Integrated Practice Working together to improve outcomes for children and young people

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Integrated PracticeWorking together to improve
outcomes for children and young people

• TRAINING IN THE USE OF THE
• COMMON ASSESSMENT FRAMEWORK AND
• ROLE OF THE LEAD PROFESSIONAL

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What is Integrated Practice?

• New ways of working which provide common methods
  of sharing information, assessing needs, and
  supports and encourages working together.
• Aims to improve outcomes for ALL children and
  young people in Sheffield, and strengthen
  protection for the most vulnerable.
• CAF, Lead Professional and SafetyNET - key tools
  developed to support integrated practice.
• Building on a long tradition of collaborative
  working in Sheffield and part of wider programme
  of change.

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The Need For Change

• WHATS THE PROBLEM WE ARE TRYING TO SOLVE?

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The Problem is ..
All Other Agencies
Universal Education
LEA special educational needs
EWS
Connexions
CAMHS
YOT
Universal Healthcare
Social Services
PCT
All Other Practitioners
Healthcare Staff
Youth Offending Team
Child Psychologist
Connexions PA
Educ. Welfare Officers
SENCO Educational psychologists
Socialworkers
Health Visitor
Education Staff
Conduct Disorder
Statement of SEN
Children in Need
At Risk Register
ASSET
APIR
Family Health
agency
practitioner
assessment
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The Solution
Integrated practice focused on Information
Sharing Assessment
Outcomes for children yp
Families Community

• Outcomes
• Be healthy
• Stay safe
• Enjoy and achieve
• Make a positive contribution
• Economic well-being

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Legal Context

• The Children Act 2004 provides the legislative
  framework for the changes outlined in Every
  Child Matters
• The Act also places a requirement on the local
  authority and key partners to co-operate to
  improve well-being of children and to make
  arrangements to safeguard and promote the
  welfare of children
• Adopting integrated practice helps agencies
  fulfil this requirement

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INFORMATION SHARINGImprovements to the way
information is exchanged within and between
agencies are imperative if children are to be
adequately safeguarded.Lord Laming
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Information Sharing

• Key to success of integrated practice is the
  sharing of information
• Key to information sharing is consent
• Key to obtaining consent is explanation at the
  outset get children/young people/families on
  board

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Agency Responsibilities

• Every organisation should already have
  information sharing protocols in place
• Agencies need to consider these in the light of
  current climate and the move towards integrated
  practice
• Memorandum of Understanding every childrens
  service agency in Sheffield is committed to the
  appropriate sharing of information and
  providing clear guidance and advice for staff

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Sharing Information without Consent

• Key factor proportionality
• -would failing to share information be more
  harmful for the child or young person, than
  sharing information without consent?
• The legal basis for sharing information to
  safeguard and promote the welfare of children is
  provided in Sections 10 and 11 of the Children
  Act 2004.

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From Every Child Matters

• Enquiries into child deaths reveal common
  threads,which have led to a failure to intervene
  early enough
• Poor communication
• A failure to share information
• Absence of anyone with a strong sense of
  accountability
• Frontline workers trying to cope with staff
  vacancies, poor management, and a lack of
  effective training

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The Legal Position

• There is nothing currently in the law Data
  Protection, Human Rights Act, personal liability,
  common law duty of confidence or others that
  stops practitioners doing the right thing. The
  well-being of the child and professional
  judgement should at all times drive the decision
  to share information.
• 
  DFES April 07

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In future

• Families/children/young people are on board and
  are willing to have information shared to get the
  best possible service
• Practitioners will seek to obtain what other
  information is out there holistic picture
• When approached by other agencies, practitioners
  will share information in the best interests of
  the child

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Information Sharing Quiz

• Does consent need to be in writing?
• Is it appropriate to share opinions as well as
  facts?
• At what age can a young person give consent to
  information being shared about them?
• The Data Protection Act 1998 prevents information
  from being shared. True or False?

