Guidance for Managers
of front-line services
in Tower Hamlets
on embedding the
Family Wellbeing Model
Guidance for Managers of front-line services in Tower Hamlets on embedding the Family Wellbeing Model
Contents Page
Introduction / 3The Family Wellbeing Model / 4
Some Key Principles in the Family Wellbeing Model / 5
Four areas of work for managers to consider / 6
1. Embedding and Capacity Building: / 7
Universal Services / 9
Targeted Services and Models of Intervention / 10
Specialist Services and Exit Strategies / 14
A Team Review and Planning approach to embedding the FWM and Integrated Working: / 15
2. Skills and Training / 17
Children and Families Partnership Multi-agency training programme / 18
Information, guidance and support for practitioners / 21
3. Support, Supervision and Conflict Resolution / 22
Team Around the Child / 23
Process of allocating a Lead Practitioner / 23
Resolving Disagreements between Agencies / 25
4. Accountability and Quality Assurance / 26
Appendix A - Audit tool for Individual CAF Assessments / 27
Appendix B - Tower Hamlets CAF Outcomes Evaluation / 29
Appendix C - Management Plan for Embedding CAF/TAC/LP / 32
Guidance for Managers of front-line services in Tower Hamlets on embedding the Family Wellbeing Model
Introduction
This Guidance is for managers of front line staff, especially those working in targeted and specialist services but also for those managing universal services.
It aims to support managers in embedding the Family Wellbeing Model and integrated working, including the use of the Common Assessment Framework, Team Around and Child / Family and the role of the Lead Practitioner.
The Family Wellbeing Model, and the tools and practices described in it, are endorsed by The Children and Families Partnership which involves key partners who ensure that we are meeting the objectives as laid out in the Tower Hamlets Children and Families Plan (previously the Children and Young People’s Plan).
Representation at the Children and Families Partnership include:
· Cabinet Member forChildren, Schools and Families (Chair)
· Corporate Director of Children, Schools and Families, London Borough of Tower Hamlets (LBTH)
· Chief Inspector, Lead for Partnerships, Metropolitan Police
· Tower Hamlets Borough Director, NHS East London and the City
· Co-Director of Public Health Tower Hamlets, NHS East London and the City
· Managing Director, Community Health Services, Barts and the London Trust
· Director for Specialist Services, East London NHS Foundation Trust
· GP Lead for children and maternity
· Two Head Teachers, nominated by the Tower Hamlets Head Teachers Consultative Forum
· Principal, Tower Hamlets College
· Registered Housing Provider representative, nominated by the Tower Hamlets Housing Forum
· Two third sector representatives, nominated by the Voluntary Sector Children and Youth Forum
· Two parent representatives, nominated by schools governing bodies
· Chairs of Commissioning and Delivery Groups not already represented above.
Managers in the services represented above are therefore charged with embedding the Family Wellbeing Model, promoting it in their work and providing support and supervision and training to their staff in the use of its tools and practices in their daily work. They will be supported in this by senior managers within their organisations.
The Family Wellbeing Model
The purpose of the Family Wellbeing Model (FWM) is to support children, young people and families to achieve their full potential by setting out in one place our approach to delivering services for all families across all levels of need. This includes health, early years, education, youth, social care, crime and justice and housing services and any other service impacting on a child/young person and/or their parents/carers.
The overall aim of Tower Hamlets’ Family Wellbeing Model is to safeguard and promote the welfare of children, young people and families
(Section 10 of the Children Act 2004)
The Model sets out how we work to respond to different levels of need in Tower Hamlets, and gives practical descriptors which anyone can use to help get families and children who need it the most appropriate help and support. The model also sets out clearly our structure for consultation, co-ordination and co-operation between agencies to promote family wellbeing, to ensure that the children of Tower Hamlets get the best deal from what is on offer to support them.
The model provides detailed guidance for workers in meeting the needs of children, young people and their parents/carers, from those at the lowest level of vulnerability and disability requiring a minimum amount of support and/or services through to those at the highest level, who may require immediate protection and/or supportive services. A framework is provided to identify the different levels of vulnerability and disability children/young people may experience.
The Model does not replace the London Child Protection Procedure and practitioners should continue to refer to this procedure in child protection cases.
Further information on the model, including:
· the tiers of intervention,
· the threshold descriptors,
· the use of the Common Assessment Framework, (CAF)
· the function of the Team Around the Child / Family (TAC)
· the role of the Lead Practitioner (LP)
· “step up” and “step down” procedures
· a flow chart to support practitioners make decisions
· the training programme to support this work
· case studies
· Information pamphlets for parents and young people
can be accessed at:
http://www.childrenandfamiliestrust.co.uk/family-wellbeing-model/
The following guidance should be used in conjunction with the materials above.
Some Key Principles in the Family Wellbeing Model
Common Assessment Framework
We will use the Common Assessment Framework (CAF) for all children and families who need access to targeted services across a range of agencies and in these cases, the CAF will act as the key assessment tool before any referral. This is to make sure that we are assessing families’ needs properly; and have a whole picture of the services they need and are being offered. It will help us make sure that families don’t get lots of well-intentioned support from different directions that isn’t co-ordinated or practical for their immediate situation. The principle is therefore that a CAF should always be completed (and consent received from the child/ young person and/or their parent or carer, unless the case is so serious that consent can be waived) before any referral. This is in order to understand the full context and nature of the problem and to inform the decision as to whether to refer and who to refer to.
