Lancashire's Wellbeing Prevention and Early Help Service Pathways

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1 Lancashire's Wellbeing Prevention and Early Help Service Pathways

2 Contents Introduction Assessment, action planning and outcomes measurement tools Service pathway Service pathway guidance Appendix 1 Report Writing

3 Introduction The Wellbeing, Prevention and Early Help Service (WPEHS) has brought together a range of services that worked with children, young people and families, including Children's centres, Young People's Service, Prevention and Early Help and Lancashire's response to the National Troubled Families Unit programme. The service works with children and young people age 0-19years (including young people up to 25yrs with special educational needs and disabilities) and their families. By responding to people's needs earlier we believe it is more likely that demand on emergency and specialist services, which are expensive, will reduce. Early Help can involve a number of agencies to help a family get the support they need and operates by providing a 'lead professional' who can coordinate the support needed and be the key contact for a family. By working with families Early Help aims to build their resilience, increasing their ability to manage challenging circumstances before they become a problem. Early Help offers children, young people and families more than just a solution to a specific problem; it offers them help to develop the skills needed to deal with a similar problem if it arises in future. Early Help is offered within a family context but can also focus on individual family members specific needs. The service identifies as early as possible when a child, young person or family needs support, helping them to access services to meet their needs, working with them to ensure the support offered is right for them, offered in the right place, at the right time. This guidance supports the establishment, management and delivery of a consistent and effective Wellbeing Prevention and Early Help Service and incorporates the services CAF pathway. This framework and guidance aims: To provide a consistent and high quality service to children, young people and their families across Lancashire. To help to ensure that all cases open to the WPEH Service are underpinned by a CAF assessment. Provide key management checkpoints with which to assist managers in fulfilling their responsibility for ensuring the provision of an effective and consistent service. To ensure the CAF process and TFU programme is embedded within the service and there is regular management oversight and review of cases. To be a reference point for staff and managers who need to clarify any areas of concern in relation to good practice, process and responsibilities. To provide partner agencies with a consistent delivery of targeted services from WPEHS. To define standards of good practice and be a source of information. To provide material for training / induction. Assessment, action planning and outcomes measurement tools CAF The Lancashire Wellbeing Prevention and Early Help service uses the CAF as the mandatory assessment where a request to support the children, young people and families have been received. This enables the service to determine the level of need on the Lancashire Continuum of Need and provide the family with the appropriate level of service. The Lancashire Common Assessment Framework [CAF] is a shared assessment and planning tool for use across all children's services in Lancashire. It assists in the early identification of needs for children, young people and families. 2

4 The CAF promotes a coordinated approach on how the identified needs should be met. The CAF/TAF and Lead Professional are contributing elements for improved outcomes and support the delivery of services that are integrated and focussed around the needs of both the children, young people and the family. Outcomes Star The Outcomes Star is an outcomes measurement tool which is used with children, young people and families. Lancashire County Council has embedded a suite of 4 Outcomes Stars that are used within the Wellbeing, Prevention and Early Help Service: Teen Star, Youth Star, My Star and Family Star Plus. They are designed to engage children, young people and families in identifying where they are in relation to various areas of their life / parenting role. Then to provide support, measure and evidence the change our users experience through their work with the Service. My Star - To be used with children and young people, it is focused on physical health, home, being safe, relationships, feelings and behavior, friends, confidence, and education. Teen Star - To be used with young people, it is focused on keeping young people safe through looking at personal safety, substance use, structure and education, citizenship, emotional health and wellbeing and family and other key adults. This outcomes star is most relevant for use when young people are identified at Level 2 or 3 on the Continuum of Need. Youth Star - To be used with young people it is focused on supporting their enjoyment and achievement through looking at hopes and dreams, communication, education and work, choices and behavior, wellbeing etc. This outcomes star is most relevant for use with groups, or when young people are already accessing specialist services (E.g. Mental Health Services, Substance Misuse Services or are currently involved with Children s Social Care) or where keeping safe is not an issue for that particular young person. Family Star Plus - To be used with parents, it is focused on effective parenting through looking at keeping children safe, home and money, family routine, progress to work, boundaries and behavior etc. This outcomes star is most relevant for use by Lead Professionals. This would run alongside the use of Teen Star with the young person. 3

