Think Family pilot WNW CDTS Adam Smith

The protocol The protocol seeks to improve the safeguarding of children and young people who live in the context of families where parents are substance misusers or have mental issues or a combination of these (dual diagnosis).

The concept that lay behind the protocol is based upon evidence collected through research of real case files and the analysis of their content. This research demonstrated how children and young people’s outcomes can be harmed by living within these families. A solution was proposed of developing a protocol which encouraged adult and children and young people’s services to better work together to improve outcomes for families.

The pilot BARCA Leeds volunteered to host this pilot activity to support the LSCB and Safer Leeds. There are two factors which need to be taken into account in terms of BARCA Leeds and this pilot. The organisation is set up in a way that provides it with a “head start” when compared to many agencies in that it is a multi-professional agency and working across a range of family needs. BARCA Leeds also was a key player in the early days of testing out Every Child Matters in Leeds and took part in developing integrated working through processes such as the Common Assessment Framework (CAF).

W/NW Staff were informed of the pilot and asked to identify families that may benefit from being involved in more family based holistic work. A home visit from the Think Family worker was offered to clients where the protocol was explained and informed consent obtained. In addition a professional tool used by Leeds Addiction Unit’s SSQ, which assesses the effectiveness of working with clients was used with individual families. The SSQ is a validated questionnaire based upon the social satisfaction of people with substance misuse disorders. The family was also given a brief synopsis of why this pilot was being run and the purpose.

Families A total of ten Families were introduced to the pilot. These families responded in different ways to the introduction of a family perspective: Some families dropped out of the pilot at an early stage. Other families withdrew consent as the pilot progressed. Reasons included: One female service user was resistant to being involved, following a school approach A family expressed concern about the impact on their children’s education. One femalecservice user decided that she felt supported enough by her family Another family moved from the area. In each case the appropriate action was taken to ensure there were no concerns about the children’s wellbeing.

Debt and Financial Services Case studies Case Study One BARCA CDTS A Surgery XXXX HOSTEL Leeds Housing Primary School Bradford Seagulls PLAY TEAM BARCA Debt and Financial Services Drug Team Bradford Sure Start Bradford Sure Start Leeds Leeds

Case Studies Case Study 2 Barca CDTS A Adult A Cooking Group A Further Education Courses A Barca Harm Reduction L.A.U West Leeds School Leeds Social Services Autism Specialists Barca YIP Barca Think Family Project Childrens Centre XXXX Childrens Centre Medical centre Medical Centre

Recommendations Training Adult teams need to be made aware that they will be expected to become involved in the whole family. They will require training to have a basic understanding of children and young people’s services. Children’s teams need training/ briefing on the increased involvement of the adult services.

Workload The protocol has a workload impact upon everyone involved, it became apparent at the beginning of the pilot that working and coordinating a family intervention was time consuming and needed to be allocated sufficient time. Increased amount of home visits adds time onto a worker’s day. Service users involved in this pilot received an increased number of home visits in order to get them to join the project and also for staff to learn about the wider family. Think Family workers should be allocated time to network, attend meetings and create joint working relationships across children and adult services.

Communication Areas of communication and information sharing need to improve between adult services and children’s/ family services in order to create a supportive package for the whole family.   To introduce Think Family, communication between the worker and the service user within CDTS needs to improve to move away from the suspicious aspect of enquiring about children and family. It is suggested that this protocol is discussed at the beginning of treatment in the assessment stages. Communication and co-ordination across services needs to be handled carefully so that parents with substance misuse issues remain in CDTS, whilst they continue to need support to face this problem.

Summary The pilot tested the protocol over a small but in depth sample and found that it worked within the context of services in West Leeds. There were services approached in the area that did not respond. This is probably due to services working historically based upon their existing professional and organisational autonomy and not recognising the benefits of Think Family. The service users who took part in this pilot did so of their own free-will. All service users who were approached recognised the influence they were having upon their children’s outcomes. Like substance misuse, the most powerful factor in improving the lives of these families is that they make, and are encouraged and supported to make the decision to change their lifestyles. The staff at BARCA worked upon this premis throughout the pilot.

Think Family policy, is that it is not left to the frontline staff to bring about change. The protocol needs to be considered and promoted by strategic leaders of services, commissioners, middle managers, frontline supervisors to support frontline staff with the challenge of developing a new “shared culture” that is required to successfully deliver Think Family. An unexpected outcome of the pilot was the emergence of efficiency saving that could be made through the application of a Think Family approach. The small sample of participant families demonstrated how multiple interventions within a family are a daily occurrence and that there is little coordination between services. By introducing a co-ordinated family centred approach services working with the family can commence working towards common shared outcomes. The pilot indicates this will improve the quality of services and reduce overall and potential waste.

Future plans Children's Panels Whole family assessments Questions Thank you