1. 1 ‘ Demand Management in Sandwell– reinventing children’s services. Simon White Director of Children’s Services, SMBC Simon_White@sandwell.gov.uk Leo Jones Senior Manager, iMPOWER Consulting ljones@impower.co.uk 07515 053534 [IL0: UNCLASSIFIED]

2. 2 ‘ Safeguarding Inspection March 2013 Start of MASH November 2013 [IL0: UNCLASSIFIED]

3. 3 ‘ Past and current work volumes Monthly Numbers31 Mar 2012April to June 2013 (Average) Current Numbers Oct 14 Difference June 2013 to Oct 14 Contacts163515941747153 more Referrals366421190231 less Section 47s1101208040 less ICPCs5547407 less Children undergoing Assessment 227480173307 less Long Term CiN with Plans9541047495552 less Care Leavers24311818567 more Total Children in Need (Exc LAC and CP) 14241645853792 less Child Protection Plans32934732126 less Looked After Children57660153863 less [IL0: UNCLASSIFIED]

4. 4 ‘ How we “think” about demand matters  Huge variance in councils with similar deprivation  We make up stories to “explain” our data  Less about prevention; more about diversion  Public Services create their own customers  Systems are often self regulating and seek equilibrium [IL0: UNCLASSIFIED] Comparative data suggests you have a choice

5. 5 ‘ IMD vs LAC [IL0: UNCLASSIFIED] A clear correlation but significant variation in Councils with similar deprivation

6. 6 ‘ IMD and CiN [IL0: UNCLASSIFIED] Little correlation Some of the most deprived have the least CiN cases Some of the least deprived have the most CiN cases Some of the most deprived have the least CiN cases Some of the least deprived have the most CiN cases

7. 7 ‘ Some values……  Very sceptical about the “reality” of CiN  Caseloads must be manageable  You must have a stable management team, and a critical mass of permanent staff  Shrink the work to fit the diameter of the pipe  A well functioning MASH is central  Targeted services cannot replace lead professionals and the TAC – if schools and the NHS do not step up, we will not step in. [IL0: UNCLASSIFIED]

8. 8 ‘ …and prejudices  Thresholds are not what they are cracked up to be  Audits rarely tell you much about them  Adult services tend to approach cuts with more of a sense of agency  Children at risk of significant harm are rare, children in need of services are too numerous to assess  Assessments are not services  If you view assessments as a “handling charge” we spend much more arranging services rather than providing them [IL0: UNCLASSIFIED] Assessment Vs Intervention

9. 9 ‘ Different types of wasted work  Some work we just shouldn’t do (its not our job)  Some work we do is misguided (it’s the wrong thing)  Some work we do is ineffective (it’s the right thing, done badly)  Sheer volume can make most work ineffective  Sometimes children are on the merry-go-round; sometimes professionals  Transition points create waste and work  Some work we do is to remedy previous failure [IL0: UNCLASSIFIED]

10. 10 ‘ Universal services Early help Entry Care and support Permanency and exit Universal & Universal Plus Early Help (Targeted) Early help (Targeted) Early help Entry Care and support Permanency and exit Savings Better utilising universal resources to complete early targeted work with children & families More targeted activitiy – specifically focused on the needs that lead to children becoming ‘Looked After’ Multi-Agency to reduce inappropriate demand Driving planning & permanency Increase the availability of permanency options including internal placement provision As is: Elongated child’s journey, poor outcomes and high cost to the system To be: Emphasis on a safeguarding and early help, better outcomes, reduced cost to the system As is = To be = Programm e start Programm e end Agree the ‘end game’ – the desired future state? Changing the Children’s System A sustainable system focused on prevention & permanence 1 [IL0: UNCLASSIFIED]

11. 11 ‘ Workflow Analysis  Analysis of workflow showed duplicated Core Assessments  Closures at ICPC after 15 days with 2 nd CA opened in Care Management  Performance data shows some CA’s are being opened on same day as IA’s in some cases  Analysis of workflow showed duplicated Core Assessments  Closures at ICPC after 15 days with 2 nd CA opened in Care Management  Performance data shows some CA’s are being opened on same day as IA’s in some cases [IL0: UNCLASSIFIED] Understand your baseline 2

12. 12 ‘ What is the real function of CiN? Being “in need” and having “additional needs” What intervention do they get? What is the real function of CiN? Being “in need” and having “additional needs” What intervention do they get? ’Changing the Children’s System Analysis of open CiN cases showed some interesting facts For all cases referred before 15 th July (including assessment) Days since last visit no visit42 <20 days271 20-39 days281 40-59 days161 60-119294 120-240177 more than 24077 Total1303 Be prepared to think differently 3 [IL0: UNCLASSIFIED]

13. 13 ‘ Changing the Children’s System It’s a whole system thing – we need to be system architects 4 Change the whole system Re-configured Early Help Services Multi-Agency Safeguarding  Integrate your early help services – remove handoffs and early help boundaries  Place them in localities, centred around schools & universal services  Ensure a social work interface in early help – to reduce the need for inappropriate referrals  Single front door through 12 agency Multi-Agency Safeguarding Hub (MASH) with 3 screening pathways (social care, DV, Early Help)  Co-located investigative team with the police to ensure quicker & more integrated assessments of risk  In essence completion of Initial Assessment in the MASH  Lots of feedback into the system to bed in approach Activity Detail Re-modelled social care journey  £500,000 out of social care and into early help to boost capacity immediately  Simple journey with reduced handoffs  Reduced caseloads to focus on quicker exit  Permanent staffing is key – reduction in work makes it easier to achieve [IL0: UNCLASSIFIED]

14. 14 ‘ The Sandwell Model Whole System Change Central to & part of ‘Early Help’ Key part of Community Operating Groups Commissioned to complete some targeted work – or pooling of their budgets for local, responsive commissioning Early Help Universal Services Community Operating Group Integrated Early Help Services with multi-agency, multi-disciplinary teams around localities Re-allocation of CiN activity to early help Supported by dedicated social worker support for each locality Targeted services based on local need with key aim of reducing demand Supported by local commissioning budgets to allow proactive response Strong performance & quality management focused on reducing demand + outcomes Targeted Early Help [IL0: UNCLASSIFIED]

15. 15 ‘ Impact  50% less referrals into the system  50% less Child in Need cases  50% less assessments  Improving re-referral rate  Reduction in agency staffing from as high as 45% to under 15%  Reduction in spend on agency staffing from £5.4m to under £1m  10% reduction in LAC with £1.6m underspend on placements from forecast spend [IL0: UNCLASSIFIED]