1. Early Help Arrangements, Effective Assessment (CAF) and Planning for Improved Outcomes FOR BOURNEMOUTH CHILDREN’S TRUST 2014 Training Matters

2. AIMS AND OBJECTIVES Aim – That participants should be able to use CAF and undertake the Lead Professional role within Plus partnership – By the end of the day, participants will be able to Describe Bournemouth’s Early Help Arrangements State the purpose and appropriate use of CAF Keep the child at the centre of the process Convene and chair TAC meetings and become the Lead Professional Action plan effectively Training Matters

3. LOCAL SERIOUS CASE REVIEWS 1 Training Matters Baby M – Died at 10 weeks june 2008 – fractured skull – Premature so only home 4 weeks when injured – Key role of universal services – Family not known to Social Care – Importance of gathering comprehensive family history – Sharing information – Impact of adult mental health on child – both parents and father alcohol abuse

4. LOCAL SERIOUS CASE REVIEW 2 Training Matters Family S3 – Mother and Grandmother wilful neglect – Filthy squalid and unhygienic – Avoided all professional contact for 5 yrs – 2 nd child some additional needs – no safeguarding concerns – 2003 hygiene concerns – health and Social Care – 2004-5 contacts at Social care offices – 2008 – new concerns re home – told to do CAF – No core assessment at any point

5. LOCAL CASE AUDIT Training Matters Death of 12 year old with diabetes History of missed medical appointments – 50% of diabetes appointments in 10 yrs No direct contact between GP and child in 5 yrs despite missed appointments GP records main source of information Parent depression and alcohol abuse – limited parenting capacity School dealt with health issues, started own CP record but did not talk to other agencies Education and Health felt Social Care would not take up the case so did not refer Failure of agencies to share and act on information

6. VICTORIA CLIMBIE 2003 Training Matters Information sharing missing at basic level Each agency and individual information considered without other concerns Attempt to secure parental permission should not block initial information gathering Judgements based on separate snapshots rather than picture built up over time. 12 opportunities to save her missed Free exchange of info inhibited by Data Protection and Human Rights – need guidance As can only share if protection issue, either deters info sharing or artificially increases concerns

7. CHILDREN ACT 2004 Training Matters duty on LA’s to promote cooperation between relevant partners To improve well being of children in the area Can include pooled budgets to assist Duty to safeguard and promote the welfare of children – ensure preventative early action Legislated for CAF

8. EARLY HELP ARRANGEMENTS IN BOURNEMOUTH Training Matters

9. Step up / Step down

10. CAF PROCESS - BOURNEMOUTH www.bournemouthcs.org.uk/eha Universal Plus – Identify needs early – one other service only and clear need – may use CAF but not registered. Plus Partnership – Multi-agency plans requiring LP – Children’s Social Care triage – Registered with Marco Goisis (456347) – CAF panel Child protection concerns – Social Care only Training Matters

11. COMMON ASSESSMENT FRAMEWORK Can be used for any in-house assessment at Universal plus level Will be used for all Plus Partnership families To develop common understanding of needs and strengths To support earlier intervention To put a multi-agency plan in place to meet needs keeping the child at the centre Training Matters

12. The content of the CAF Training Matters Process for undertaking a common assessment Pre-assessment checklist Bournemouth CAF form Family and environmental Groups & elements Parents and carers Development of child

13. Training Matters EARLY HELP – IDENTIFICATION OF RISK AND REFERRAL Identify child with poor outcomes Is child at risk Of significant Harm? Use Consult offer If unsure yes Interagency Referral form to Children First to assess Assessment & safeguarding or Other SW team Determine Who helps And progress to Universal, Universal Plus Plus Partnership Multi-agency approach Needed? CAF and LP Plus partnership no Can needs be met At Universal Plus? no Yes Can ART brokerage Help? Phone them Deliver service And review Needs met? Yes Continue within Universal services

