SSIA Better Outcomes for Children in Need Better Outcomes for Children in Need in Conwy Gwilym Roberts and Katy Burch

Purpose of the National Programme To achieve better outcomes for children in need and better value for money by improved matching of services to needs for children through effective commissioning. Sponsored by WLGA and SSIA Supported by IPC SSIA Better Outcomes for Children in Need

SSIA Better Outcomes for Children in Need Focus on: Community-based support for children and families experiencing severe stresses and at risk of significant harm, family breakdown or compulsory entry into the care system. Support for children and young people living away from home in a variety of family-based or residential care settings. SSIA Better Outcomes for Children in Need

SSIA Better Outcomes for Children in Need Programme Elements Projects undertaken by 5 pioneer authority and their partners, supported by IPC. Sets to share learning for 4 key change agents in each pioneer authority. Access for all agencies in Wales to materials, tools and events developed by IPC and SSIA, with advice from pioneer authorities and programme associates. Messages for policy-makers from the programme via SSIA. SSIA Better Outcomes for Children in Need

SSIA Better Outcomes for Children in Need Pioneer Authorities Conwy Merthyr Tydfil Rhondda Cynon Taf Swansea Vale of Glamorgan SSIA Better Outcomes for Children in Need

SSIA Better Outcomes for Children in Need Why? Generally considered that higher tier preventative services are insufficient to meet demand, and that some children and young people are coming in to care because of this. No strong correlation between lower tier provision and reduction in demand for tiers 3 or 4. Local authorities’ role is changing from market provision to market shaping, complemented by effective needs analysis and matching. SSIA Better Outcomes for Children in Need

What Changes? - Community Services Rigorous gatekeeping for access to care (for example: a change to the existing thresholds; improved application of thresholds within field work services; multi-agency panels for children with high or complex needs)? Quality assurance of assessment and planning? Allocation of core and any additional funding across preventive services, particularly targeted at the higher tiers? Development of higher tier family support services to reduce demand for looked after or rehabilitate them quickly and safely? A move away from ‘grant giving’ towards competitive tendering and formal contracting for support services to children in need? A shift towards more outcome-based approaches? SSIA Better Outcomes for Children in Need

Use of The Commissioning Cycle SSIA Better Outcomes for Children in Need

SSIA Better Outcomes for Children in Need National Materials National overview of children in need in Wales. How can commissioning help to achieve better outcomes? Literature review, what works for children in need in the community and LAC What works .. Parental substance misuse What works .. Domestic violence What works .. Parenting support SSIA Better Outcomes for Children in Need

SSIA Better Outcomes for Children in Need Key Research Themes Effectively configured services include the following key characteristics: Accessible. Acceptable. Non-stigmatising as possible. Focus on key transitions. Focus on whole child. Enabling and empowering. Good links with adult services. Evidence-based. Build on existing successful networks – sustainable. SSIA Better Outcomes for Children in Need

Family and Parenting Support What constitutes family and parenting support? Family Support: ‘Any activity or facility provided either by statutory agencies or by community groups or individuals, aimed at providing advice and support to parents to help them in bringing up their children’. Parenting Support: ‘Any intervention for parents aimed at reducing risks and promoting protective factors for their children, in relation to their social, physical and emotional well-being’. SSIA Better Outcomes for Children in Need

SSIA Better Outcomes for Children in Need Dimensions Family and parenting support can be located in three dimensions: Dimensions: 1 – considers the age of the child. 2 – considers the differing levels of need. 3 - considers the focus of intervention in terms of ecological layers – work with the child; support to parents and families; changes to the economic and social environment within which parenting is taking place. Most services take a pragmatic approach by focusing mainly on family and individual factors. SSIA Better Outcomes for Children in Need

Design and Delivery of Services Current provision: Market is fragmented, patchy and complex. Lack of coherent strategies. Interventions focused on remedial rather than preventative. Implementation issues: ‘Getting’ parents. ‘Keeping’ parents. ‘Engaging’ parents. Factors that influence effective implementation: Practical. Relational. Cultural, contextual and situational. SSIA Better Outcomes for Children in Need

Parenting Support - Limitations Many existing services do not address disengaged parents and families or parents of vulnerable or in need children. SSIA Better Outcomes for Children in Need

SSIA Better Outcomes for Children in Need Key Messages – 0-5’s Often multi-faceted issues (multi-disciplinary approach required). However, a key element should address the quality of parenting and factors that impact on parenting, e.g. substance misuse, dv, mental health issues. Balance the need for accessibility with an ability to reach high level need groups. Targeted works! SSIA Better Outcomes for Children in Need

SSIA Better Outcomes for Children in Need Health / Home Visiting Main messages are for more effective targeting of vulnerable families. Recent studies of targeted services identify huge variation in outcomes (highly dependent on how delivered on the ground). Focus interventions on parent and child (particularly around first birth). Use screening tools to identify at risk parents Smaller number of high intensity services over 6 months plus works best. Select interventions to meet individual needs. Targeted health visiting may result in a greater number of referrals to SSD. Effectiveness of Home Start questioned by recent research. SSIA Better Outcomes for Children in Need

SSIA Better Outcomes for Children in Need Parenting Education Parenting style has a pervasive influence on wellbeing. Parenting education incorporates a wide variety of activities, methods and client groups. Webster-Stratton and other similar programmes have been positively evaluated. Even successful programmes are unsuccessful with up to a third of parents (maternal depression is a key factor). Parenting programmes should be combined with other inputs for more vulnerable children and families (e.g. direct work on behaviour with child). SSIA Better Outcomes for Children in Need

Family Centre / Multi-Function Support Recent research has been very critical of family centre-based support, including outreach provision. More must be done to ‘reach out’ to most disadvantaged families. Services must be clear about the goals to be achieved with each family and the theoretical rationale behind interventions. Interventions that seek to build carer’s own support networks may be the most effective. Staff must be suitably qualified and trained to deliver to disadvantaged families in particular. SSIA Better Outcomes for Children in Need

Key Messages Older Children and Young People Significant recent research highlights difficulty for families in receiving support just below the statutory thresholds – in particular CAMHS, mental health for parents, and domestic violence. Positively evaluated services include: Specialist adolescent support teams. Family Group Conferencing. CAMHS (although high levels of problematic access still reported) including particular models, e.g. Multi-Systemic Therapy + PCAMHS. Multi-disciplinary, including outreach provision for drugs, alcohol, mental health and sexual health services. SSIA Better Outcomes for Children in Need

SSIA Better Outcomes for Children in Need Project in Conwy Improving outcomes for children and young people in need who are at risk of abuse, neglect, or entry into care SSIA Better Outcomes for Children in Need