Community Budget Programme Board December 12 th 2011

By 2014/15 we will aim to have:- 1.a shared view of all the Families with Complex Needs in Leicestershire as well as the families at risk of becoming complex 2.streamlined needs-based, focussed and cost effective services, that address the needs of these families, improving their lives and reducing their costs to the public purse 3.integrated public and voluntary sector family focussed services designed around a single Leicestershire Family Model 4.service delivery based on a re-balanced provision focussed more on targeted services than universal 5.a place based structure responsible for commissioning family focussed services from a single, shared budget Families with Complex Needs

Family Insight- a comprehensive approach The detailed Insight report is now published on the Leicestershire Together Website

Common issues for FCN Poor/overcrowded housing (incl. homelessness) High risk behaviours (incl. substance misuse) Poverty (incl. debt & unemployment) Health (incl. mental health & disability) Crime (offending and/or experience of) Lack of education/ attainment Domestic violence Poor parenting Difficulties maintaining relationships (incl. family, friends, peers, isolation & social marginalisation) Lack of resilience (incl. capability, capacity, confidence & inability to cope) Feelings of having limited choices/control over lives Adverse effect on aspirations/ perception of social mobility In already fragile families, incidents can happen that have multiple implications

Additional intergenerational risks children of FCN face.. Childhood spent in care Becoming carers at an early age Chaotic family lifestyles and lack of continuity Mental health issues Increased risks of substance misuse Increased risk of poor health Abuse/exposure to exploitation & violence Girls/women with poor self esteem and low confidence can often become victims of domestic violence Unresolved anger can lead to violence Children of FCN often become future FCN.. Setting up Intergenerational cycles..

Types of Changes Communication between agencies Attitudes Information sharing Communities Mgmt needs to listen and act Advocate / Lead organisation Senior Managers back to the floor Widen scope of FIP Better working together Stop being precious, be more flexible, changes in funding Earlier intervention POLITICS More resources / money Shared vision, shared targets Family, not organisation- centred ways of working Needs assessments Re-skill / believe in people – professional respect Personal responsibilit y Long Term strategy Action, not talk Single IT system Leadership Earlier interventio n Shared vision and stronger leadership Family-centric, not organisation-centric approaches to working and funding Advocate / FIP Politics / resources Re-training / attitude of workforce Information sharing Better joint working Shared processes / systems Community

Family Support Model - Key Principles  Any new model is sustainable beyond the medium term  Aims to move families closer to independence from public services  Model will need to be underpinned by cultural change with strong leadership across Leicestershire Public Sector/Voluntary Sector  ‘champions’ and SRO in all organisation to lead required cultural change?  Supports early/earlier intervention  Builds on good, well evaluated practice  Incorporates some personalised commissioning at family & locality level  Workforce development a key component (multi-agency training)  Families/workers are able to access services required quickly with some priority (with lower entry thresholds)  Is able to influence commissioning for identified service gaps and policy changes  Single Family Assessment Framework

 Team around the family with dedicated family support worker  may require 1 for adults, 1 for children in some families  Role is outreach working in family homes and communities with small caseloads and intensive approach as required by family circumstances/needs  Co-located services in localities (demand determined)  Local integrated multi-agency teams  Mix of permanent & co-opted staff delivering core needs/services  Necessary administrative support  Locality partnership solutions and delivery  Mix of local & County commissioning  Sensitive to local needs assessment, local intelligence and opportunities  Builds family capacity, capabilities & aspirations  Recognises strengths within the family  Builds self esteem, skills, relationships and aspirations  Has flexibility built in so families are able to move in and out of support for a period of time Family Support Model - High Level Operating Model

 Dedicated family support worker will  Support the family and co-ordinate relevant and required services  Provide practical support around basic issues & life skills  Be a positive role model  Spend time working with family members within the home & community  Be an advocate for the family  Recognise the importance of the communities role in supporting families & identify opportunities for integration  Have access to locality ‘families’ budget  Consider Personalised Budgets for some families  Case loads of 5 for most complex to enable sufficient time to work with the family - up to 12 for least complex Role of Family Support Worker

Child Protection Police Probation YOS Mental Health Youth services Domestic Violence GP JCP SM Treatment Brief interventions (SM/Health) Benefits Counselling ETE Education support Youth/children workers Housing Support Health Visitor? Administrator Family Model Draft 1: FCN Team around the family with lead family support worker

 ‘Place’ information hub solution  Access to a single view of family and history  Decisions made with a view of all known information about a family  This needs to be dynamic and growing as information and involvement grows  Presumption is to share information oprinciple that we ‘dare to share’ on a basis of ‘what specifically don’t we need to share’? oquestions over the depth/degree  Requires a well trained workforce re: information sharing  Requires cultural change Family Support Model Core Support Elements

Family Worker Co- ordinates HousingEsteem Practical Support Positive activities Mental Health Substance Misuse Educational /behavioural support EmploymentBenefits Domestic Violence Disabilities Family Worker co-ordinates CORE family support themes i.e.