14. Training Matters CAF PROCESS FLOWCHART Contact CAF registrar – case open to CSC or current CAF NO YES Contact LP? SW join TAC Contact LP? SW join TAC yes Can you decide who LP and CAF completion? Can you decide who LP and CAF completion? NO Contact your CAF champion Or CAF help – ready to cont Contact your CAF champion Or CAF help – ready to cont Do you need Support to Complete CAF Do you need Support to Complete CAF yes Holistic assessment Focused on child Recorded on CAF Send CAF to CAF Registrar for CAF panel Incorporate feedback, TAC Could ART brokerage Assist? TAC review at least Every 12 weeks All identified needs met? Close and send final TAC Review to coordinator

15. An assessment that is: Focused on strengths as well as needs. Valid and accurate. Clear and uses appropriate language – good communication Inclusive with the child at the centre Unbiased. Authentic. Professional but not formal Solution focused. Practical. Evidence based with opinion recorded as such. What makes a good CAF assessment? Using an approach that is: Empowering. Accessible. Developmental. Transparent. Leading to… Training Matters

16. What makes a good CAF plan? Good action planning is: Comprehensive. Efficient. Inclusive. Informative. Focused. Logical. SMART. Transparent. Involves the child CAF initial plan and delivery plan should: Build on strengths and help meet needs identified through the assessment. Not promise support on behalf of others. Agree who will do what by when and when review will happen. State anticipated outcomes and how progress will be measured. Record consent to record and share. Gather information Undertake assessment AnalysePlan Training Matters

17. The CAF review The CAF review should gather and record: Has to be done within 12 weeks and every 12 weeks at least Who is present. Progress against each of the actions in the CAF delivery plan. Next steps. Review notes. Child/young person and parent comments and where necessary, additional consent. Outcomes of the review could be one of the following: New assessment needed New actions agreed and review date set CAF closed Training Matters

18. Closing a CAF A CAF can be closed for many reasons, including: Additional needs met when reviewed. Child or young person has moved to another area. Child or young person has made the transition into adult services. CAF assessment superseded by specialist assessment. Consent withdrawn. Others? Training Matters

19. FIVE KEY CONTRIBUTORY FACTORS TO SUCCESS OF CAF Engaging children, young people and families as partners Developing better understanding of children’s needs at the earliest possible stage Ensuring consistency of LP support, building trust Ensuring multi-agency working and info sharing Integrating all elements of the CAF process – Assessment – Engagement with families – LP role – TAC – Reviews – Easton et al 2010

20. IMPACT OF CAF Parents positive about CAF and support LP highly valued – Emotional and practical support – Coordination and advocacy Some parents feared negative judgements and possible Social Care involvement Professionals reported – Increased knowledge of services – Broader perspective – Duplication with other records – CAF used where should be Social Care Holmes et al 2012 Training Matters

21. INFORMATION SHARING Need to share to – Work in effective partnerships – Identify who needs early help – Support transitions eg children’s to adult services – To ensure we have the best plan in place for a child that reflects the real needs Training Matters

22. INFORMATION SHARING WHERE THERE ARE CHILD PROTECTION CONCERNS Always consider referring concerns to children’s social care or police, following LSCB procedures Seek advice if unsure what to do Practitioners must:Issues to consider: Confidential information can be shared without consent if justified in the public interest Timely sharing is important in emergency situations Significant harm to children and young people or serious harm to adults can arise from a number of circumstances It is good practice to seek consent and/or discuss concerns, unless this would increase the risk of harm Training Matters

23. INFORMATION SHARING DECISIONS Decisions about information sharing should be based on an assessment of benefits and risks to the child, young person or family. You must assess: What are the benefits of not sharing information? What are the risks if information is shared? You must assess: How would sharing information benefit the child, young person or family? What are the risks if information is not shared? Decision to share Decision not to share Training Matters

24. SEVEN GOLDEN RULES FOR INFORMATION SHARING Data Protection Act is not a barrier to sharing information. Be open and honest with the person from the outset. Seek advice where in doubt. Share with consent where appropriate and where possible, respect the wishes of those who do not consent to share (unless there is sufficient need to override the lack of consent). Always consider the safety and well-being of the person and others. Ensure information is accurate and up to date, necessary, shared with the appropriate people, in a timely fashion and shared securely. Record the reasons for the decision – whether it is to share or not. Training Matters

