OPTION PROPOSALS FROM R&A WORKING GROUP

1. LIST OF MAIN SERVICE IMPROVEMENTS

Changes that need to be made regardless of which options are selected and need to happen within one year maximum.

The changes identified below incorporate the findings of the review group, stakeholder preference for `direction of travel' and are in line with the Green Paper. They reflect a four- tier model of service provision: universal, early intervention, targeted and crisis intervention for children and young people

0 - 19yrs.

· Begin to adopt a whole systems approach to children in need in the community

- Move towards a more integrated model of service.

- Improve communication and access

- Together with partner agencies publish agreed thresholds for

- accessing services. Requires social services to review and

- potentially revise its current Needs/Thresholds matrix.

- Increase opportunities for partnership working in assessment by

- adopting a common approach to needs led assessment (The

- Framework for the Assessment of Children in Need and their

- Families). A model is already in use, is regularly used by health

- visitors and can be revised and re-launched as an extended

- partnership initiative.

- Partner agencies to complete this assessment before referral to

- others in order to access additional services.

- Agree standards and audit progress.

- With partner agencies and organisations, maintain an up to

- date, online community `resource directory' in each R&A area.

· Social services `front door' service to apply consistency & equity across the county

- A consistent/efficient business process

- A consistent application of the threshold/eligibility criteria for accepting a referral and progression to assessment: initial and core

- Audit progress of consistent application of thresholds/eligibility criteria

- A smooth and speedy transfer to family support teams

- Identify a baseline of demographic need/ONS vulnerability indices to inform resource distribution/capacity required for future front door services.

- Every social services `front door' team to include a senior practitioner.

· Improve performance

- PI: increase `front door' capacity to improve PI's for completion of initial and core assessments on time

- PI: begin to reduce re-referral rate, target area Basingstoke as highest re-referral rate in county.

Note: for this PI, progress in any area will be dependant on effective links with and provision by early intervention tier.

2. DESCRIPTION OF EACH OPTION

Option A: Single agency service with improved links to local agencies - targeted tier

Key features: Social services remain single point of access for all contacts from public or contacts/referrals by professionals (local office or contact centre). R&A team members linked to key referral points/groups (schools, GP surgeries) with consultancy role re social services thresholds for referrals.

Local social services R&A manager retains responsibility to determine outcome of referrals, and may `deem' another agency's assessment a completed initial assessment if meets required standard, allocate for initial assessment by social services or request joint assessment. Those below social services thresholds either receiving no further action by social services or advice/signposting to other agencies/organisations.

Staffing & management: To achieve option A, clear backlog, manage demand and improve PI's requires additional time/ capacity & the ability to cover absence for leave/training etc. (see local weekly workflow returns and response times in DIS).

Baseline: 1 team manger and 1 senior practitioner in each team, but until staffing levels can be informed by demographic needs/vulnerability indices any viable service requires a minimum of 6 FTE staff (excluding TM and Snr Prac), and 1FTE admin support, with admin cover available for absence.

Under 19 population breakdowns, existing knowledge of needs/vulnerability indices, current demand/referrals and PI's indicate that minimum staffing levels in Alton/Aldershot, Fareham/Gosport and Havant should be higher: 8 FTE staff (excluding team manager & senior practitioner).

Skills mix of this service should reflect its role in initial risk management: eg per 6 FTE, ideally 2 higher grade social work, 3 main grade social work staff & 1 SSA.

Location: no change

Funding: social services

Option B: `Virtual' multi-agency service - early intervention linked with targeted tier

Key features: Social services remain single access point for contacts from the public (local office or contact centre). Reduced local social services R&A service to respond to new contacts/referrals by public requiring initial assessment but maintain response to professional referrals requiring S47 enquiries. Initial assessments undertaken by social services, but below threshold for access to further services re-routed through virtual team to arrange lower level care management.

`Virtual' multi-agency service achieved by `patching' partner agency staff with community access points (schools and/or early years centres), and co-locating at set times for `virtual team' working: existing R&A staff delivering joint assessment, consultation. Members of this `virtual team' delegated by employing agencies would meet to agree thresholds of single agency assessments, refer across/up or down the tiers of service.

Where social services thresholds were met, an initial assessment would be `deemed' completed. Decision re further action/access to additional services provided by social services retained by the local social services R&A team manager with potential to `fast track' to social services family support team. Where a single agency referral led to a dispute re social services thresholds, this would require a joint assessment with social services. Below the threshold for social services intervention, referring agency retains responsibility for care management.

Staffing & management: To achieve option B, manage demand and improve PI's also requires additional capacity, but with responsibilities shared by key `supply chain' partners for assessment standards, advice re compatibility with thresholds prior to the multi-agency meeting and where necessary, supervision of any ongoing care management.

Baseline: as Option A, but with input by partner agencies.

Location: community access point and local social services office

Funding: as Option A.

Option C: Fully integrated multi-agency service -early intervention & targeted tiers, OR targeted tier `linked' with early intervention

Key features: Fully integrated access point(s) for all contacts from the public (local office or contact centre) and S47 referrals from professionals. Line manager(s) determine outcome, and access appropriate type & level of assessment via fully integrated multi-agency team(s) but maintain current arrangements for managing S47 enquiries.

Staffing & management arrangements: 1 overall `service' manager responsible for management of the integrated team although with first line managers responsible for different groups of services operating across the early intervention and targeted tiers. Team seconded by all partner agencies working with children and families in the community, acting as care managers for allocated caseload. Seconding agencies retain responsibility for professional development of their staff.