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COMMON ASSESSMENT FRAMEWORK

• A common process, a standard form, a shared
  understanding

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Common Assessment Framework

• What is the CAF and how does it help?
• Who will complete the CAF?
• When will the CAF be completed?
• How do I do it?
• What do I do when Ive done one?

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What is it and how does it help?

• A common approach to conducting an assessment of
  the needs of a child, unborn baby or young
  person.
• One form used by everyone
• Holistic - covers all needs and strengths
• Not agency specific
• Supports early identification of need
• Prevention not cure
• Stimulates multi-agency activity to support need
• Building a team around the child

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• Improves joint working and communication by
  helping to embed a common language.
• Easily understood
• Practical tool for sharing information across
  agencies - reducing the number and duration of
  assessments.
• Information sharing tool
• Improves quality and consistency of referrals -
  evidence based, reflecting full picture of a
  childs needs.

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Who Will Complete the CAF?

• Developed for use by practitioners across ALL
  childrens service agencies statutory or
  voluntary.
• Every agency will identify some staff to complete
  common assessments.
• These practitioners will have the skills and
  knowledge required to complete assessments.
• Every practitioner in Childrens Services should
• Know about the CAF.
• Know how to complete/how to get one completed.
• CAF not intended to replace specialist
  assessments.

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When Will the CAF Be Completed?

• Not with every child/young person you work with!
• No blanket threshold at which a common assessment
  should be completed.
• Requires professional judgement in the light of
  local/agency policy and practice.

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Tiered Model of Need

UNIVERSAL SERVICES
e.g. mainstream school, primary healthcare,
hospitals, youth services, Connexions, etc
TIER 1
SafetyNET CAF
ADDITIONAL SUPPORT
e.g. Homestart, Surestart, Health Visitor,
Learning Mentor, Tier 2 Family Support, Domestic
Violence Drug Projects, Tier 2 CAMHS, Education
Welfare, disability etc
TIER 2
SPECIALIST SUPPORT
e.g. Tier 3 CAMHS, Children in Need, Child
Protection Social Work, Disability, Education
Psychology, Tier 3 Family Support, etc
TIER 3
CARE AWAY FROM HOME
TIER 4
e.g. Looked After Children, Adoption, etc
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When to complete a CAF

• Common assessment is
• likely to be helpful when
• There are concerns about progress
• Needs are unclear.
• Support of more than one agency is needed.
• It would be helpful in engaging support of other
  agencies.

• Common assessment
• need not be done when
• Progress is satisfactory
• Needs have been identified and are being met
• Needs are clear and can be met by the family or
  by the assessing agency

IF AT ANY TIME THERE ARE CHILD PROTECTION
CONCERNS THEN FOLLOW SSCB PROCEDURES WITHOUT DELAY
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Integrated Induction training
The CAF process 3 key steps
Learning Mentors
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CAF assessment domains (similar to Framework for
Assessment of Children in Need their Families
2001)
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Exercise One

• Aim - to understand when it might be helpful to
  complete a common assessment

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What makes a good CAF?

• See the headings as prompts dont slavishly fill
  in every box if no information available or no
  concerns, say so to show its not been
  overlooked.
• Evidence your concerns if Mum struggling to
  cope say why.
• Distinguish between fact, observation, allegation
  and opinion
• Complete CAF in partnership with parent/child/YP
  no blame culture this is about supporting
  families.
• Write clearly common sense, but not common!

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What makes a good CAF contd

• Safeguarding is everybodys business what can
  you do? Exhaust available resources first
• Include a clear summary and plan of action
• Be clear about what service/support is being
  requested
• Service Directory of resources will be available
  early 2008
• Be clear about what has already been done by your
  own and other agencies particularly if making a
  referral to Social Care .
• Remember- the CAF is an assessment process-not
  just a form to fill in!

