BEST VALUE REVIEW
SUPPORT FOR CHILDREN & YOUNG PEOPLE IN THE COMMUNITY
Summary of stakeholder event 20 November 2003
INTRODUCTION
Stakeholders in the review including representatives from social services' children's services, partner agencies and county council members took part in a half-day consultation event at the Royal Hotel, Winchester on 20 November 2003
Members of the core review team and chairs of working groups outlined the review findings together with a summary of the Green Paper, "Every Child Matters", to enable stakeholders to consider the way forward for the three services under review; reception and assessment teams, inclusion social work and out of hours services to children.
METHODS
Stakeholders looked at three options for developing each of the three services under review and judged them against the following criteria:
· stakeholder vision and priorities agreed in January 2003
· proposals in the Green Paper,
· the objectives for each service
· cost and efficiency
· feasibility and ability to implement in next 2-3 years
Group exercise one - `option appraisal'
Taking each service in turn, groups were asked to consider the criteria above and then make a list of pros and cons against each option A-C on flip chart (see appendix I).
Group exercise two - `option scoring'
Groups were then asked to estimate the impact of each option towards achieving the stakeholder priorities and to score each option on a scale of 0 -5 (0= no change; 5=major improvement). See appendix II for a breakdown of scores and groups' comments.
FINDINGS
The overall view was that in each case, Option A would be likely to bring about some degree of improvement but would not meet the criteria fully. Options B and C were considered to be more promising and the majority of stakeholders present thought they would meet the criteria and achieve the desired improvements. However, stakeholders were concerned that these options could not be implemented within a 2-3 year timescale. Stakeholders also debated whether their preferred options were feasible in terms of cost. Combined group scores for each option are presented below with highest scoring options highlighted in bold.
Combined option scores:
Reception & assessment |
Option A Single agency service with improved links to partner agencies |
Option B `Virtual' multi-agency service |
Option C Fully integrated multi-agency service |
6 |
16 |
14 |
Inclusion social workers |
Option A `Virtual' team with separate line management |
Option B Joint team of ISWs with corporate management |
Option C Corporate management of all joint Education/SSD services including ISWs |
1 |
12.5 |
17.5 |
Out of hours services |
Option A Enhanced service with district-based SWs on call |
Option B Extended R&A service working beyond office hours |
Option C Multi-agency response service with single co-ordination point |
3 |
12 |
13 |
COMMENTS
Groups made a number of comments about the various options and about the process of appraising and scoring e.g.
· options not necessarily mutually exclusive-might be on a continuum/direction of travel
· options need to take into account local differences and patterns of need i.e. `one size won't fit all'
· need to acknowledge differences of opinion among stakeholders
· scoring needs to take into account feasibility versus `desirability'
Groups also highlighted where further work needed to be done in order to select preferred options including:
· clearer, more detailed descriptions of options i.e. `what they would look like'
· need for additional evidence and information in support of various options including impact analysis and costing of each option
· further consideration of amended and alternative options
· wider consultation with other stakeholders
1. Reception and assessment
|
|
Option A: Single agency service with improved links to partner agencies |
Group A |
_ ` a starter'- would improve accessibility _ any formalised arrangement with partner agencies would bring some improvements _ if keeping `status quo' there are many locally delivered services _ advantages of A & B = don't require major structural changes, only at point of service delivery × won't deal with challenges of GP requirements and inequities × need to look at whole picture to clear thresholds into preventative services × disadvantage with `A' is we inherited resource allocations - no analysis of need - we need to address demand and resources i.e. no structural change unnecessarily - NB any changes have to reflect GP and stakeholder views |
Group B |
_ improved links need to happen _ service `known' who to contact etc _ achievable × [dis?] dependant on individual people and no formal accountability, local networks |
Group C |
_ common assessment structure already in place less change for workers recognises current issues / pressures × communication and recording × confidentiality and data protection × crisis management × lack of protocols between agencies × not doing what we want it to × inconsistency |
Group D |
_ building on existing links _ possibility of using partners/other agencies to pick up work currently not being achieved _ reduce time wasting when sharing information and responsibilities × keep sight not losing good practices we have × resource issues - more meetings = more time |
|
|
|
Option B: `Virtual' multi-agency service |
Group A |
