services.
The Local Government Association (LGA) commissioned public sector researchers Isos Partnership to carry out the study, which looked in-depth at eight local areas' early help offers.
The study set out to evaluate the combined impact of councils' different measures, rather than individual ones - as is claimed to be the case with existing research - after a report by influencial charity the Early Intervention Foundation called for a new approach.
"It is therefore the aim of this research to make a contribution to addressing this gap in the collective understanding of system-level approaches to the design and delivery of early help," the report states.
It worked with areas which have developed "integrated and established partnership-based early help offers", aiming to:
Develop a clearer understanding of what is meant by a "local early help offer", identify the key enablers which support the systematic development of partnership-based early help offers at the local level, and consider some of the issues that local areas will need to address in developing their early help offers in the future/
"It is hoped that the findings of this report will be of use to local areas as they look to develop their approaches to early help, particularly in the context of increasing pressure on resources and increasing demand for children's services," the report states.
While the chosen offers were all different, researchers identified 16 "key enablers" which they shared in common for establishing an effective programme.
The researchers pointed to the importance of creating a core team, empowering and enabling partners, harnessing the power of communities, and developing a coherent offer around a place.
This involved local authorities making use of existing physical assets, such as children's centres, within communities.
"Organising teams either physically, or virtually, around a place can bear dividends not just in the interactions between different professionals, but also in the depth of community knowledge that those individuals begin to develop and create around the needs of the place in which they work," the report advised.
When working with families, the report recommended establishing a "safe and effective front door, focusing on the needs of the family as a whole, developing a practice model based on evidence, and promoting resilience and being responsive.
And when evaluating impact and quality of early interventions, the LGA said authorities should develop and effective management and information system, have auditing and quality assurance practice in place, be clear about the desired impact, and put in place proportionate and informative reporting.
The LGA chose Barking and Dagenham, Greenwich, Kent, Lincolnshire, Oldham, Southend, West Sussex and Wigan local authorities, because their approaches are "interesting and innovative".
In addition, they all have areas of high and low deprivation, urban and rural communities, and differing levels and types of underlying need.
What the research found at some of the areas:
Barking and Dagenham
The offer is embedded within and largely delivered through the Community Solutions directorate, which brings together 16 services including the front door to adults and children's social care, housing, anti-social behaviour, libraries, children's centres, troubled families, targeted youth services and work and skills.
Referrals are considered at a daily multi-agency meeting, at which point families are assigned to one of five ‘life-cycles', which are: Universal, Triage, Support, Intervention, and Work and skills, or to children's social care.
Families assigned to ‘support' or ‘intervention' will be given a key worker or lead professional who will carry out an assessment and develop a support plan with the family.
The intervention service works with families with wide-ranging needs, including those who meet the Troubled Families criteria, homelessness and families negatively impacted by Universal Credit.
On average, around 110 early help assessments are initiated each quarter, although that number has been rising with 141 assessments in the most recent quarter. The large majority of these (over 80 per cent) were initiated by the local authority, with around 16 per cent initiated by schools.
After cases are allocated to a worker, they are kept open until there is confidence that the family has made significant and sustained progress.
In general, families are now being held in early help longer than they had been previously, meaning that fewer families are returning after cases had been closed.
This is also enabling early help to better control the flow of new cases into children's social care.
Staff in early help receive the same training as qualified social workers where appropriate and also receive case supervision by social workers on higher cases, so are confident in managing risk.
Lincolnshire
The area aims to put early help at the forefront of the mind of all staff - referring to it as "everybody's business".
The emphasis is on there being a team-around-the-child (TAC), with the "right person providing the right support at the right time".
Among its aims are ensuring high quality, strengths-based multi-agency working to achieve lasting outcomes for children and families.
The role of lead professionals is central: at any one time, around 80 per cent of around 2,500 TAC cases are held by lead practitioners who work in other services.
Around 70 per cent of these cases are held by lead practitioners in schools, demonstrating a distinctive feature of the approach, that early help be seen as part of a broader offer and a wider system.
The local authority early help service itself, operates on a locality basis in four quadrants:
One or two early help teams for each district, making up a total of seven. Children's social care and 0-19 health services are organised on the same geographical basis, enabling stronger partnership working at locality level, and a relationship-based practice model is used.
Within each locality, there are around 50-75 early help professionals, dependent upon need.
Early help workers come from a wide range of professional backgrounds, within and beyond children's services.
All receive core training to be able to provide a wide range of advice and
help to the families and lead practitioners they may be supporting.