Lead Practitioner
Where a family is receiving a range of targeted services, we will always identify a Lead Practitioner to help co-ordinate their support and focus it on the needs of the family. All Tower Hamlets services which work with children will readily take on the Lead Practitioner role, because we understand how important it is for children and families that someone takes a lead for them.
Team Around the Child - Think Family
In Tower Hamlets we have deliberately developed a Family Wellbeing Model rather than a Child Wellbeing Model. It is rarely helpful to consider the adults and children in a family entirely separately even though they may not always be seen together by the same agency. Therefore all services will adopt a whole family approach when working with a child, young person, parent or carer
This means that if staff are working with a child, while ensuring that the child’s
welfare is always the priority, they should consider their parent/carer and the services they may need to support the family as a whole, rather than just looking at the
child’s needs. If they are working with a vulnerable adult, they need to ask if they are either a parent or a carer and consider the needs of any children or vulnerable adults they may care for.
The CAF is a guided conversation with a child or young person and their parents. It provides a series of standard headings to ensure all areas of the child’s development and any other factors that may affect this are taken into consideration when looking at the strengths and needs of a child or young person. It requires practitioners to engage with the child or young person, and in most cases their parent/ carer (taking into account Gillick/ Fraser Competence - see page 17 of the Tower Hamlets Sharing Confidential Information Guidance) to gather and analyse information using a standardised format.
As well as acting as the basis of an action plan for intervention that can help the family move forward, this process also helps to identify additional services the family may need, and who would be the most suitable Lead Practitioner to take forward and coordinate the support required.
The Lead Practitioner can support a family as well as a child and the Team Around the Child can be a Team Around the Family, involving those working with adults in the family as well as those working with the children.
Four areas of work for managers to consider:
Embedding and Capacity Building:
· Embedding the FWM in your work, adopting the terminology and practices
· Embedding CAF and CAF review processes as the one assessment framework used by your service i.e. not duplicating work with other assessments, planning and review processes but adopting this framework, tools and practice wherever possible.
· Building capacity in teams for TAC and LP roles and acknowledging these roles in job descriptions, team planning and allocation of resources, including time and personnel.
· Agreeing in teams the type of cases for which members of the team will take on the LP role – and how many of these cases they can realistically manage in the role of LP.
Skills and Training
· Ensuring staff have the skills to complete a CAF assessment, to formulate an action plan and undertake a CAF review
· Ensuring staff have the skills to participate effectively in a Team Around the Child or Family
· Ensuring staff have the skills to be an effective Lead Practitioner either in their individual work with children, young people and families (sole agency work) or as part of a Team Around the Child / Family for multi-agency work.
· Devising training programmes for staff by identifying what is available centrally that they can access and what needs to be delivered in-house because it is specific to the team.
Support, Supervision and Conflict Resolution
· Providing staff with advice, support and supervision for their immediate case work.
· Using professional development reviews or similar to highlight ongoing issues or training needs and resolving these.
· Providing support for negotiation or conflict resolution with other services if problems arise with integrated working: being clear about what is required of staff and when the manager should step in and take responsibility for addressing these issues.
· Being prepared to refer un-resolvable problems up through your organisations’ representative on the Children and Families Partnership Board.
Accountability and Quality Assurance
· Ensuring staff are held accountable for the outcomes for families as a result of integrated working, including by determining how they will report on those outcomes both within the team and to multi-agency partners within the TAC.
· Providing quality assurance so that you know the work is being done effectively.
1. Embedding and Capacity Building:
· Embedding the FWM in your work, adopting the terminology and practices
· Embedding CAF and CAF review processes as the one assessment framework used by your service i.e. not duplicating work with other assessments, planning and review processes but adopting this framework, tools and practice wherever possible.
· Building capacity in teams for TAC and LP roles and acknowledging these roles in job descriptions, team planning and allocation of resources, including time and personnel.
· Agreeing in teams the type of cases for which members of the team will take on the LP role – and how many of these cases they can realistically manage in the role of LP.
Context
How managers proceed in embedding the FWM and its tools and practices will depend on a number of things including:
· the nature of the service you offer;
· the current roles and responsibilities of staff.
· current policies, procedures and practice that determine the way in which staff currently undertake assessments and action planning
· your team’s prior knowledge and experience of the model and the practices it describes;
· the current level of staff skill and practice in terms of assessment, planning and review;
· the extent to which staff are already engaged in multi-agency work and integrated practice;
· the confidence of staff in working with vulnerable children and young people and their parents/carers
Experience of embedding this model with early adopters has shown that it is least effective when it is seen as an “add on” exercise and most effective when it is
· led by a review of current team practices, policies, and procedures
· supported by an analysis of the knowledge and skills and experience of staff
· followed by a realistic action plan to embed practice over time.
It is essentially a change management exercise and requires careful thought and planning with realistic timescales. It also requires a genuine willingness to replace existing practices with those aimed at supporting early identification and intervention to address the range of needs a family may have in a way that is more integrated with other services across the borough.
However, change is difficult and managers will need to acknowledge that it requires time and other resources and that staff will need to feel supported throughout. As such it needs to be part of whole team planning.
Appendix C is a possible format for planning action to embed CAF / TAC and LP
Look for opportunities to replace and reduce bureaucracy.
Wherever possible the polices, procedures, practices, and tools within the FWM should replace existing ones because adding layers of new policy and bureaucracy is wasteful of time and resources and merely makes things more confusing and complex for staff. A key aim of the FWM is to clarify and simplify policy and practice and remove the need for repeated information gathering, assessment and form filling.