ITEM CH6
CHILDREN’S SERVICES SCRUTINY COMMITTEE 28 OCTOBER 2008
IMPLEMENTATION OF THE CHILDREN AND YOUNG PEOPLE’S PLAN – REPORT OF THE TASK GROUP
1. Oxfordshire produced a Children and Young People’s Plan in 2006, to comply with government requirements in Every Child Matters. The Plan covers all services for children and young people in the county, including health services, early years, education, youth and play services, housing, safeguarding, youth justice services, etc. The CYP&F directorate reviewed what had been achieved in Year One, publishing a report in June 2007, which was presented to Children’s Services Scrutiny Committee. The Committee established a Task Group to scrutinise the implementation of the Plan.
2. The Group noted the areas identified for further development in the Review of Year One:
· develop joint agency, integrated early intervention and preventative approaches for vulnerable children; · outcomes for children in deprived areas; · the 19-year gap in life expectancy between the ‘best’ and ‘worst’ wards; · poor educational achievement of vulnerable groups; · earlier and better cross-agency support to promote mental health and wellbeing in young people.
3. Cross-cutting priorities identified for Year Two were:
· preventative and early intervention support; · raising educational aspiration, enjoyment and achievement; · improving sexual health, reducing unwanted teenage conceptions; · emotional and mental health and well being; · improving outcomes for children, young people and families in areas of deprivation; · ongoing engagement and participation of children, young people and families.
4. The Task Group felt that a key area to investigate was the new emphasis on multi-agency working to improve outcomes for children and young people. This led to scrutiny of the Sounding Board, which gave a voice to children and young people, the new locality teams and PCAMHS. Lead officers were interviewed and visits planned to see locality working in action.
5. It became clear during our work that the introduction of the new working practices requires a huge culture change which will take time to complete. During our visits we found that not unsurprisingly there were some concerns expressed (these are described later in the report) about new ways of working, however we overwhelmingly found excellent examples of good practice and multi-agency working. We met very enthusiastic and dedicated staff who are embracing new ways of working, determined to achieve better outcomes for children, young people and families.
Sounding Board
6. Two members of the task group attended the first meeting of Sounding Board Five on July 2nd, whose topic was ‘Improving Attainment’. The Board includes 33 children and young people from across the county, including some looked-after children, youth council members, youth parliament members, as well as some 20 ‘leaders’ and support staff. The Council has promised to give more feedback to the young people on how their views have been taken on board. Until now, the subjects have been chosen to tie in with those being considered by the Children’s Trust. The next meeting of the Board on October 1st considered ‘Accidents’ and gave the participants feedback on the actions taken following the suggestions made at the previous one.
Locality Working
· put children, young people and families at the centre and involve them in decision making;
· be coordinated across agencies with one lead contact person to help them navigate the system and support;
· have fewer assessments, reduce duplication and give more practical support;
· be available earlier – before things deteriorate;
· be organised so that services are easy to access locally.
8. Oxfordshire has been divided into
13 geographical areas, each with its own
Locality Support Team. (See Annex 1 (download as .doc file) for a list of people involved, from many
agencies).
9. They continue to be managed within their own services but operate integrated teams with a coordinator – a virtual team of staff working together to provide preventative support for children, young people and their families.
10. Each of the 13 localities has a Locality Coordinator whose role is to:
· Develop a good working knowledge of support services in the area and identification of appropriate resources;
· coordinate locally based practitioners to work as a multi agency team around individual children;
· advise and support the lead professional;
· support the development of common processes to improve information sharing and assessment including an electronic child index, electronic case records and service directory;
· facilitate and provide joint agency training on common core skills and competences to help in the localities.
The Common Assessment Framework (CAF)
11. CAF provides a common method of assessment across all services working with children and young people. It aims to help early identification of needs, leading to co-ordinated support. The common assessment is used by practitioners to identify those children who have additional needs and are not progressing and/or where needs are unclear and more than one service is needed. When CAF identifies that a multi agency response is required, a “Team Around the Child” (TAC) meeting takes place. The Team Around the Child is a team of relevant professionals (representing universal and targeted services) working together with the family to address the child or young person’s needs. The team works together to plan co-ordinated support from agencies to address problems in a holistic way. The family and child are integral parts of the process to develop the action plan.
12. Where a child or young person has additional needs requiring a multi-agency response, a relevant practitioner from among those supporting the child is identified to carry out the functions of the Lead Professional who:-
· acts as single point of contact for the child or family;
· co-ordinates the delivery of the actions;
· reduces overlap and inconsistency in the services received;
· continues to support the child and family if more specialist assessments need to be carried out;
· supports the child through key transition points but where necessary, ensures a careful and planned handover takes place if it is more appropriate for someone else to be the Lead Professional.
13. The CYP&F Directorate’s criteria for establishing whether the Locality teams are working are:
· Improved achievements in education, health, and social care against the “Every Child Matters” outcomes.
· Coordination of service with more parents, children and young people satisfied with the service received.
· Fewer children needing to be “Looked After” or on the Child Protection Register; fewer children in out of county facilities/placements.
· Positive feedback from schools and GP’s about better and earlier coordinated support to help them meet young people’s needs.
· Better use of resources.
· Widespread use of the Common Assessment Framework (CAF) and Team Around the Child (TAC).
· Full implementation of the Lead Professional role.
Visit to Didcot
14. The Task Group visited Stephen Freeman Children’s Centre, Willowcroft and Northbourne Primary Schools, had a discussion with members of the Locality Working Network and a presentation from the Didcot young people’s network.