25. Key questions to inform decision making Is there a clear & legitimate purpose to share the information? Does the information enable a living person to be identified? Is the information confidential? Do you have consent to share? Is there sufficient public interest to share? Are you sharing information appropriately and securely? Have you properly recorded your decision? Training Matters

26. WHAT IS CONFIDENTIAL INFORMATION? Confidential information is… Personal and private or sensitive, and… Not already in the public domain, and… Shared in confidence. Consent is given by the person who provided the information or the person to whom it relates. OR It can be shared without consent if justified in the public interest. Training Matters

27. WHAT CONSTITUTES CONSENT? Consent is key to information sharing, it is good practice even where the law does not demand it. Consent: Must be informed. Should be explicit but can be implied in some circumstances. Is preferably written, but can be verbal. Must be willing and not inferred from a non response. Must be sought again if things change significantly. Can be withdrawn and have limits. Should be recorded and stored. When gaining Consent: Explain it at the start, using suitable language. Explain the limits to confidentiality. Be aware of relevant legislation. Follow local policies and procedures. Do not seek consent where it would increase risk Training Matters

28. WHOSE CONSENT SHOULD BE SOUGHT? People aged 16 and over – generally presumed to have the capacity to understand and may give (or refuse) consent. Children aged 12 or over – may generally be expected to have sufficient understanding to give (or refuse) consent. Younger children may also have sufficient understanding. Sufficient understanding is indicated if they can: Understand the question. Understanding what might be shared, why and implications of sharing/not sharing. Appreciate and consider alternative actions. Weigh up aspects of the situation. Express clear, personal, consistent view. Record the decision and try to balance the wishes of the child or young person and the parent/carer Activity next Training Matters

29. The role of the lead professional The lead professional is a set of functions to be carried out as part of the delivery of effective integrated support, when a range of services is involved with a child or young person following a common assessment. The lead professional will: Coordinate the delivery of the actions agreed by the practitioners involved. Act as a single point of contact for the child, young person or family. Reduce overlap and inconsistency in the services received. Training Matters

30. “MYTH BUSTING” – THE LEAD PROFESSIONAL Does not have to be an ‘expert’ in everything Is not automatically the person who initiated the CAF Does not need any particular qualifications Will not be expected to work outside their usual remit Is not responsible or accountable for actions by other practitioners or services in the TAC Will have support mechanisms in place to resolve any issues Does not become responsible for the needs of the entire family May use more time in one area, but save time elsewhere Training Matters

31. CORE TASKS OF THE LEAD PROFESSIONAL Be a single point of contact for the child, young person and family Be a single point of contact for all practitioners working with the child Build a trusting relationship to secure engagement Continue support if appropriate, if specialist assessments are needed Convene the TAC meetings to enable integrated multi- agency support Identify where others may need to be involved and broker involvement Support the child/young person through key transition points Ensure a safe and planned ‘handover’ if a different LP is agreed and more appropriate Coordinate delivery of solution focussed actions and ensure regular reviews Training Matters

32. Knowledge and skills of a lead professional Knowledge – understand: CAF and integrated working. How to access services. The child/young person’s strengths and needs. Information sharing, consent and confidentiality. Safeguarding. Boundaries of own knowledge. Skills – ability to: Establish relationships. Support, empower and challenge children and young people. Convene inter-agency meetings. Work with practitioners from a range of services. Knowledge and skills underpinned by: Effective communication. Planning, organisation and coordination. Critical and innovative thinking. Training Matters

33. CRITERIA FOR SELECTING A LEAD PROFESSIONAL The wishes of the child or young person, and their family. Any statutory responsibility to lead on the work. The level of trust built up. Any previous or potential ongoing relationship. Who has primary responsibility for addressing the needs. The main needs (as assessed through the CAF). The skills, ability and capacity to provide leadership and coordination in relation to other practitioners involved. The ability to draw in and influence universal and specialist services. Training Matters

34. KEY ACCOUNTABILITIES Each lead professional is accountable to their home agency for delivery of: – their part of the action plan; and – the lead professional functions (as previous slide) The lead professional is not responsible or accountable for services delivered by other agencies lead professional is responsible for gathering people together to review progress up to the individuals to deliver on their agreed actions A clear line of accountability for lead professionals would run from the practitioner, through their line management to the children’s trust arrangements and the DCS OFSTED are coming and will be looking at early help!

