Contact: Natalie Trentham, Partnership and Performance Manager, ext. 7166

e-mail: [email protected]

Alison Heywood, Quality and Performance Manager, ext. 7235

e-mail: [email protected]

Glynis Hodges, Service Manager, ext.

e-mail: [email protected]

1. Summary

1.1 This report concludes the second phase of the support for children & young people in the community review (stage one) which looked at inclusion social workers based in schools (ISWs), reception and assessment teams (R&A), and the out of hours service to children and families within Social Services Direct.

1.2 The review project brief was agreed by the Social Care PRC on 14 March 2003. A progress report was presented to Social Care PRC on 28 November 2003. The timescale for completing stage one of the review was extended by four months in the light of the publication of the Green Paper, `Every Child Matters' which set out a framework for wide-ranging reforms of children's services.

1.3 The vision for the review identified by stakeholders in January 2003 was:

`all children will have the best start in life through the provision of a range of locally based, accessible, child and family-centred services which are responsive to and supportive of their needs. Services should work in partnership to ensure the most effective use of resources and improved outcomes for children and families.'

1.4 The issues to be addressed were identified as:

· better outcomes for children

· accessibility of services

· maximising participation (community, children and families)

· effective partnerships at all levels

· commonly agreed referral, assessment and planning processes

· effective and efficient use of all resources, including staff

· effective communication and information sharing

· effective monitoring and evaluation

· direction and leadership

2. Progress during phase two of the review

2.1 The work of the review team has been carried out by a core team and three working groups comprising representatives from social services, partner agencies and elected members (see appendix I).

2.2 A second stakeholder event was held on 20 November 2003, to consider findings from the second phase of the review and the green paper proposals. Stakeholders considered and appraised options for the future of the three services under review. A summary of stakeholders' views can be found in appendix II. These views have been incorporated into the options appraisal for this report. A follow-up meeting was held on 3 March 2004 to update stakeholders about further options development and to discuss proposals for taking the review forward.

3. Challenge

3.1 There has never been a more challenging time for services for children and young people in the community. This review has taken place in the context of national proposals for major changes to children's services and coinciding with the publication of the Green Paper which included the government's response to Lord Laming's enquiry into the death of Victoria Climbié and focuses on four main action areas:

· early intervention and effective protection;

· supporting parents and carers;

· accountability and integration (locally, regionally and nationally);

· workforce reform.

3.2 The Children Bill published on 4 March outlines legislative changes to address the above areas. This review has explored the potential implications of the Green Paper and the anticipated legislative changes throughout the options phase.

Throughout the review further challenge has been provided by:

3.2.1 stakeholder representation on the core review team, working groups and at stakeholder events;

3.2.2 feedback from internal and external comparison and consultation;

3.2.3 findings from the SSI Inspection of Children's Services January 2003 and outcomes of the audit of child protection procedures and subsequent inspection of services to children in need, July 2003.

4. Consultation

4.1 There has been wide ranging consultation with internal and external stakeholders. This has included:

4.1.1 a review of existing local and national consultations, evaluations and inspections completed within the last five years;

4.1.2 direct consultation through; on site visits, postal and telephone questionnaires, focus groups, interviews and informal feedback.

5. Comparison

5.1 Working groups have compared objectives, capacity, working practices and performance of the three services under review through:

5.1.1 statistical analysis of results from national performance indicators;

5.1.2 benchmarking with Best Value reviews carried out by other local authorities;

5.1.3 visits and telephone contact with Devon, Essex, Hertfordshire, Luton, West Sussex and Bolton;

5.1.4 internal analysis of job descriptions, exit information, staffing profiles.

6. Competition and collaboration

6.1 In response to the Green Paper proposals for greater collaboration and integration between agencies, work is underway between Education and Social Services at a strategic level to consider the way forward and how services could be realigned in Hampshire.

6.2 The working groups addressed competition and collaboration in the following ways:

6.2.1 measuring cost effectiveness of services;

6.2.2 statistical analysis of cost and activity (Children in Need Census);

6.2.3 considering alternative models of delivery for elements of the service;

6.2.4 identifying duplication and overlaps in service provision;

6.2.5 criteria for options appraisal.

6.3 Further collaboration in the options phase has included meeting with the Best Value review team undertaking the review of Education Other Than At School services (EOTAS), in order to ensure a joint approach to the Green Paper and consideration of improvements to County Council services.

