Keeping Children Safe - An Outcomes Approach - LSCB Development Day Rob Hutchinson, CBE 4 th & 19 th November 2010

Children & Young People Leadership at every level Shared Vision Involvement of children & young people Childrens Trusts involve… Source: DfES

Outcome Based Accountability is made up of two parts: Performance Accountability about the well-being of CUSTOMER POPULATIONS For Programmes – Agencies – and Service Systems Population Accountability about the well-being of WHOLE POPULATIONS For Communities – Cities – Counties – States - Nations

THE LANGUAGE TRAP Too many terms. Too few definitions. Too little discipline Benchmark Target Indicator Goal Result Objective Outcome Measure Modifiers Measurable Core Urgent Qualitative Priority Programmatic Targeted Performance Incremental Strategic Systemic Lewis Carroll Center for Language Disorders Measurable urgent systemic indicators

Definitions Children born healthy, Children succeeding in school, Safe communities, Clean Environment, Prosperous Economy Rate of low-birthweight babies, Percent 16 & 19 yr. olds with 5 A-C GCSEs, crime rate, air quality index, unemployment rate 1. How much did we do? 2. How well did we do it? 3. Is anyone better off? OUTCOME or RESULT INDICATOR or BENCHMARK PERFORMANCE MEASURE A condition of well-being for children, adults, families or communities. A measure which helps quantify the achievement of an outcome. A measure of how well a service, agency or service system is working. Three types: = Customer Outcome Population Performance

1. Safe Community 2. Crime Rate 3. Average Police response time 4. A community without graffiti 5. % of surveyed buildings without graffiti 6. People have living wage jobs and income 7. % of people with living wage jobs and income 8. % of participants in job training who get living wage jobs Is it a Result, Indicator or Performance Measure? RESULT INDICATOR PERF. MEASURE RESULT INDICATOR RESULT INDICATOR PERF. MEASURE

POPULATION ACCOUNTABILITY For Whole Populations in a Geographic Area

Every Child Matters – Children Act Outcomes for Children and Young People Being Healthy: enjoying good physical and mental health and living a healthy lifestyle. Staying Safe: being protected from harm and neglect and growing up able to look after themselves. Enjoying and Achieving: getting the most out of life and developing broad skills for adulthood. Making a Positive Contribution: to the community and to society and not engaging in anti-social or offending behaviour. Economic Well-being: overcoming socio-economic disadvantages to achieve their full potential in life.

1. Health & Emotional Well-being 2. Quality of life 3. Making a positive contribution 4. Exercising choice & control 5. Freedom from discrimination & harassment 6. Economic well being 7. Personal dignity & respect (8. Effective leadership) (9. Effective commissioning) Our Health, Our Care, Our Say – White Paper Outcomes for Adults Source: A New Outcomes Framework for Performance Assessment of Adult Social Care

Outcomes: The Portsmouth 8 Children and Young People should grow up - * Having an active say in any development * Healthy * Emotionally secure and confident * Having succeeded as far as they can at school * Having facilities and opportunities to play safely * Having stayed out of trouble * Living in a safe place * Having the opportunity to succeed in their dreams

New Zealand Kruidenbuurt Tilburg, Netherlands Country Neighbourhood

Coventry Data Book

Performance Measures Against the Portsmouth 8 Baseline

Healthy Eating and Exercise Project in Portsmouth Project Driven by LSP and a local Community Board Focused on one community Many 1%'s ……. Secondary School Primary Schools Surestart Faith Community Playgroups and Child Minders Dieticians "Trained" parents Childrens Video Schools Meal Service Co-op University Portsmouth Football Club Health Visitors Public Health Consultant PCT Chief Executive ……….etc

Performance Accountability For Services, Agencies and Service Systems

How much did we do? Programme Performance Measures How well did we do it? Is anyone better off? Quantity Quality Effect Effort # %

How much did we do? Quadrant How well did we do it? Is anyone better off? How many nurses appointed since 1997? Reduction in Waiting Times Percentage of patients saying their health has improved as a result of the hospital intervention Number of fatalities within 2 months of operation

How much did we do? Proposed National Indicator Set How well did we do it? Did it make a difference? % of initial assessments carried out within 10 working days % of core assessments completed within 35 working days % of child protection plans lasting 2 years or more % of child protection cases which were reviewed within required timescale % of referrals to childrens social care going on to initial assessment % of applications for care proceedings which have been assessed as incomplete Childrens social worker vacancy rate Childrens social worker turnover rate Population: % increase of children and young people who have suffered unintentional/deliberate injuries or preventable deaths % children who report they feel safer Performance: % children becoming the subject of child protection plan for a second or subsequent time Did it make a difference?

