1. Birmingham City Council Identifying and Working with Troubled Families in Practice

2. Identifying and Working with Troubled Families in Practice  Identifying Families under the Troubled Families Programme Working with Troubled Families in Practice:  Case Study: Communities Based Budgets Pathfinder for Families with Complex Needs  Emerging Troubled Families Delivery Model

3. Identification – The Theory  National estimates of 120,000 Troubled Families based on 2005 Family and Child Survey 2005  Focus on poverty/low income, poor health/mental health, unemployment, poor housing, no qualifications  Using this model Birmingham has estimated 4,180 Troubled Families  Troubled Families Programme Guidance published March 2012, confirmed national identification criteria as:  Youth crime/ASB  Truancy/school exclusion  Worklessness  Local discretion to consider other factors

4. Identification – The Practice  Our data tells us that cases meeting all 3 national criteria will only make up around 7% of our TF target, mismatch between sets of criteria.  Local additional criteria therefore become critical, currently under consideration:  Free school meals take up  Adult offenders at risk of re-offending  Those in treatment for drug & alcohol problems  Child Protection Plan Cases  Confident we can identify 2,600 families this year and the remainder next year.

5. Identification – The Issues  Data quality problems across systems, eg address formats  Data access/co-ordination challenges eg RSLs and ASB data  DWP overwhelmed by task of checking benefit status of potential Troubled Families, slow response is likely to delay full identification of families  Need for new systems to handle, analyse and report on vast quantities of data  Criteria don’t include some potentially important issues, for example around health/mental health  Appropriate level of data to pass to lead practitioners needs to be worked through – benefits data, police intelligence etc

6. But That’s The Easy Bit – What’s Next?  Data Analysis – identifies 2,600 families this year  Verification through multi-agency assessment team, create family case file, identify most appropriate service to make contact with family  Main Service Area (e.g. YOS/IFST/PRU etc) make first contact and make family ‘offer’  Main Service Area draw in agencies for fCAF Multi Agency Assessment and Integrated Support Plan – to focus on achieving Troubled Families Outcomes  Build capacity within service areas to engage with the approx 50% of families not already worked with in some way  Commencing now with 120 known Troubled Families

7. Working with Troubled Families In Practice: CBB FCN Case Study  Birmingham one of 16 national CBB pathfinders for Families with Complex needs  Work with families with five or more needs  Design and align services better around needs of families  Maintain affordability for required services, within a context of reducing expenditure  Work with 160 in 2011/12 in Shard End and 4,180 city- wide by 2015

8. Why Shard End? “risk index” by ward Shard End pilot Kingstanding “control” site

9. CBB FCN – Main Partners  Birmingham City Council: Children, Young People & Families, Adults & Communities, Housing & Constituencies and Development Directorate  Be Birmingham – Local Strategic Partnership  Jobcentre Plus  Health Sector Partners  West Midlands Police  Schools and Children’s Centres  Drug & Alcohol Action Team and service providers  Domestic Violence agencies and groups  Voluntary / Community Sector Organisations

10. r r Universal Screening Framework Family Common Assessment Framework Specialist Assessment Frameworks Families with Complex Needs Families with additional needs Families whose needs can be met in universal settings FNP Incredible Years PATHS Evidence Based Early Intervention Programmes FIP IFSTS CBB Whole System Model For Shard End Pathfinder WISH - DWP Co-Design Intensive Family Advocacy Services

11. Family CAF Business Process Pre Assessment Checklist Section 1 Family Details Section 2 Children’s Assessment Section 3 Adult Assessment Section 4 Analysis & conclusion Integrated Support Plan Integrated Support Plan Review Summative Evaluation May include early screening tools & risk assessments eg SDQ, DAS, CAT etc Section 1 Core demographic details& existing service involvement Section 2 exactly the same as existing CAF. All children on the 1 form Section 3 general assessment of needs & existing service assessment Section 4 Consent obtained (if not already) Analysis of needs & which services to involve ‘Contract’ with family & agencies – who will do what by when. Evaluation of actions put in place, next steps required & new needs identified & planned KPI Target Summative evaluation of over-all satisfaction KPI Target 15 Working Days 15 Working Days 15 Working Days Maximum 6 months Episode End