7. Consideration of the key strategies

7.1 This review has been undertaken within the context of the overall corporate strategy. All options for improvement would contribute to achieving the three main aims of the corporate strategy; `maximising life opportunities', `building strong and safe communities' and `improving services'.

7.2 Working groups used a set of criteria including the impact on the four key strategies (equalities, crime and disorder, e-government sustainable development) to appraise options.

8. Analysis of information

8.1 The review has identified examples of good practice and positive outcomes for children and families in all of the services reviewed in stage one. However, all three of the services needed to make improvements to ensure equitable access, consistent service delivery, more efficient processes and integrated and collaborative working.

8.2 A summary of the findings for each service is given below together with a list of service improvements. This is followed by an outline of the options for future development and their key advantages and disadvantages. Service improvements identified by stakeholders that do not come within the scope of this review have not been included in this report.

8.3 In each case, options A, B and C reflect a continuum of change from minor adjustments through to major structural change. Costs are given where information is available and are approximate. It is not possible at this stage to cost options for integrated multi-agency services. Appendices III-V provide a more detailed description and appraisal of the options for each service.

8.4 Options for `no change' to the three services under review were considered and rejected by the core team and working group. Stakeholders further endorsed the need for fundamental changes to ensure sustainable improvements. Stakeholders agreed that the options are not mutually exclusive but together represent the direction of travel towards integrated services in line with the Green Paper.

9. Inclusion social workers

9.1 Inclusion social workers (ISWs) are based in schools and carry out preventative work with children and families to help reduce the likelihood of school exclusion and family breakdown.

9.2 Findings indicate that this service is highly valued and effective. It is seen as an excellent model of integrated and preventative practice. The workers have established joint working between social services, schools and families. In surveys conducted in mainstream schools and those for children with emotional and behaviour difficulties (EBD), 90% of pupils rated the service they received as good to excellent. It is perceived as a less stigmatising and accessible service, which offers valuable support at times of transition. It provides fast tracking to appropriate services for children and young people. Schools report a positive impact on pupil behaviour and reducing school exclusions. There is also evidence of a reduction in referrals to social services.

9.3 Inclusion social workers were jointly created by Education and Social Services. Of these posts, 5.5 full time equivalents are currently funded by Social Services; one by Education and four jointly funded by both departments.

9.4 To ensure equity of access to this valued, preventative service requires further investment. Expanding the service to targeted schools with the greatest need would require an additional 25 social workers at a cost to Education/Social Services of £660,575 (excluding admin. support).

9.5 Further improvements to the service could be achieved by addressing inconsistencies in working practices and processes across the county and variations in funding and management arrangements. Workers are currently managed by a range of managers within different services in both social services and the education departments. Workers express dissatisfaction with these arrangements, which clearly impact on cohesion and identity of the service.

9.6 Service improvements

9.6.1 Ensure the service is linked to Education and Social Services policy and strategies.

9.6.2 Develop a training plan for inclusion social workers across the Social Services and Education Departments including clear career pathway and progression criteria.

9.6.3 Agree the aims and outcomes of the service between partners.

9.6.4 Identify a clear and consistently applied job title.

9.6.5 Define operational process for all inclusion social workers, which includes consistent recording, compliant with legislative requirements.

9.6.6 Establish consistent funding arrangements.

9.7 Option A: 'virtual' team

9.7.1 Inclusion social workers would remain in present locations attached to different teams but with a single manager and dedicated budget for the service held by either Social Services or Education. An existing manager would take on the lead role in co-ordinating the service at no additional cost.

Advantages:

· remain responsive to local needs

· improved team identity

· clearer accountability and responsibility

· access to consistent management, supervision and training

Disadvantages:

· business processes may not improve because of different team approaches and locations

· no corporate identity

· continued isolation of workers day to day

· continued tensions around differences in teams in which workers based

· no improvement in accessibility and consistency

9.8 Option B: joint corporate team

9.8.1 Inclusion social workers would be based together in the same teams and attached to schools with corporate line management, development of the service and a pooled budget. The additional annual cost of employing a team manager with admin. support totals £45,532.

Advantages:

· greater consistency

· improved integration in line with Green Paper proposals

· potential to attract staff by offering new ways of working

· corporate responsibility, accountability and strategic direction

· standardised operational processes and team approach

Disadvantages:

· lack of fit with Education Welfare Service

· any joint corporate approach would need to address inequities in Social Services/Education funding

9.9 Option C: corporate management of all joint Social Services and Education provision

9.9.1 Establish a corporate department comprising ISWs and all joint services in Social Services and Education. Additional annual costs of employing a service manager and team manager with admin. support total £97, 105.