How much did we do? How well did we do it? Did it make a difference? Number of children with protection plans % of initial assessments within 10 working days % of core assessments for childrens social care carried out within 35 working days of commencement % of child protection plans lasting 2 years or more % of child protection plans reviewed within time scales % of applications for care proceedings deemed as incomplete by the courts service % social worker vacancy rate %social worker turnover rate % complaints % surveyed families saying service was delivered in a respectful and timely manner Population: % reduction in children referred for physical, emotional and sexual abuse and neglect % increase of children who have suffered unintentional/deliberate injuries or preventable deaths Performance: % of children subject to CP Plan for a second or subsequent time % of childrens plans whose recommendations have been successfully implemented % reduction of children with CP Plans % of children whose risks are reduced as a result of intervention and are removed from protection plans within 6 months Numbers of children who report that they feel safer Numbers of parents who report that their parenting has improved as a result of intervention Did it make a difference? Possible local additions to the NIS

Swale Kids Performance Measures How much did we do? (Quantity)How well did we do it? (Quality) Types of activity: Number of Children seen by Team - parenting groups - one to one with children - group work with parents % staff turnover % of children per staff member % of staff trained % of children completing activity % of parent/carer completing activity Is anyone better off? No. of pupils with improved results No. of permanent exclusions Number of fixed term exclusions No. teachers who say the intervention a difference No. parents/carers who say the intervention made a difference No. children who say the intervention made a difference % of pupils with improved attainment % of permanent exclusions % of fixed term exclusions % teachers who say the intervention made a difference % parents/carers who say the intervention made a difference % children who say the intervention made a difference

Mentoring Scheme # No. attended No. mentors recruited Training for mentors No. of referrals made No. of 1:1s % Distribution of referral by agency Mentors staying 1 year or more YP staying 1 year or more YP / mentors treated well * Referrals accepted Partner agencies who attend meeting about CYP Recruited who serve for more than 1 year* Unit cost per mentor YP matched within 30 days Rate of attendance at 1:1s # YP reporting programme has helped improved relationships with parents / carers % YP say prog help in probs at exit, 3, 6 months* YP say improved relationships YP showing improved attendance * YP showing reduced exclusions (days) Average length of exclusions Attainment levels (mentor exceed set targets)

How much did we do? How well did we do it? Did it make a difference? Number of meetings Numbers of agencies attending LSCB meetings Frequency of meetings Progress on business plan Financial management Numbers of member annual appraisals carried out % of Members attending regularly % of Members presenting items % of Members stating their satisfaction with meetings % serious case reviews considered % recommendations in training plan implemented % recommendations in Reports agreed Identifiable progress achieved on business plan % agreed recommendations reviewed on a regular basis Population: % of children who report that they feel safer % reduction in children referred for physical, emotional and sexual abuse and neglect % hospital admissions caused by unintentional or deliberate injuries Performance: % of children whose risks have been reduced and whose protection plans are ended within 6 month % reduction of children with child protection plans % protection plans which have been successfully implemented % of parents who report that services have improved the parenting of their children % children becoming the subject of Child Protection Plans for second or subsequent time LSCB effectiveness Did it make a difference?

LR UR

How much did we do? How well did we do it? Did it make a difference? Population Children are safer… Performance % Children subject to SFF less likely to exp repeat PP % reduction in time subject to PP per category/need % reduction in children experiencing further episodes of harm (S47s?) % increase in # of children who stayed at home safely % children who report they feel safer % parents who report that intervention helped them to make children safer % agencies who report that intervention made children safer Strengthening Families Framework Did it make a difference? # of children subject to S47 # of consultations carried out using SFF # of consultations which dont lead to CP intervention # of children subject to SFF ICPCs/RCPC # of children with PPs % of consultations leading to ICPCs % reduction in time subject to PP % ICPCs held in 15wdays % professionals who feel meetings are run well/timely % profs who deliver actions in timescales % parents/CYP who report feeling listened to % parents/CYP who understand/agree with the aim of the plan at the end of the meeting

How much did we do? Success Measures for Childrens Trusts How well did we do it? Did it make a difference? Establishment of Joint Commissioning Strategy and Plan No.of attendees at Trust meetings No.of items considered No. of agencies represented No. of children and young people attending No. of events/learning opportunities undertaken No. of staff whose awareness is realised on CT priorities % Joint Commissioning Strat. which identifies both population and performance priorities % Joint Commissioning Strat/ plan implemented within defined timescales % Joint Commissioning Strat. Delivered within budget % of trust members attending meetings % of reports with agreed implementation plans % of items actioned from meeting % of priorities reviewed on regular basis % of plans consulted on/approved by children & yng people % of children, y. people & families who say services are delivered in timely and respectful manner % of staff and public who understand CT priorities POPULATION: %of children, young people & families who say services made difference to 1 or more of 5 outcomes (Tell Us survey) PERFORMANCE: % of professionals who say CT priorities contributed to an improvement of 5 outcomes for children, young people & families BOTH: Depending on priorities, theres evidence that the curve had turned on Top 2 priorities at both populations and performance level, eg teenage pregnancy & obesity for population levels eg A to Cs in school x for performance level

How much did we do? How well did we do it? Did it make a difference? Number of young people offered services through CAHMS Number of mental health assessments carried out Number of universal services being used by young people feeling excluded Amount of attachment support for young people and their families Numbers of follow up missing interviews % mental health assessments which led to signposting to other agencies % 10 – 16 year olds and their families receiving attachment intervention % of families that are responded to as per the Rapid Response Protocol % childrens workforce trained in brief interventions % young person satisfaction with post return home services % placements receiving additional support for young people % increase in school attendance % increase in targeted CAMHS provision for young people with emerging mental health difficulties Population % reduction in young people that self harm or attempt suicide % reduction in the number of attendance at A&E due to drug or alcohol misuse % young people that report feeling safe Performance % reduction in young people that repeatedly self harm % reduction in young people committing suicide % reduction of young people experiencing long term rejection % reduction in placement breakdowns % reduction in repeat missing persons % increase in children returning home in a planned way % in repeat attendances in A&E % of young people that say they have been properly consulted on their plans and the development of services people Safeguarding young people at risk of self harm or suicide Did it make a difference?