12. 0 to 18 Years – Early Intervention & Prevention Evidence Based Programmes FNP Family Nurse Partnership Pre birth up to 2yrs for first time Teenage mum Incredible Years Parenting Programme Targeting all 3 – 4 year olds with behaviour problems Triple P Parenting Programme Targeting 4 – 6 year olds With behaviour Problems PATHS Promoting Alternative Thinking Strategies All primary aged children commencing In Reception & Yr1 Public Health Approach to Early Intervention & Prevention For All Families in the Shard End CBB Area Birmingham Community Health Trust Integrated Family Support Team Integrated Family Support Team 11 CBB Primary Schools Evidence Based Programmes

13. CBB Exemplar Project: Cost/Benefit Realisation through fCAF Unit cost for each partner intervention gives cost of each fCAF (in aggregate gives ‘community budget’) + Projected savings for each intervention/fCAF (in aggregate is community efficiency targets) = Beneficiaries tracked across all partners gives actual savings realised CBB Budget Adjustments

14. Pilot Area Multi Agency fCAF/CAF Activity Compared to the rest of the City

15. ANALYSIS OF 40 fCAFS UNDERTAKEN IN FEBRUARY 2012 ISSUENumber% UNEMPLOYED1845 UNABLE TO ENFORCE RULES/BOUNDARIES1640 DVI VICT ADULT PERP1128 DEPRESSION1025 MENTAL HEALTH ISSUES820 HOUSING ISSUES820 DEBT820 MENTAL HEALTH ISSUES EXT FAMILY513 STRESS513 PHYSICAL HEALTH ISSUES513 DVI VICT CHILD PERP38 BEH ISSUES38 POOR HOUSEKEEPING38 SEXUAL ABUSE HIST25 DRUGS AND ALCOHOL25 BEREAVEMENT25 DVI PERP13 DVI EXT FAM PERP13 OFFENDING13

16. Coordinating Services for Parents - What Parents Say: Success  fCAF makes complete sense! You cannot not address the needs of the children without addressing the needs of the wider family.  Relationship with key worker and family is key  Families using FIP value the support provided.  High awareness about PATHS so benefits of population wide public health approaches. Challenges  Still relatively low awareness amongst families  Parents often feel overwhelmed by the role of parenting but limited support  Support parents earlier – not just when problems arise  Lack of activities in the local area  Lack of training and employment opportunities.  Need to improve the ‘place’ as well as the ‘people’

17. What Partners Agencies Say Successes  Partners value partnership working  fCAF helps unpick issues that might have been more difficult to address through single agency interventions, e.g. the impact of alcohol misuse.  Sense amongst families and schools that things getting better Challenges  Identification involving data sharing and analysis hugely problematic  Some agencies are still not actively participating  Need for greater realism on how long it takes to work with families.  One-off training for agencies will not suffice.

18. CBB Pathfinder – Next Steps  Evaluate impact of pathfinder  Roll out whole systems model city wide  Shard End Test bed are for Troubled Families programme

19. Emerging Birmingham Model: Service Delivery Troubled Families to be catalyst for systems change which will:  Embed ‘think family’ practice across whole system  Be outcomes driven at all stages  Adopt ‘whole systems approach’  Build in demand reduction from outset  Enable families to self determine issues and barriers  Test new approaches e.g. personalised budgets  Explore family contracting – reward and enforcement models  Leave a self sustaining service delivery model that works without PbR support

20. Any Questions? Contacts: Bridget.kerrigan@birmingham.gov.uk Tony.bunker@birmingham.gov.uk