Advantages:

· provides clarity for the role of ISWs in relation to other childcare workers

· increased scope for joint and preventive working

· in line with Green Paper proposals

· provides more joined up services- 'one stop' for children

Disadvantages:

· any joint corporate approach would need to address inequities in Social Services/Education funding

· need to manage change well to ensure local needs are met

9.10 This service meets many of the Green Paper proposals. However, further work needs to take place to enhance accountability and integration. These options are not mutually exclusive but together they provide a direction of travel towards integrated services. Option C represents the long-term vision for the service as stakeholders were concerned about the feasibility of implementing this option within two years. Option B fits well with the R&A Option C whereby ISWs become part of a multi-agency front-line service. Option B could also be achieved through a remodelled Behaviour Support Team which could be extended to include secondary schools.

10. Reception and assessment

10.1 The seven Children and Families reception and assessment teams receive and screen all referrals and initial contacts, make decisions on eligibility criteria and respond accordingly in the following ways:

10.1.1 giving advice and information;

10.1.2 signposting to other services;

10.1.3 carrying out an initial assessment;

10.1.4 undertaking a child protection (Section 47) investigation.

10.2 The audit of services to children in need (in response to the practice recommendations of the Victoria Climbié inquiry) and follow-up SSI inspection in July 2003 found that children's services in Hampshire were serving most children well with promising prospects.

10.3 The Best Value working group's review of reception and assessment teams across the county, found the key strengths to be the committed and dedicated workforce and strong local leadership. A telephone survey of service users who had recent contact with the area teams, found a high level of satisfaction with the service. This survey included responses from third party referrals where the service was unsought. There is a clear a framework for reception and assessment processes, contained in the care management manual introduced in 2003.

10.4 However, the working group concluded that there is a need for improvement in performance across the seven teams. Last year, performance in relation to timescales for completing initial assessments was poor with an average of only 30% being completed within the government target of seven working days. Performance against new criteria in April-September 2003 has improved with an average of 44.5% initial assessments completed within the timescale.

10.5 Timescales for completing core assessments have also improved from an average 45% completed within 35 working days in 2001/2002 to an average 59.1% for the period April-September 2003.

10.6 Hampshire's re-referral rates are also higher than the national average of 20%. In Hampshire the current figure across the county is 30% (ranging from 18%-36.5%).

10.7 The most critical issues are consistency, equity of access to services and capacity. Resource and staffing levels, constrain the capacity to provide an efficient and effective service at all times and to meet the required timescales for assessment. Further improvements are needed to streamline business processes, to enable the transfer of ongoing work to family support teams and to increase collaboration with other agencies.

10.8 Service improvements

10.8.1 Agree a minimum establishment of social work and admin. staff for all R&A teams. The working group recommends employing two additional senior practitioners and seven social workers to address capacity and equity problems at an additional annual cost of £296, 847 (including admin. support and on costs).

10.8.2 Together with partner agencies publish agreed thresholds for accessing services;

10.8.3 Agree a consistent threshold and application of the eligibility criteria for accepting a referral and progression to initial and core assessments;

10.8.4 Increase opportunities for partnership working in assessment by adopting a common approach to needs led assessment;

10.8.5 Agree a consistent business process across all teams, for referrals, assessment and transfer;

10.8.6 Agree and implement a protocol for information sharing between statutory and voluntary agencies to inform assessments;

10.8.7 Identify a baseline of demographic need using Office of National Statistics vulnerability indices to inform resource distribution and capacity required for future front door services;

10.8.8 Establish clear procedures to address issues of staff working in excess of contracted hours and identify costing implications.

10.9 Option A : single agency service with improved links to local agencies

10.9.1 Reception and assessment teams would remain the single point of access for Social Services for all contacts from the public and professionals. Identified R&A team members would link to partner agencies ensuring regular contact. Achievement of this option would require additional staff in some teams.

Advantages:

· some improvement to accessibility and partnership working

· formalise arrangements with partnership agencies and improve relationships.

· enhanced knowledge and understanding of local services and developments.

