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Agenda item

Children & Young People's Services Edge of Care Provision

Minutes:

In accordance with Minute No. 117 of the Cabinet/Commissioners’ Decision Making Meeting held on 14th November, 2016, Jenny Lingrell, Acting Head of Service, Early Help, presented an update on the implementation of Edge of Care Services by the Children and Young Peoples’ Services Directorate as follows:-

 

Family Group Conferencing (FGC)

-          Launched in April 2017 and consisted of a FGC Co-ordinator and 3 Family Group Conference Practitioners.  The size of the team was dictated by the funding that was made available.  An additional practitioner was added to the team in December 2017

-          The focus of the team was to work with families who had a Child in Need (CIN) plan particularly if risks were escalating.  During the initial year following the service launch it had been necessary to be flexible and test work with families with a Child Protection Plan (CPP), families who were already in a Public Law Outline process and with Looked After Children where there may be an opportunity for a child or young person to return home

-          61 FGCs took place in the last financial year

-          25% of FGCs that did not take place during the 6 week timescale.  These were families who required a longer period of time due to family dynamics and availability of family members when arranging a conference date

-          Only 38% of referrals were allocated within 3 days

 

Edge of Care Team

-          Was a multi-disciplinary team made up of practitioners who had complementary skills and experience developed through working with adults with complex needs as well as with families

-          The Team had the skills to address behaviours linked to adult trauma and its impact and has, at its core weekly group, supervision with a consultant clinical psychologist

-          In addition the Team Co-ordinator had monthly personal systemic supervision, the Team took part in monthly group supervision and an ongoing programme of systemic training

-          The Team consisted of a Consultant Clinical Psychologist, a Team Co-ordinator (skilled in systemic family therapy), a Parenting Practitioner (who could deliver 1:1 outreach support), a Level 3 Social Worker and 3 Family Intervention Workers

-          All referrals were made through the new Edge of Care Panel, a multi-agency Panel chaired by a Head of Service from Social Care, which met on a weekly basis

-          79 families were referred to the Panel between 26th September 2017 and the end of the financial year

-          The Team was currently at full capacity

-          It was estimated that the average cost for a child in care was £50,000

-          5 children had successfully moved home from foster care following an intervention by the Edge of Care Team with 2 more on caseload representing a full year saving of £350,000

 

Multi-Systemic Therapy (MST)

-          MST was a shared service delivered in partnership by Rotherham and Barnsley Councils to support families where there was a risk that a child or young person would become looked after or go into custody

-          The pilot arrangement had commenced in July 2014 for 10 young people.  A formal agreement had been in place since April 2015

-          All MST referrals were now allocated via the Edge of Care Panel

-          MST was an evidence based programme and routine outcome measures recorded for each case

-          Consistently difficult to achieve a positive outcome for education for young people on the MST caseload

-          Learning from MST embedded in all Edge of Care work with close joint working with the lead Social Worker a requirement

 

Pause Rotherham

-          Funding identified from the Early Help budget to set up a Pause Practice for a minimum of 18 months

-          Each Pause Practice comprised a Pause Practice Lead, 3 Pause Practitioners and a Pause Co-ordinator

-          The Team had capacity to work with between 20 and 24 women during the pilot phase

-          The planning and implementation phase had been successful to date

-          Pause Rotherham Board established and included broad multi-agency representation as well as a Rotherham Councillor

 

Discussion ensued with the following issues raised:-

 

·           Multi-Systematic Therapy was separate intervention to Edge of Care but the principles of joint working was exactly the same between the 2.  Much of the work would be completed by the Edge of Care practitioner; they were part of Early Help but had the additional layer of therapeutic intervention.  There would be joint supervision whenever the Edge of Care Team worked with the Family Team Manager from the Edge of Care Team and Social Worker who would plan their work jointly so it was clear who was doing what within the timescales prescribed by the CPP

 

·           The work fell into 2 categories with constant review to ensure the model responded appropriately:-

 

Adolescents - often these were situations where there may have been historical issues and, on becoming adolescents their behaviour prevented in a more challenging way.  It was also known through “Right Child, Right Care” approach that the outcomes for a child that went into the care system after the age of 14 years was very negative.  The Edge of Care Panel would make a decision on how to proceed safely

 

Neglect – large sibling groups whose parents who had their own issues around mental health, drugs, alcohol and domestic abuse.  This involved a more family intervention model 

 

Work of the Edge of Care Team - often the work needed with the adolescent cohort was more therapeutic in nature.  Family therapy work talked much more about the family dynamics and patterns of behaviour that developed over time 

 

·           As part of the Family Group Conference the child was very much part of the process.  A specific resource was allocated to advocate and capture the child’s voice and wishes.  As part of the preparation work the views of everyone who would be attending the conference were captured.  It was very much part of the Edge of Care Team’s intervention work and the voice of the child was very much apparent.  The voice of the child has its own section on the form 

 

·           The Routine Outcome Measures and Score 15 captured the levels of depression, anxiety and stress.   The Edge of Care Team would record it on every visit to a family.  In the future graphs could be submitted which would show how high it was at point of referral and the impact the Service had had

 

·           Multi-Systematic Therapy offer had been available in Rotherham since 2014.  Approximately 20 Rotherham children were worked with annually aged between 11-16 years of age 

 

·           The Pause Rotherham Team was now fully staffed

 

·           The Pause Rotherham Board was Chaired by the Assistant Director of Safeguarding, the Chief Executive of the Pause national charity, South Yorkshire Police, the Community Rehabilitation Company, Adult Services, Domestic Abuse Service, Sexual Health, Housing, CAFCASS, Councillor Clark, Drug and Alcohol Services

 

·           The established model was the same as that delivered in other authorities

 

·           Pause was really active and engaged in terms of making every Pause practice successful

 

·           Although Pause was targeted at women it was about positive relationships.  Sometimes the relationships were not positive but women may still want to remain in that relationship; Pause would continue to work with them to make it as good as it could be.  If it was a positive relationship Pause would embrace that positivity so there was no reason why they would not involve the father in that

 

·           It was quite difficult to benchmark some of the work taking place.  MST was reported in the national framework. 

 

Resolved:-  (1)  That it be noted that Family Group Conferencing and Edge of Care Teams were fully operational.

 

(2)  That the Select Commission scrutinises the performance outcomes to date.

 

(3)  That the launch of Rotherham’s Pause Practice in July, 2018 be noted.

 

(4)  That the frequency of updates be determined once the 2018/19 work programme had been agreed.

 

(5)  That the Select Commission suggest that the scorecards be submitted on a quarterly basis as part of the performance report.

Supporting documents: