Getting it right for every child Andrew Keir: GIRFEC/eCare Programme, Requirements Manager, Scottish Government

Learning experience for everybody. Introduction 3 Workshops. Learning experience for everybody. Throughout the day presentations and discussion groups. Practice leading to systems Homework

This abstract ink on canvas painting is entitled “together we are stronger”. It speaks of the importance of not just the parents but the family and the community as a whole helping to bring up a child. From the time that the child is a baby the family and the community should come together in oneness to raise the child so that the child can grow up to be a pillar of society. In so doing everyone benefits and the community is strengthened.

Getting it right for every child Lorraine Spalding: Communications adviser, GIRFEC Team, Scottish Government

Getting it right for every child Information Sharing Workshops Shared knowledge and understanding

What is GIRFEC ? Getting it right for every child is a way of working which focuses on improving outcomes for all children by placing the child at the centre of thinking, planning and action It affects all services that impact on children (i.e. adult services working with parents/ carers) It builds from universal services: moving from crisis intervention to early intervention GIRFEC streamlines processes and uses IT to support best practice on information sharing Key messages: GIRFEC has evolved over time: Kilbrandon Report 1964 Children (Scotland) Act 1995 For Scotland’s Children (2001) It’s everyone’s job to make sure I’m alright (2002) Review of Children’s Hearings (2004) GIRFEC affects all services for children and is about improving outcomes for all children It involves transformational change and is strongly connected with the Early Years Framework

How implement nationally? CULTURE CHANGE Learning together, co-operating, children at the centre SYSTEMS CHANGE Streamlining, simplifying, improving effectiveness PRACTICE CHANGE Appropriate, proportionate and timely help, shared materials, tools, protocols Key message: To support culture change, developed values and principles, promoting shared understanding and a common language To support systems change, developing the eCare programme and IT component of GIRFEC, promoting business process mapping, one approach, one planning/delivery mechanism To support practice change, building from what works, existing good practice, published the Guide, established an on-line learning community, working with pathfinders and learning partners The IT solution is built around the GIRFEC practice model, so it is an enabler of GIRFEC practice The national implementation plan focuses on change across these three areas

The GIRFEC approach comprises: Core components (see no 10 in the Guide) Principles and values Common understanding Shared language Practice model (needs and strengths) Well-being and well becoming Key messages: Through the GIRFEC approach, promote opportunities and value diversity, put safety first and consider the whole child: a developmental-ecological approach Promote well-being of individual children and young people Build on strengths and promote resilience Help should be appropriate, proportionate and timely, co-ordinated as necessary Support informed choice, working in partnership with families Information sharing with consent or when necessary without consent for reasons of safety Shared values across professions Connected workforce development and service inspection It’s about how services work together to support any child Starts in the universal services for all children – health and education Early identification of problems and early intervention Immediate response to protecting children in cases of serious risk Build on strengths, support family solutions when safely possible Shared framework for assessment and planning Streamlining processes when possible Lead professional to co-ordinate complex services One child’s plan

GIRFEC: Child at centre & a network of support Key messages: This is the central concept of GIRFEC – the vision. Promoting appropriate, proportionate and timely action As the spiral progresses, the help provided is more targeted, more specialist and ultimately ends with compulsory measures In GIRFEC there are no thresholds - but depending on need, action should be taken. Need to ensure practitioners share information when appropriate Build from the needs of the child, drawing on the family and those closest to the child as necessary – to build a strong network of support What does this mean for children and young people, they will: Children will: feel confident about the help they are getting understand what is happening and why have been listened to carefully be appropriately involved be able to rely on appropriate help and have a streamlined and co-ordinated response.