35. MANAGEMENT FOR LEAD PROFESSIONALS AND THE TAC Lead professionals should expect managers to ensure: Lead professional responsibilities are taken into account when setting caseloads. Performance in delivering the lead professional functions is recognised and recorded. Clear communication between agencies to support lead professional practice. Appropriate and up to date training and supervision is provided along with coaching and mentoring where appropriate. TAC practitioners should also expect support to fulfil their responsibilities Training Matters

36. SUPERVISION FOR LEAD PROFESSIONALS ManagerialFocused on effective delivery of services and the lead professional functions SupportFocused on reflection and evaluation of lead professional practice (could be from line manager and/or local support functions) Training and development Focused on continuously assessing strengths and identifying training and development needs for practitioners acting as the lead professional Training Matters

37. RESOLVING DISAGREEMENTS AND DISPUTES Could arise over: Selection of the lead professional. Roles and responsibilities of TAC members. The need for action and by whom. Communication. Others? Resolve problems quickly through clear local systems: Between the parties. Line manager support and/or other local support systems. Early help implementation group meeting Negotiation between agencies at senior management level. Children’s Trust coordinated arrangements at strategic level. Director of Children’s Services. Training Matters

38. OBJECTIVES Specific Measurable Achievable Realistic Time

39. IMPACT OF TAC MEETINGS 50% parents had TAC meeting Frustrated by lack of follow-up from CAF Most positive where resulted in action plan Least positive where review or “catch-up” Wanted to ensure they were listened to Some professionals reluctant to take on LP role because of workload – Holmes et al 2012 Training Matters

40. PRACTICALITIES OF TAC MEETINGS Where? – Family home? A venue family are comfortable in? Who? – Those who can help with action plan – People family are comfortable with – Family – parents and yp should influence the meeting and contribute – Children of sufficient age to understand Training Matters

41. PURPOSE OF TAC MEETINGS Consider the needs/strengths of the child as identified through CAF Identify what actions or services might meet those needs Keep the family at the centre Agree a Delivery Plan with smart objectives Agree LP to co-ordinate Decide if any specialist assessment needed and make referrals Agree review date Training Matters

42. PREPARING FOR TAC Normally done by CAF completer for 1 st one Book venue and refreshments Ensure the family know and have agreed on who is attending Give everyone a copy of CAF in advance with family’s permission Send invitations to participants Think about access and communication difficulties Training Matters

43. PRESENTATION SKILLS FOR WORKERS Confident but not arrogant Sitting looking interested Nerves – not talk too quietly or fast Time to calm down Be prepared Speak via chair Present facts and relevant information Ask questions if don’t know Training Matters

44. CHAIRING TAC 1 Introductions Clarify purpose and process of TAC State principles of respect, equality and confidentiality Keep meeting focused on delivery planning – stick to time Ensure everyone can contribute Facilitate exchange of relevant and up to date information Encourage creative thinking about solutions Training Matters

45. CHAIRING TAC 2 Manage any conflict and facilitate discussion of opposing views Encourage clear, jargon free communication Summarise regularly to ensure all involved are aware of what is happening Clarify next steps including attendance, date, timing and venue of future meetings Training Matters

46. TAC PRACTITIONER RESPONSIBILITIES Jointly responsible for developing/delivering the CAF delivery and review plan Responsible for delivering the planned activities Responsible for monitoring and keeping TAC informed about their progress Attend TAC meetings and contribute to taking minutes, chairing and other tasks Support the lead professional, including providing information and offering guidance and advice Contribute actively and positively to problem solving and resolving difficulties in a child centred way Remember the ‘T’ in TAC stands for team Training Matters

47. TRANSFER AND ENDINGS FOR THE LEAD PROFESSIONAL Being a lead professional is not a permanent thing: –Children and young people’s needs change (in their level, extent and focus). –Situations and relationships change. –Practitioners change. –Children and young people get older. Transfer and endings of the lead professional functions, where appropriate, need to be carefully planned and managed. Training Matters