· least disruption to staff

· efficiencies in time spent sharing information

Disadvantages:

· potential increased costs through additional staffing

· no impact on crisis intervention at the front door

· no improvement in early intervention

· does not deal with existing inequities or inconsistencies

· does not address improvements highlighted in the Green Paper.

10.10 Option B: `virtual' multi-agency service

10.10.1 A targeted R&A service to respond to new contacts/referrals by the public requiring an initial assessment and only those referrals from professionals requiring a child protection investigation. Cases referred to Social Services who are subsequently assessed to be below the threshold for access to further services would be re-routed through a virtual team. The team would be `virtual' as members would not be co-located and would not have common management.

Advantages:

· improved communication and access

· follows Family Support Services Team (FASST) model; a proven effective model for holistic partnership working across a continuum of need

· reduced overall number of referrals

· reduced professional duplication

· improved response times

· provides links with Children's Fund and preventative services

· lead professional retains responsibility for care management, ensuring continuity of worker

Disadvantages:

· requires increased capacity/incurs costs to social services

· needs commitment by partner agencies

· potential for competing priorities between agencies

10.11 Option C: fully integrated multi-agency service

10.11.1 This would be an early intervention service providing access points for all contacts and referrals from the public and professionals. Teams would consist of childcare professionals from the key agencies. The line manager would determine outcome, and access the appropriate type and level of assessment. Teams would be co-located in community access points such as children's centres or in full service teams supporting schools

Advantages:

· as in Option B

· potential shared focus on child's need

· increased preventive focus

· scope for more balanced casework

· single processes reduce duplication of workers time, referrals and save time at meetings

· lead professional will ensure responsibility is taken for individual children

· one manager will provide greater accountability

· approach supports Information Sharing

Disadvantages:

· disruption and dislocation caused by structural change and major reorganisation

· fear of loss of separate professional identities

· identifying potential managers with appropriate range of skills

· wider staffing issues e.g. different pay scales and conditions

10.12 The options for change for R&A are not mutually exclusive but together they provide a direction of travel towards integrated services. Stakeholders considered that Option A would bring minimal improvement to the service while Options B and C would achieve more substantial improvements. Options B and C are most congruent with the Green Paper and could contribute to maximising life opportunities for children and young people, building strong and safe communities, improving services and developing staff. Option B was seen to be the most feasible option in the shorter term as it could be implemented within two years. Option C represent a long-term vision for the children `s services. This option is underpinned by an early intervention tier as part of a multi-agency preventive strategy developed by the Children and Young People Strategic Partnership (CYPSP).

10.13 The review has explored possible sites to begin the implementation of this approach. There may also be opportunities for the department to include this model as part of the County Council's application for a Local Public Service Agreement (LPSA2) depending on the criteria which have yet to be defined.

10.14 R&A teams as they are currently staffed are unable to meet demand. This is clearly demonstrated by the department's poor performance in key indicators. Although establishing the multi-agency teams would require initial investment to improve capacity, there is potential for savings in the long-term from economies of scale, improved performance and better quality of services to children and young people.

11. Out of hours services for children

11.1 Outside office hours all calls to social services including those involving the welfare of children are routed to Social Services Direct where they are screened and responded to accordingly. Social Services Direct is a centralised service accessed by telephone that covers all care group sectors and is staffed and managed separately from the main body of district and county-wide services.

11.2 Social Services Direct is a trailblazer in implementing service centre technology to provide 24-hour public access to information and advice. Service advisors route calls and provide an initial, low level response freeing up social workers to deal with situations requiring a high level, specialist response.

11.3 The Social Services Direct team have recently undertaken a review of staffing arrangements to improve their efficiency and flexibility. This has included ensuring the availability of qualified childcare social workers to meet peak demand. However, meeting the demands from government to provide a more comprehensive 24-hour service and providing a response that is consistent with mainstream services represent significant challenges given the constraints under which the service currently operates. The current service is not resourced to carry out direct work with families and has limited capacity for social workers to make visits to children and young people with two generic and two childcare social workers on duty across the county during evenings and weekends and one social worker plus a social services assistant on duty after midnight. Consultation showed that there is a lack of clarity among other professionals about the level of service that can be provided out of hours.

11.4 Service improvements

11.4.1 Strengthen links between Social Services Direct and Children and Families managers and improve the management information available to them from Social Services Direct regarding services provided for children (including breakdowns of activity for each area).

11.4.2 Facilitate wider direct telephone access to out of hours social workers for other professionals regarding existing referrals.