Elements of the GIRFEC practice model My World Triangle Well-being wheel Resilience matrix Key messages: These are the components of the GIRFEC practice model: well-being, child’s world, resilience Designed to break down real or artificial barriers. Based on shared values and principles, building to a common language and understanding and looking for transformational change. Aim to: Identify and support protective resources Nurture the child’s capacity to benefit from these resources Understand the impact of adversity and trauma Work to reduce impact of adversity

Well-being Key messages: Inter-relationships between the segments To be successful learners, confident individuals, effective contributors and responsible citizens, a child’s well-being should be considered as set out in the eight indicators: safe, healthy, achieving, nurtured, active, respected, responsible and included

Key messages: Consider each side of the triangle and identity what needs to be done; Take an overview of what is needed, making use of the resilience matrix; Don’t just record the information, but analyse it and plan accordingly Need for coherence across policies Note: The above was developed as part of the preparatory work for an integrated assessment framework (IAF) in Scotland. Similar to those in England and Wales and Northern Ireland. In Scotland we have placed the child at the centre and describe everything from the child’s perspective. This IAF preparatory work was absorbed into Getting it right, although many local authority areas continue to work on IAF development. Moving to developing GIRFEC practice building from IAF work.

Resilience Matrix Key message: Always trying to move from the deficit to the positive. Strengths and need as two halves of the same coin Adapted from Daniel, B., Wassell, S. and Gilligan, R. (1999) Child Development for Child Care and Protection Workers, Jessica Kingsley Publishers Ltd., London and Philadelphia and Daniel, B. and Wassell, S. (2002) Assessing and Promoting Resilience in Vulnerable Children, Jessica Kingsley Publishers Ltd., London and Philadelphia. Published by kind permission of the authors and Jessica Kingsley Publishers Ltd., London and Philadelphia.

Planning, action and review Use the well-being indicators to plan, take action and review. Where necessary develop a plan that incorporates all elements of involvement to meet a child’s needs. When two or more agencies are involved, action coordinated by a Lead Professional. Review the outcome of the plan with the child, young person and family. Key messages: Inter-relationships between the segments To be successful learners, confident individuals, effective contributors and responsible citizens, a child’s well-being should be considered as set out in the eight indicators: safe, healthy, achieving, nurtured, active, respected, responsible and included

The GIRFEC Practice Model Key messages: Brings together core tools into one practice model applicable to all professionals The GIRFEC model requires everything to be looked at in the round as soon as possible to ensure that planning and action addresses those needs and risks If a specialist assessment is made and the analysis requires immediate action to keep the child safe, that is done and represents an immediate short term outcome However, other short, medium and long term needs and risks have to be tackled too

Andrew Keir: GIRFEC/eCare Programme, Requirements Manager, Information sharing in context Andrew Keir: GIRFEC/eCare Programme, Requirements Manager, Scottish Government

For Scotland’s children The report included a six point action plan which outlined the way forward in terms of integrating children’s services, including the sharing of information. Those leading children's services must ensure that all children have access to the universal services of health and education. In most areas this will simply require effective mechanisms for information sharing between agencies. In some areas though, predominantly the cities, with more transient populations, careful consideration should be given to active methods of identifying and maintaining contact with all families.

Everyone's job to make sure I’m alright Recommended the development of linked computer-based information systems including a single integrated assessment, planning and review report framework for children in need. Cumulatively, such developments (sharing information through electronic means) hold out great advantages for improving child protection: • rationalising a number of different records and enabling all agencies to contribute relevant information; • ensuring professionals working to protect children have access to information such as vulnerability factors relevant to their decisions; • prioritising shared identification and assessment of need, plans for action and the intended outcomes for the child; • pooling and making information quickly and readily available to all agencies, so tha they can respond quickly to changes in needs and circumstances;

Framework for Standard - Standard 4 states that “agencies and professionals [should] share information about children where this necessary to protect them” Preventing Offending by Young People A Framework for Action (2008) – ‘Ensure that all our systems are more effective in sharing information to support identification and intervention for young people at risk.’

National Domestic Abuse Delivery Plan for Children and Young People (2008) Priority Area 2 - Develop a universal, systematic approach to information gathering and decision making that will place children’s needs and wishes at the heart of agencies’ response to domestic abuse. the Pathfinder is supporting the development of information-sharing protocols and procedures across all agencies, including the police, education, health, the voluntary sector and Children’s Reporters to streamline communication and the decision-making process. To achieve this, each Pathfinder is drawing on local resources as well as identifying technological solutions to assist agencies to gain skills and develop capacity to work in this new multi-agency context.