- would like to see interfaces established in some areas to virtual location in other areas `no turf wars' - SSD need to be clear about what they can do! - need to look how other agencies are constructed and how this will be constrained (need a menu of options) - one size won't fit all - need to learn lessons from pathfinders e.g. CAMHS to show the way - we're all configured wrongly to deliver B & C but this is the way forward to local delivered services - will resource constraints remain? |
Group B |
_ more holistic _ easier to tap into other professionals expertise and knowledge × management problems over ownership of decisions - need commitment to work together |
Group C |
_ more comfortable _ FASST team model _ common goal _ communication improves × how do you make it work? × timescales × works in limited geographical area × needs one strong leader × line management × competing priorities |
Group D |
_ partnership working _ reduce referrals _ reduce lead professionals duplications _ clarity for family _ continuum _ could use children's fund links × need technical systems IRT - selling to staff/practitioners × cost - would need to show cost benefit analysis × initial set up costs could be high × size of HCC works in local community model would need mapping × time of meetings - initial assessment must be 7 days × need partners to sign up |
Option C: Fully integrated multi-agency service |
Group A |
[See comments option `B']- will need real links through to YOTs given requirement to spend 25% budget on diverting YP from crime - ring fencing - need for sign up for how this is allocated - against is staff's ability to change post remodelling |
Group B |
- desired point - if we can make it work from the users point - would be the ideal |
Group C |
_ will reach more children and families - impact on referrals _ pooled budgets - could be increase in find _ efficiency savings on finance and resources = economies of scale × as before on option B and major re-organisation, more complex detail, practitioners = job spec who would finance pooled budgets × might loose some good working practices × technology issues - IRT × data protection × learn from experiences in CHMTs and other authorities × need to hold on to professional identity and roles - could be pro or con depending on situation i.e. initial assessment process - clarity on funding streams and accountability required |
Group D |
_ future lack of duplication _ improved communication _ break down barriers _ joint ownership _ joint processes _ quicker earlier response? _ joint responsibility _ improved funding _ avoid children slipping through the net × different pay and conditions × scary! × major re-organisation × tensions × resourcing? |
2. Inclusion social workers
|
|
Option A: `Virtual' team with separate line management |
Group A |
_ Advantage of preventative service i.e. less stigmatising (in any option there are groups of children excluded from provision who don't want SSD intervention) × can't put ISWs in schools with no framework × need clarity of practice × need clarity about respective functions of generic and specialist services - N.B. success of `Start' model |
Group B |
_ could respond to local needs × service needs to have improvements × anomalies/duplications × more accountable × decisions made more quickly when local × service standardised × concerns over roles of EWSs / ISWs × ISWs can feel isolated |
Group C |
_ working in some areas _ flexibility to meet local need × lack of consistency across county × isolation × tensions around line management × resource and training issues × `bitty' coverage of areas × mixed funding stream × relies heavily in the individual × no link people from SSD/Education at county level |
Group D |
× would not improve leadership × FSS would still not be able to predict time × no improvement on findings |
|
|
Option B: Joint team of ISWs with corporate management |
Group A |
_ exciting new ways of working and will recruit staff _ way forward but there are many considerations × dangers of duplicating through creation of new service - must not be called a social work service-needs to be multi-partnership service to schools × key services are missing from the list- need to work with feeder schools too - what does corporate management look like i.e. is it SSD/Education (would be problem if county council)? - what about other management options e.g. Connexions? |
Group B |
_ most feasible option - communication / decision making line management - need clear instruction - clear aims and objectives of service needed |
Group C |
_ achievable in 2 years _ strategic direction _ clear line management _ consistency of policy _ workers feel supported / valued less isolation _ standardise business process status × size of Hants. × travel costs × efficiency × time |
Group D |
_ consistency for EWS e.g. job description /supervision _ improve leadership _ consistent practices in social work and administration× behaviour support teams would still be in two teams× what about inclusion young workers? × where do EWS fit in? |
Option C: Corporate management of all joint Education/SSD services including ISWs |
Group A |