5 Lancashire Wellbeing, Prevention and Early Help Service Flowchart for delivery of targeted Wellbeing, Prevention and Early Help Services with Children / Young People and Families. = Management Checkpoint. Recording. Caseload Management. Quality Assurance. Workforce Development. Supporting admin & MI processes. Request for Support (RfS) received &/or family identified as unmet needs or meeting the criteria for TFU within WPEHS Acknowledgement of receipt of RfS. Allocation to WPEH Worker within 5 working days WPEH worker check if CAF exists. If not request a URN Level 1 Needs and Risks can be met by universal services. Initial visit within 7 working days with referrer if possible. Complete or input clients details onto MIS system. Complete CAF assessment & Outcomes Star over initial and subsequent 2/3 visits. Consider wider family circumstances, TFU criteria and level of need with child / young person and family. Escalation Signpost and close CAF in agreement with line manager by ing caf@lancashire.gov.uk Record and evidence decision. Possible Outcomes and Actions following assessment Complete Outcomes Star at 12 week review & / or closure. Where consent has not been obtained return RfS to referring agency and request consent to be completed. If a CAF is already in place, WPEH worker to contact the Lead Professional (LP) and request that the LP gain consent from the family for the WPEH worker to attend the next TAF meeting. Where a family refuses consent for completion of a CAF assessment WPEH worker to refer to line manager. Where worklessness is identified contact with WPEH Employment Advisor must be made. Level 2 Level 3 & 4 Evidence of some Unmet needs and Low Risk been identified. Requires Targeted support via CAF/TAF. Escalation Identify a LP with CYP&F ASAP. Develop action plan from part 3 of CAF assessment. Identify and invite relevant agencies to TAF meeting. Submit CAF/TAF to caf@lancashire.gov.uk Review progress every 6-8 weeks and submit at each review to caf@lancashire.gov.uk Evidence of Higher levels, Unmet Needs and Medium Risk or Significant Unmet Needs and High Risk. If needs met close CAF with agreement from line manager. Feedback to referrer. Discussion with line manager / DSO regarding referral to Children's Social Care and agree future role of WPEHS. caf@lancashire.gov.uk Guidance for the delivery of targeted Wellbeing, Prevention and Early Help Services 4 If the needs of a child or young person escalate and they are in need of protection follow safeguarding procedures.

6 Guidance for the delivery of targeted Wellbeing, Prevention and Early Help Services This guidance supports managers and practitioners to provide effective and consistent delivery of targeted support services to children, young people and their families. Building on the existing good practice within Targeted Youth Support and Children Centres Family Support Processes. This document incorporates the WPEHS CAF Pathway and guidance and should also be viewed alongside: Lancashire's CAF Guidance Tools, LCC Step Up / Step Down Procedures Case Management and Supervision Policies The various quality assurance tools such as file audit tools and staff observation Guidance for Professional Recording Guidance for WPEH in working alongside families with identified needs around employment. The guidance covers the following areas of delivery: Request for Service Allocation Initial Contacts and Home Visits Assessment Intervention and Contacts Progress Reviews Case Closure Management Checkpoints Request for support. Requests for Support (RfS) will come from a number of sources, for example from other professionals or services, from families or young people themselves. An RfS must be completed for all families identified by partner agencies as having potential unmet need. When a CYP or family self-refers an RfS must be completed by the WPEH practitioner, informed consent should be gained and recorded. The RfS, along with discussions with referrer, family & CYP, should form the basis of initial visits and assessment. Therefore RfS must be completed comprehensively; clearly identifying the reason for request, outlining unmet needs in addition to family strengths and ensuring TFU criteria, where appropriate, has been identified and recorded. If the RfS is incomplete and/ or further information or clarification is required contact with referrer should be made prior to allocation and a professional challenge made regarding the quality of the RfS. A RfS will ideally be supported with a CAF which identifies the unmet need. Where there is no CAF a professional challenge should be made and a request that a CAF is completed and forwarded. Where this is not actioned the RfS will still be accepted and the WPEH will complete the CAF. For accountability, safeguarding and resource management reasons casework managers are required to have a clear overview of all RfS received and cases allocated via the RfS tracker, RfS should be submitted to the caseload manager for allocation. Checkpoint: Is the RfS appropriate, is it completed fully with reason for request clearly stated? Has TFU criteria been considered or identified with use of crib sheet? 5