15. The overwhelming impression was of real inter-agency cooperation, with the Network having 60 members from the schools to the CAB, social workers, drugs advisers, Didcot First (businesses), health visitors, police and the Home School link worker. This last post was invaluable in working with families and often helping to complete a CAF. When asked for the key issue to be tackled, the answer was immediate ; ‘parenting’. The Home School link worker runs a support group for parents twice a month in the Children’s Centre and is helping the Team around the Child to become a Team around the Family.
16. Outreach work sessions involving the Home School link worker were critical in developing support, not just for children and families in need, but specifically for parents. The Children’s Centres ran ante-natal classes and these provided opportunities for families to get to know appropriate professionals much more quickly than they might otherwise do and therefore helped in gaining parents’ trust. The benefit of the Locality Network was that when issues were identified that had an impact on families, the CAB could utilise its voluntary workers to visit and work with families.
17. Willowcroft School had experimented with a ‘nurture’ class to support vulnerable children away from their normal classes. It is mixed ages and treats each child as an individual. Small sums of money can be allocated to an individual child by children managing the Community Chest ; one child had been given a guitar and another riding lessons, enabling them to grow in confidence and achievement. It was emphasised that intervention should be as early as possible; by Years 5 and 6 it is very difficult to re-integrate a child into the mainstream activities,
18. Northbourne School highlighted the time taken to complete a CAF form; the SENCO felt the 2-3 hours involved was too great a load. The head has developed an alternative ‘creative curriculum’ and emphasised the need to help parents early. It was reported that some GP’s are cooperating extremely well and their input has been greatly appreciated. It is true to say however, that more generally there is an issue with GP engagement. It was felt that more health visitors were needed in the south of the county. Some staff reported that in their view the capacity of PCAMHS was exceeded with an 8-10 week wait now –and that there were not enough social workers.
19. The school was in a deprived area, but innovative leadership had enabled the introduction of greater flexibility around the National Curriculum and it was anticipated that justification for this approach would be provided by Key Stage results. Further work should be carried out to monitor the success of this approach and then to consider whether it might be applied elsewhere. The Task Group was advised that the context for this was the new Locality working arrangements that had enabled “access to all of the appropriate professionals and agencies, regularly and quickly”.
20. The young people told us that their greatest need was for someone to contact after school and at weekends. They want to be able to access an adult apart from their parents or carers, and to have ‘places to be’, not necessarily things to do.
Wheatley/Headington Locality,
21. To see locality working in a different area, we visited The Slade Nursery and Children’s Centre, Cheney Secondary School and Great Milton Primary School. At the Slade Day Nursery and Children’s Centre the Locality Social Worker was regularly on hand to provide support, the TAC was being implemented successfully in the handful of varied cases managed there to date, and outreach work was comprehensive and effective. Great Milton School had not yet used the CAF process, but extended services were being developed which were providing care from 8am to 6pm. It was also reported that there had been tremendous inter-agency support and good integrated working across a number of services and agencies to establish the children’s centre in that area. The green setting of this school would be the envy of most other primary schools!
22. A discussion with locality staff showed a few problems – we were told that the service directory was out-of-date and that the 6 week intervention from PCAMHS was not thought long enough.
23. Cheney School did not think the CAF/TAC process was significantly different from their current practice. They particularly felt that children should be assessed before coming to secondary school, when it might be too late.
PCAMHS
24. This service has won national awards and has seen many hundreds of children. Although most schools have found this service excellent, waiting times have grown due to the lack of capacity with increasing demands. For some young people their needs are very complex and the six week intervention is not long enough to meet those needs.
25. CAF and TAC processes have also identified that a number of children who are involved in these processes have complex needs and require a high level of support.
26. Teaching staff, during our visits to localities as already stated, raised concern about the amount of time they are spending completing CAFs and working intensively as Lead Professionals to support these children.
27. In a second interview with Paul Sheffield (PCAMHS lead) and also in discussion with Maria Godfrey (Service Manager Locality Working & Integrated Support Services), we were told about the proposal to establish a new service called TACYP (Team Around the Child and Young People Service). This will extend the remit of PCAMHS to offer a service where a co-ordinated multi-agency response is required.
28. Intervention will be underpinned by the Common Assessment Framework and Team around the Child and a Lead Professional will be identified in all cases. For school aged children interventions will critically link into school based services. It is the intention that this new service will in offering more direct support to schools and settings around complex cases and this will alleviate some of the issues around capacity heard from teachers and SENCOs about CAF, TAC and the Lead Professional role.
Conclusions of our review of CYPP implementation.
29. We found that very good progress is being made in the areas identified for further development in the Review of Year One, however, we identified some areas where more work is needed:
· The Locality planning structures do not currently fit with school partnerships;
· More training is needed for all staff involved. Maria Godfrey has described implementation of the skills development programme which is part of a whole workforce strategy. This will ensure that staff feel confident and equipped to engage in partnership work. We feel that this is a very important part of further developing and embedding the CAF and TAC processes.
· Schools need to be helped to identify their vulnerable children.
· More Home School Link Workers are required who are appropriately trained and supervised.
· Good practice should be shared
· As we found that there has been less takeup of the CAF and TAC process in the Central Area, this needs investigation
· Ways should be found to meet young people’s need for someone to contact after school and at weekends and to have ‘places to be’.
· GPs need to be encouraged to co-operate more fully in CAF and TAC processes.
· Building on the success of PCAMHS, implementation of TACYP to improve support for children and young people
30. In spite of some delays in Locality working being fully implemented, Oxfordshire is more advanced than many other comparable authorities. The relationship with the PCT is “very good”, for instance, when the County Council moved to a 13 locality team structure, the PCT moved the appropriate staff to a mirrored 13 locality team structure. There is a view that more health visitors should be employed.
31. It has been emphasised many times during our visits that this new way of working is a cultural change process which will take time to embed. We were impressed by the dedication of all the staff we met and suggest that a further review of Year Two of the implementation should be undertaken to monitor further progress.
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