_ key message = need for early engagement with preventive services _ can't afford to wait!! Could recruit SW vacancies into preventive services although would risk losing staff _ a successful approach would be to model this option in 3-4 areas of the county (especially where there is existing infrastructure, needs are established and priorities are clear so can compare urban & rural areas) - NB fear of pilots as good work never gets mainstreamed |
Group B |
_ keeps focus on preventative work _ provides more joined up services _ opportunity to combine services as a stepping stone - EWS/ EOTAS/ ISWs- should /would it become one job? |
Group C |
× there should be an option D which adds other agency's workers (e.g. health) to inclusion teams |
Group D |
_ improve working practices; one vision/aim/objectives _ improve service to children - `one stop' _ builds on behavioural support team model _ time resource efficient × set up costs × need to address issues of funding × need to manage change well to ensure local needs are still met × sign up required by all partners × do not use the current good practices × need to roll out across the county to provide equitable service but cost of this needs to be met |
3. Out of hours services
|
|
Option A: Enhanced service with district- based social workers on call |
Group A |
× current service very limited and inefficient use of social workers travelling to the north of the county × need for clarity about what can/can't be done by SSD agencies and SSD service × social workers on call not a safe service × where would additional resources come from? |
Group B |
- service needs to meet demand extended services needed - general service v extended service? - Swift will `be' SWs into office hrs |
Group C |
_ shift work (child care) _ financial incentives for workers _ better service for children & families × recruitment problem × resource / funding issues × H/S - lone working at night × retention × stress |
Group D |
_ information on children both ways, would improve could lead to wilder resources through local knowledge input _ local links will improve service _ continuity day - evening, quicker response _ relieve stress for families × capacity of R & A teams × recruitment and retention × staff morale :clarity of rules new contracts etc |
|
|
Option B: Extended R&A service working beyond office hours |
Group A |
_ why is OOH separate from `day-time'? _ current arrangements (9-5) compound barriers with other _ inconsistency in remuneration of SS Direct staff working OOH and other SSD teams working outside rostered hours _ won't necessarily cost more × options B & C can't be afforded [NB some differences of opinion!] |
Group B |
_ preference for opt B with A as well _ flexible working could help recruit retain staff × difficult to get Ed staff OOHs × staffing issues a concern across all options × not cheap option |
Group C |
_ get paid for overtime we're doing now! _ flexibility for workforce × management issues (cover) × not enough social workers |
Group D |
_ same advantages as above but added value as local staff will make visits _ recruitment and retention - attract new staff who want to work non- standard hours _ provides a local responsive service _ potential saving on reduction of children coming into care _ over work done in hours not just responsive e.g. risk assessment × recruitment and retention - change of work patterns for existing staff × management continuity- need clear lines of accountability × direct cost of new pay structure × impact of integration on OOHS for other client groups |
Option C: Multi-agency response service with single co-ordination point |
Group A |
_ 4th option - vision cease separate service need a 24 hr service that is a multi-agency response based on need and whole department and partner agencies need to identify needs and redevelop accordingly _ N.B. changes to OOH, GP services and radical changes in PCTs - potential for connections to SSD OOH - April 2004! _ could manage in existing resources if took a skill mix and rota at peak times and target use of specialist staff and review continued use of office buildings doesn't change lack of accommodation for young people and other resources |
Group B |
- have to involve social workers being involved and not dependant on other services - map of needs to predict services - walk in surgeries appear to work e.g. Southampton - extended schools increase contact with staff - can raise expectations beyond ability to deliver |
Group C |
_ economical- some already in existence, this would bring them together _ link with voluntary sector × is there a need? × how? |
Group D |
_ true joined up service in spirit of Green Paper _ `in your dreams' × long time to establish, major implications in workforce planning × national - not Hampshire × all partners to be signed up × building blocks not in place yet e.g. IRT |
OPTION SCORES AND GROUP COMMENTS
0 = no change 5 = major improvement
1. Reception and assessment service
|
|
|
|
Options |
Option A Single agency service with improved links to partner agencies |
Option B `Virtual' multi-agency service |
Option C Fully integrated multi-agency service |
GROUP A |
1 |
4 |
3 |
Comments: - Option B - amend to include common assessment - Options B/C are not mutually exclusive. Selection of options should be predicated on local need i.e. one model won't suit all districts - Option B scored higher because it's more feasible - Option C not feasible within the timescale NB the scoring process is not sufficient basis for a final decision about the preferred options!