Proposals for Action 2005 ‘Where more than one agency has to work with another in a structured way to help the child, key bits of this information should be shared to make sure that the help proposed is right for the child. The child’s or young person’s record is the place where this information should be brought together and shared where appropriate. Whoever is involved with the child can see what relevant information is available and can make a more informed decision about what action is really needed to help the child’.[1] [1] Getting it right for every child Overview: General Information and Responses to Questions

GIRFEC/eCare (information sharing in context) GIRFEC Core Components 10 - The capacity to share demographic, assessment, and planning information electronically within and across agency boundaries through the national eCare programme where appropriate

eCare background eCare is a set of standards, services, frameworks and technologies designed to support the provision of more integrated care to the citizens of Scotland eCare is a multi-year programme with current capabilities and future plans and goals eCare has predominantly been driven by the areas of Single Shared Assessment and Child Protection Messaging eCare is additionally now supporting the transition of Getting It Right For Every Child (GIRFEC) policy into practice and supporting the development of GIRFEC implementation

The GIRFEC Practice Model Work stream 1 (i2) Work stream 2 (CVSR and Plan)

Vision Analysis Functional Scope in 2 main workstreams: I – “Point to Point”. Allows practitioners to coordinate and collect appropriate information from other sources in order to facilitate better decision making. II – “Case Management”. Supports coordinated multi-agency working through the management of shared case records, such as the Child’s Virtual Shared Record. 25 25 25

What does supporting GIRFEC involve? (some initial thoughts) GIRFEC introduces some new concepts and requirements into the eCare domain The concept of “spectrum of need” and early intervention The concept that the practitioner controls “who sees what” and “how the recipient can use it” The need for highly controlled contribution and access to shared data around the child (Child’s Virtual Shared Record & Plan) based on a “Case Management” model The concept of more targeted communication Allows practitioners to get in touch & identify who’s involved Provides controlled access to limited information The new concepts are not fully supported within 1.1.3 and will need to be developed. In the short term 26

Workshops

Practice considerations (Using the practice model) Describe the range of circumstances you would consider sharing information or would need information to meet a child’s needs and enhance their well-being? ? At what points in your consideration of this child’s needs do you think you would you share with or seek info from others, and with whom? What information do you need against the specific circumstances in question 1? How would you like the information provided to you?

Kirsty has been attending the Nursery for 3 weeks. Kirsty Brown – age 4 Kirsty and her mother Fiona Brown have recently arrived in the area. Kirsty has been attending the Nursery for 3 weeks.

Miss Brown brushes off these concerns and refuses to accept any advice we give her She has said that she moved from Othershire but can’t remember the name of her Health Visitor or G.P. She has not registered with a G.P in this area. She does say that we can contact whoever we like but would not provide us with any details. We would like to offer support but would like any information to help us.

Mrs White does not know which nursery Trevor attends or who the HV is. Trevor White – age 4 Trevor lives with father but stays overnight with his mother one weekend every month. During this weekend visit he tells his mother that his father has kicked him in the leg, punched him on the arm and held him roughly around the neck. Mrs White notices bruising on his arm and legs and takes Trevor to the local SW dept. Mrs White does not know which nursery Trevor attends or who the HV is.

Jimmy aged 10 Police were called to the house the previous week because of a domestic incident involving the parents. Jimmy was in bed at the time but police were concerned that the conditions in the house were very poor and seemed chaotic. Jimmy is in primary 6 and has recently become somewhat disruptive. School would like to be able to support Jimmy better.

Practice considerations (Interactive) Scenario x3 1. What are the issues for your agency in this scenario? 2. Practice – What would happen now from your agencies perspective? 3. Practice –What information would you share? 4. Practice – What process would you use to share it? 5. Practice – When would you share and with who? 6. Practice – What would you need to be shared with you by others ? 7. Practice – What needs to happen now? 8. Practice – What processes or systems are used?