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And Finally

• Record that a CAF has been completed
• on SafetyNET if no one knows its out there
  we cant share!
• If you cant access SafetyNET ring the team and
  we can log it for you
• Agencies need to develop their own policies and
  procedures around storage,retrieval etc
• National eCAF process is being developed which
  will simplify the process (available 09)

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LEAD PROFESSIONAL

• Children and young people with additional needs
  who require support from a number of
  practitioners, will receive coherent and
  coordinated support through the input of one
  practitioner acting in a lead role

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What is a Lead Professional?

• When support from more than one practitioner
  is required a lead professional will be
  identified to
• Act as the main point of contact for the
  child/young person and family
• Co-ordinate the delivery of actions that have
  been agreed by the practitioners involved
• Reduce overlap and inconsistency in the services
  received
• Aim-to provide a better experience and better
  outcomes for the children, young people and their
  families who are involved with a range of
  agencies

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What Will The Lead Professional Do?

• Key tasks
• Build a good and trusting relationship with the
  child/YP and family and be the main point of
  contact
• Undertake an assessment if one does not already
  exist
• Identify other practitioners/services that need
  to be involved and secure their support
• Co-ordinate multiagency meetings
• Ensure that the needs of the child/young
  person/family remain central, are involved in
  meetings as appropriate and are kept informed of
  decisions made
• Monitor progress and co-ordinate review meetings
• Agree and implement a clear exit strategy or
  manage the handover

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Selecting a Lead Professional

• Many practitioners in the childrens workforce
  could take on the lead professional role
• Role defined by the functions and skills
  needed,not by particular professional or
  practitioner groupings
• Most relevant practitioner will be chosen through
  a process of discussion taking into account
• Existing practitioner relationships with
  child/family
• Needs of the child/young person and agency
  responsibilities for meeting needs
• Skills, knowledge and competencies of
  practitioners
• Not necessarily the first person involved or
  the person who undertook the CAF !

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Key Accountabilities

• The lead professional is accountable to their
  home agency for delivery of their part of the
  action plan.
• The lead professional is not responsible or
  accountable for services delivered (or not!) by
  other agencies
• The lead professional is responsible for
  gathering people together to review progress -
  but it is up to individuals to deliver on their
  agreed actions
• Where failure to deliver agreed actions cannot be
  resolved at practitioner level the matter should
  be referred via their line manager and ultimately
  to the 0-19 partnership board for resolution

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Lead Professional for children with complex needs

• Lead role is already being provided in most
  cases- required by statute/best practice
• Called a range of terms - key worker named
  social worker YOT supervising officer etc.
• Functions and tasks are key not the title -
  key issue is that someone is delivering these
  functions to ensure effective support for the
  child
• Need to ensure effective handover/transition
  processes when child no longer requires this kind
  of intensive input- ensuring continuing support
  if necessary
• - new LP agreed through multi-agency meeting
  

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Emerging Practice

• Commitment and ownership for the role from all
  partners - Memorandum of Understanding
• Senior Managers across all Childrens services
  have been involved in developing guidance on the
  lead professional role
• Specific guidance for Service Districts is also
  being developed
• Key issues to be addressed include
• gt support /supervision
• gt dispute resolution
• gt resource implications

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EXERCISE

• ANDREWS STORY

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BARRIERS AND SOLUTIONS

• What are the barriers to the successful
  implementation of the lead professional role?
• What are the solutions?

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USEFUL RESOURCES

• Safeguarding Children Advisory Service 2053535
  available for advice on ANY aspects of
  safeguarding, not just child protection. Mon-Fri
  9-5 or e-mail safeguardingchildrenadvice_at_sheffi
  eld.gov.uk
• Protocols e.g. working with hostile and
  unco-operative families, domestic abuse etc.
  available on Sheffield Safeguarding Board website
  
• Every Child Matterswww.everychildmatters.gov.uk
• Service Directory available early 08 - access via
  link on the SafetyNET website
• www.sheffieldsafetynet.gov.uk