11.4.3 Set up regular, formalised arrangements for the exchange of social workers and managers between Social Services Direct and mainstream services. This could be achieved through secondments, job swaps and by ensuring that exchanges are included in inductions of all new staff.

11.4.4 Evaluate the impact of changes to the rota and the staffing structure on the use of overtime and capacity to ensure children placed out of hours are visited by a social worker.

11.4.5 Provide further information regarding the out of hours service for professionals both within the department and other agencies.

11.5 Option A: enhanced out of hours service with district-based social workers on call linked to Social Services Direct.

11.5.1 This addition to the current out of hours service would mean that social workers were available to undertake visits to children and families in distress.

Advantages:

· Improved service to children and families

· Locally responsive

Disadvantages:

· Management cover

· Risks to staff of lone working at night

· Some additional staffing costs

11.6 Option B: extended reception and assessment service working beyond office hours

11.6.1 This would involve staff in areas working to a flexible rota to cover early mornings, late evenings, weekends and public holidays. Social Services Direct would continue to provide a service through the night.

Advantages:

11.6.2 Greater continuity of care for children and families

11.6.3 Potential reduction in calls to Social Services Direct

· More locally responsive

· Staff could be properly remunerated for the hours worked

· Recognition and remuneration for work being done should increase the goodwill of staff

· Options for flexible working could help recruit and retain staff

Disadvantages:

· Significant staffing costs (estimate that would need 50% more social workers and more managers)

· Staff attitudes to working flexible hours are unknown

11.7

11.8 Option C: 24-hour multi-agency response service for children and families.

11.8.1 Access to all services to children and families would be via a single
co-ordination point Separate out of hours services would cease.
Advantages:

· Substantial improvement in access to services for children and families

· Integrated services would meet Green Paper requirements.

Disadvantages:

· Major work required to achieve this.

11.9 Option A was rejected by the stakeholders as a backward step that would create an unsafe service. Option B would significantly streamline the service, reduce the frequency of information transfers and prevent breakdowns in communication. However, the costs of extending R&A services beyond office hours would be substantial as it is estimated that teams would require 50% more social workers. Option C was seen as a long-term vision in the spirit of the Green Paper. Stakeholders agreed that this option could not be implemented within two years.

11.10 The working group proposed a variation on Option B with children's social workers working outside office hours. These additional workers could be partly ring-fenced to deal with new work. This option would provide an enhanced service to families and children in need with the aims of preventing family breakdown and reducing re-referral rates. Advantages of operating a more flexible service include the potential for social workers to provide back up for support workers and volunteers working outside office hours.

11.11 While costs preclude additional staffing across the county, piloting in one district with a view to phased implementation, would provide an opportunity to test the market for recruiting social workers to flexible `out of hours' posts. This would also enable work to be done to identify the impact of an enhanced reception and assessment service on Social Services Direct. Piloting this option for one year in one district, would require additional staff comprising of one team manager, two admin. support workers and up to six social workers at a cost of (£231, 550 excluding 20% enhancement for weekends and public holidays). It may , however, be possible to achieve some economies of scale through the combination of options to increase the capacity of R&A teams and inclusion social workers with the establishment of full service teams.

12. Recommendations currently being taken forward

12.1 A number of performance issues were identified in the findings of the review. This information has been used by the Children's Performance Action Group. Action plans have been implemented for each of the areas, to ensure improved performance.

12.2 The review highlighted the need to ensure that all services under review have access to electronic client records with effective business processes which enable the safe transfer of information. Substantial improvements should be achieved through the implementation of the SWIFT case record system.

12.3 Consultancy work is underway to determine the business case for developing new departmental contact centres as part of the County Council's E-government Improvement Programme which aims to make services more joined-up, efficient and accessible.

13. Conclusions

13.1 The options developed by the review will all go some way to achieving integrated services for children and young people in the community in line with the Green Paper. These options are also consistent with the stakeholders' vision of responsive, locally-based and accessible services. All options require funding for additional staffing and will only be achieved through structural and cultural change and collaborative arrangements with partners. It is proposed that the findings of this review and the options that have been developed inform the joint work being carried out by the Education and Social Services departments to take forward the Green Paper recommendations.

Section 100D - Local Government Act 1972 - background papers

The following documents disclose facts or matters on which this report, or an important part of it, is based and has been relied upon to a material extent in the preparation of this report.

Core review team file. Contact: [email protected]