Development considerations (information sharing solution) Andrew Keir: GIRFEC/eCare Programme, Requirements Manager, Scottish Government

Challenges Different technology choices (and solutions) and complex landscape. Different Practice priorities. Competing policy priorities. Different understanding of Data and privacy principles. Impacts on technology framework and models Understanding of GIRFEC Language and understanding.

Adam Ingram, Minister for Children and Early Years Agencies are rightly and legally protective of the information that they hold and disseminate about our children. Like many, I have concerns about centralising that amount of information in one place, given that we know how good Government is at not holding on to information. There must also be no room for an arbitrary "information is (my) power" attitude to disseminating information. We need to be careful to ensure that that is clear. Hugh O’Donnell (Lib Dem) Adam Ingram, I reassure Hugh O'Donnell that the approach in Scotland is not to create a central database. Information will be held and controlled by agencies and data will be brought together only when required. We are not going down the road that has been taken in England. There will have to be justification for access to information, and databases will not be open to being searched without there being a clear reason for doing so. Debate in Parliament 4th September 2008

Privacy and confidentially, rights etc Joseph Rowntree Foundation – Database State (2009), ‘Britain is out of line with other developed countries, where records on sensitive matters like healthcare and social services are held locally. In Britain, data is increasingly centralised, and shared between health and social services, the police, schools, local government and the taxman.’ A quarter of the public-sector databases reviewed are almost certainly illegal under human rights or data protection law; they should be scrapped or substantially redesigned. More than half have significant problems with privacy or effectiveness and could fall foul of a legal challenge. ………. Fewer than 15% of the public databases assessed in this report are effective, proportionate and necessary, with a proper legal basis for any privacy intrusions. Even so, some of them still have operational problems. red Contactpoint and eCaf (the system collects far too much data, much of it subjective, on dubious legal grounds. The data are also too widely disseminated and likely to lead to stigmatisation of young people.)

Article 29 Data Protection Working Party (2009) The core legal principle is that of the best interest of the child The principle of best interest requires a proper appreciation of the position of the child. This involves recognising two things. First, a child’s immaturity makes them vulnerable, and this must be compensated by adequate protection and care. Second, the child’s right to development can only be properly enjoyed with the assistance or protection of other entities and/or people

Email Threats to patient privacy (including unauthorised interception of unencrypted emails, receipt or retrieval of emails by unauthorised people, inappropriate physical security measures) Email consultations in health care: scope and effectiveness (2004) BMJ Using the information in Chronology – Case/Patient/Pupil records etc National solution (nationally agreed encryption etc)

Workshop

Questions from last week?

Development considerations (information sharing solution) 1 How could this information sharing (in the previous discussion groups) be enhanced with the aid of electronic tools? 2. What would these tools look like (remembering the constraints)? 3. How would they be used?

Planning for the next session Homework GIRFEC Guidance Info Sharing Processes etc Business Requirements Give us a name

Introduction to the Information sharing Models and process including Learning tool. Andrew Keir: GIRFEC/eCare Programme, Requirements Manager, Scottish Government

Information sharing Models and process including Learning tool The Information Sharing Models and process and Learning tool are based on :- GIRFEC Core Components GIRFEC Principles GIRFEC Values GIRFEC Practice Model Business Requirements so far

The GIRFEC Practice Model Work stream 1 (i2) Work stream 2 (CVSR and Plan)

i2, GIRFEC and eCare The i2 practice tool will... Be the first national user interface to support practitioners using targeted communication, Be used to prototype and pilot future phases of GIRFEC requirements Allow those organisations without the systems or infrastructure and practitioners whose systems have yet to be upgraded, to participate in the GIRFEC approach Be designed to allow rapid prototyping and flexibility to support the implementation of GIRFEC Be used to allow practitioners to exchange ‘point to point’ communication of any concerns, whether statutory or non-statutory 49 49

User-Centred Design Framework Conceptual Design Visual Design Evaluation Interaction Design Prototype Design Analysis 50