Assumes that with the police, a social services line manager retains responsibility for S47 enquiries, manages the process, outcome of the enquiry and specialist supervision of their staff undertaking S47 enquiries.

Location: community access points/schools or early years centres

Funding: as Option A. Partnership basis for `service' manager.

3. KEY ADVANTAGES & DISADVANTAGES OF OPTIONS

(includes comments from stakeholder event)

· Option A

Advantages

- `a starter' to improve accessibility & build on existing links

- common assessment format already in place

- any formalised arrangements with partner agencies would bring some improvements - `would know who to contact'

- if keeping `status quo' there are many locally delivered services

- no major structural change

- some reduction in time spent sharing information/recording

Disadvantages:

- requires increased capacity/incurs increased cost to social services

- not sufficiently `joined up to provide whole picture of child and do what we want it to' - ie. provide earlier intervention and reduce level of crisis management at front door

- does not deal with existing inequities or inconsistencies

- will not meet challenges of GP requirements

- different services retain different priorities

· Option B

Advantages

- improve communication & access -`easier to tap into other

- professionals expertise and knowledge'

- `provides a FASST team model (Family Support Services

- team)'for holistic partnership working across continuum of need

- `reduce time wasting referrals'

- `have a common goal & reduce professional duplication'

- provides more clarity for families

- improved response times

- `avoids children slipping through the net'

- provides links with Children's Fund & prevention resources

- lead professional retains responsibility for care management - `less

- pass the parcel'

- effective early warning to reduce perceived levels of crisis

- management

- increased opportunities for local training for staff development

- maintains safe systems for response to S47 enquiries

- Disadvantages

- requires increased capacity/incurs costs to social services

- `needs full sign up by partner agencies' or `how can you make it

- work'

- `one size wont fit all'

- does not address leadership, so competing priorities remain -

- `potential turf wars'

- will need regular meetings to ensure can meet 7 day deadline for

- initial assessments

- cost to social services

· Option C

Advantages

- as in Option B

- and

- efficiency savings/finance and resources from economies of scale

- in longer term

- formal arrangements increase ownership of goals - lead to more

- focus on outcomes for children

- single processes reduce duplication & save time at meetings

- leadership = 1 `service'manager results in clarity of accountability

- for care management below the threshold for S47 enquiries

- test-beds for electronic information sharing across agencies

- Disadvantages

- structural change & major reorganisation

- takes time to plan and set up

- `scary': could `lose professional focus'

- `one size won't fit all'

- different pay scales and conditions

- cost to social services

3. THE CASE FOR YOUR PREFERRED OPTION

The options above are not mutually exclusive. The stakeholders consultation event rated option B highest (16), option C (14), and option A (6), but together these options provide for a direction of travel - towards integrated services.

· Options B & C constitute the stakeholders preferred options, with Option B seen as the most feasible in the shorter term.

· Option C constitutes the BV Group's preferred option in the medium term (1-2yrs). The Group accepts that resource limitations may make this difficult to achieve in 2004/5.

· Nevertheless, the Group wish to stress that to achieve the original stakeholder vision, it is important to achieve the direction of travel and plan to move towards the goal of Option C. This means working towards targeted tiers linked with early intervention as a starting point.

· Both options meet the requirements of stakeholder priorities: accessibility, participation, partnerships, common assessments, efficiency, communication & information, accountability & integration; workforce reform.

· Both options meet the requirements of the Green Paper, if underpinned by an effective early intervention tier: supporting parents and carers, early intervention & effective protection, accountability & integration

(Option C rates higher), workforce reform - although this has only been considered from a local, service delivery perspective, but is based on experience of implementing The Framework for the Assessment of Children in Need and their Families.

· Whichever option is followed, all need increased capacity in the existing

R&A teams, as specified above. The overall level in the longer term will

be determined by applying ONS/vulnerability indices to each area's

under 19yrs. population profile. Cost is therefore a factor, but the cost of

doing nothing also needs to be factored in. In areas of the county where

recruitment is difficult, if this option is piloted, increased staffing costs

can be offset against vacancies, carefully monitored and evaluated.

· No change is unacceptable given existing PI's for completion of

assessments on time, re-referral rates and the stated intentions of the

Green Paper. The risk of doing nothing in the short term is status quo

re PI's, but in the longer term risk of increased re-referral rates, and

crisis intervention by social services - and no improvement in outcomes

for children and young people.

· Service models working successfully elsewhere are in immature, but

exist in West Sussex, Bolton, North Lincolnshire, and Portsmouth.

Experience from West Sussex and Portsmouth suggest a decrease in

referrals to social services, but no mature evidence exists in practice.

Nevertheless, it is clearly unacceptable to do nothing.

· Suggested pilots for taking the above options further in Hampshire

are areas where the following are part of the local infrastructure:

¬ coterminous agency boundaries for health and social services

¬ one police division

¬ a volunteer school pyramid or pyramids

¬ opportunity to test effectiveness of contact centre

¬ established preventative services

Having considered the above, the group suggest New Forest, Gosport and Basingstoke. There was considerable debate about the most appropriate pilot site in the north of the county, as both Basingstoke and Alton/Aldershot have similar needs. However, the critical factor for the group was the high level of re-referrals to social services.

· The above options meet corporate priorities, but in the group's view, options B&C are the most congruent. In particular to achieve maximum life opportunities for children and young people, equalities, sustainable development, build strong and safe communities, e-government, improve services and develop staff.

MC/22 January 03.