|
GROUP B |
2 |
4 |
3 |
Comments: - Wouldn't want achievement of option B to stop development of option C |
GROUP C |
2 |
4 |
5 |
Comments: - Options A/B are the only feasible options in the timescale - Option C- we can for the structure and ??? in 2 years but not get to the vision |
GROUP D |
1 |
4 |
3 |
Comments: - Long-term aim should be to work towards option C. Option B is achievable but Option C isn't achievable in the timescale - Option B would require a minimum of weekly meetings and a manager co-ordinating |
2. Inclusion social work
|
|
|
|
|
Option A `Virtual' team with separate line management |
Option B Joint team of ISWs with corporate management |
Option C Corporate management of all joint Education/ SSD services including ISWs |
GROUP A |
0 |
2.5 |
4.5 |
Comments: - The name `inclusion social workers is inaccurate and misleading - `Corporate management' needs to be defined i.e. multi-agency but not HCC - Option C -more feasible to propose that additional (not all) joint Education/SSD services be managed corporately. This is the ideal option but isn't feasible. Option C is the `firm direction of travel' and Option B would be the `journey started' |
GROUP B |
1 |
3 |
4 |
Comments: - Option - ISWs still out posted - Option C less feasible |
GROUP C |
0 |
4 |
5 |
Comments: - Option A wouldn't deliver on accessibility - Option B would be achievable in 2 years and could be a starting point in moving towards option C as there are overlaps between options B and C - Option C is probably not achievable in 2 years |
GROUP D |
0 |
3 |
4 |
Comments: - Greater accessibility can be achieved by extending the service across the county (for all options). NB no option addresses this - Option C is feasible-suggest this is done by extending the Behavioural Support Teams model |
3. Out of hours services
|
|
|
|
Options: |
Option A Enhanced service with district-based SWs on call |
Option B Extended R&A service working beyond office hours |
Option C Multi-agency response service with single co-ordination point |
GROUP A |
1 |
2 |
4 |
Comments: - Option A would make some improvements e.g. more locally based and efficient - Option B recognises that SWs do work outside office hours so this is better - Option C- problem with this model is that other agencies have their own call centres- lack of co-terminosity BUT there could be opportunities for combining with other agencies e.g. new GP arrangements from April 2004 (greater `political will') - Option C-group disagree about feasibility and costs - NB see exercise one proposals for `Option D' |
GROUP B |
1 |
4 |
2 |
Comments: - Option B not just R&A service-other parts of child care service would be involved |
GROUP C |
0 |
3 |
5 |
Comments: - Option A would be going back to 1978 and now it wouldn't work - Option B would be difficult to have good partnerships unless the ?? as well - Option B could be linked with Option C - Option C could feasibly be affected within 3 years |
GROUP D |
1 |
3 |
2 |
Comments: - Option B achievable with additional resources - Should strive towards Option C- needs national support |