Each locality has two early help consultants (funded by the local authority and schools forum), whose role is around case supervision for schools, support and challenge to all lead professionals, quality assurance of TAC cases, and the facilitation of multi-agency learning opportunities.
The role of 0-19 health workers, who are based in each locality combines what was previously the role of health visitors and school nurses
and has been repurposed to focus on ensuring younger children are ready for and make a successful transition to school, as well as providing a more holistic approach to health and wellbeing support for young people throughout the childhood.
Each locality also has two improving access to psychological therapies practitioners - a role developed in partnership Clinical Commissioning Groups and schools.
The focus of the role is providing targeted support and building skills within universal services around social, emotional and mental health needs that may fall between pastoral support and more specialist CAMHS support.
Working in partnership between the local authority, schools, health services and the police has been central to the vision for early help, and specifically in ensuring professionals in those services feel confident in initiating conversations and accessing the right support for children and families. The overall leadership and oversight of the early help offer LSCB.
Oldham
Investment in the the early help offer came in response to a realisation that families with complex needs were not well-served.
A "deep dive" exercise identified a number of families who were accessing a variety of support services, without any one intervention making a lasting difference.
A new model of early help was developed, based around three tiers of support.
A unique feature is that early help is an all-age offer, for both children and adults.
Intensive support is provided by an in-house council service which supports around 230 households per year. It employs 15 staff, each with caseloads of around seven to eight families, who are worked with intensively over around six months.
There are also specialist advisers offering support on domestic
violence and honour-based violence.
Medium-level support is provided by charitable trust Positive Steps, which is based in Oldham and was commissioned to deliver part of the borough's offer.
It does so through three teams that operate within Oldham, each with has a team manager, a senior engagement worker, and eight engagement workers.
These each have caseloads of around 20 families, supporting between 400 and 500 families at any given time, and a total of 4,000 individuals annually. Families are supported for an average three months.
Low-level support is also provided by Positive Steps through the same structure as the medium level, but may consist of information or advice for a person or family and over a shorter period of time.
All Early Help staff are trained in a range of engagement techniques and evidence-based interventions, so that they are equipped to provide holistic support to families, which includes building rapport and trusted relationships that allow both challenge and support.
The success of this approach was demonstrated within early troubled families work, in which 96 per cent of all families - many of
whom had previously been considered ‘difficult to work with' - were engaged.
A current focus is on forming a continuum of support with social care services.
This is linked to implementation of a place-based "Oldham Family Connect" model, with plans to engage closely with schools, as well as strengthening joint working with local partners such as health services and the police, together with the wider range of community services.
Renewing partnership governance is also a key focus of its January 2019 Children and Young People's Board relaunch.
Greenwich
Early help focuses on providing support at two distinct levels. Leaders wanted to make clear the unique role of "intensive" early help, which
supports several inter-related needs, and is distinguished from "additional" support that may involve a single issue/service.
In November 2017, Greenwich restructured its offer, after recognising gaps in support for children and families, such as focusing on a single need, rather than a holistic approach to the family.
It now aims to provide intensive and holistic support to families as well as meet needs early to prevent escalation and the need for specialist/statutory intervention.
The offer is divided into two levels:
The area is moving to deliver "Connect", which aims to "nip issues in the bud", on a unit basis, with two units operating across the borough.
Each unit will have a team leader and three practitioners, each holding 15 to 20 cases. An integrated approach will draw on information, advice and support from a range of universal and targeted services, including the Family Information Service, the Special Educational Needs and Disability Information, Advice and Support Service, youth services, employment services and the Community Interventions Team.
The next "Core" level, provides more intensive, and generally long-term work via eight units across the borough.
Most families are supported for between three and six months, depending on need.
Each unit is made up of three youth and family practitioners, one senior practitioner, one unit leader, and a unit coordinator.
The unit-based approach is based on a "team around the professional", with staff trained to provide a range of support, including restorative family therapy and supporting those who have experienced trauma, so that they can work directly with families, rather than having to refer to multiple other services.
In total, the core and connect units employ 48 staff and support between 950 and 1000 families at any given time.
The work of these units sits within a wider offer of early help, which is delivered through a broad range of partner organisations.
This includes schools and settings, the police, public health, local health
services, and a broad range of voluntary and community sector partners including Charlton Athletic Football Club.
The overall early help offer is overseen by the London Safeguarding Children Board (LSCB), supported by an Early Help Partnership Group.