7 A record and chronology of all contacts and activity must begin on receipt of the RfS using current record keeping systems, RfS should be date stamped or noted on MI systems on the day received. If RfS indicates there is an open CAF, contact the Lead Professional (LP) to update that a RfS has been received and with consent contribute to CAF/TAF process (if unsure who the LP is contact caf@lancashire.gov.uk ). If CYP/family meet TFU criteria notify the LP to inform the assessment and ensure this information is fed into the CAF process via the TAF meeting. Allocation. All requests for support will be allocated to a practitioner within five working days. Caseload managers will have an overview of practitioner's workloads and to whom cases can be allocated, a matching up of practitioner to family must be considered. Checkpoint: Has case been allocated within the timescale of 5 working days? Factors to consider when allocating cases: Troubled Families criteria: Use Crib sheet to identify the TFU criteria link into crib sheet /guidance Child and family: Practitioner: Age, number, known potential needs of children, age, potential or known needs of parent(s), i.e. domestic abuse, substance/ alcohol misuse, mental health, family circumstances such as housing or debt issues, current or previous CAF/ TAF,CSCS involvement, likely levels of support needed. Seniority and level of skills, knowledge, expertise, current capacity including levels of cases held and LP role, specialism i.e. DA/ teenage parents etc., responsible for delivery of other activities, any additional travelling. Contact will be made with the referring organisation to update them on who the WPEH case worker is. Initial Contact and Home Visits Pre-visit Prior to visit WPEH case worker to check if CAF exists. Check if CAF exists by ing name, DOB, address of child / young person and your contact details to; caf@lancashire.gov.uk. 6

8 If CAF in place details of author or Lead Professional will be sent to you to contact and agree involvement. If CAF not in place you will be sent unique reference number (URN) - begin assessment. If consent not given and if there are no safeguarding concerns, discuss alternative means of supports Discuss with manager reason for consent not given and record decision. Revisit completing CAF assessment/process at later date with family. Contact with the referrer must be made by the allocated WPEH practitioner prior to an initial visit taking place and where possible these visits should be undertaken jointly with the referrer. Where worklessness has been identified contact with an employment advisor must be made prior to visit in order to share information. Contact with CYP & Family must be made to arrange an initial visit or contact within seven working days of allocation. A home visit / lone working risk assessment must be completed and relevant policy adhered to. To support completion of risk assessment information from RfS, referrer and MIS should be used. Initial Home Visit and Contact Complete initial visit within 7 working days of allocation. In Lancashire the CAF is the holistic assessment tool for practitioners to use and it should be undertaken for all of the CYP and Families referred for targeted support. CAF and Outcome Star processes must be discussed with CYP/family at this initial meeting to gain consent to proceed with assessment. If not previously identified check do individuals within the family meet TFU criteria? As with the CAF process the TFU programme is led by consent to engage and have information shared, using the information contained within TFU privacy notice. Informed consent must be gained and this must be recorded within Part 3 of the CAF. Where a family 'Opt Out' of Trouble Families the WPEHS Worker must the central team at wtwf@lancashire.gov.uk Assessment Whilst information from the referrer and the RfS will form the basis of these initial meetings, practitioners must also explore with the family/cyp the wider family circumstances, including TFU criteria. A number of information sources / tools can and should be used to explore more than the presenting concern and help identify the level of possible unmet need as well as help to identify strengths, these include: CON/ Threshold Document Neglect Risk Assessment Existing assessments (CIN, CP, ASSET) 7

9 Outcomes Star Strengths and Difficulties Questionnaire Development Matter (Early Years Foundation Stage) CAF Family Guidance CAF Practitioners Guidance How to engage with individual children and young people CAF assessments should be completed over a number of visits and within a maximum of six weeks, Outcome Star to be completed alongside CAF. Where possible CAF assessment should be undertaken jointly with the referrer and/or other key agencies involved with the family/ CYP. If consent is not provided and if there are no safeguarding concerns, discuss alternative means of support with the family. Discuss with caseload manager and record decision. Revisit completing or engaging more fully in the CAF process at later date with the family. CAF assessments should be completed ensuring that there is; o The involvement of all family members and practitioners working with the family, based on consent provided. o A focus on strengths and needs. o The voice of the child / young person is reflected. o All sections are complete and signatures are recorded. o Evidence of the TFU criteria has been identified There are four possible outcomes to the CAF assessment: Level 1: Needs and Risks can be met through Universal Services or simple specific agency response. Agree with CYP/family and line manager, signpost and close CAF by ing caf@lancashire.gov.uk Level 2: Evidence of some Unmet Needs and Low Risk which can be met through targeted service provision; Wellbeing Prevention and Early Help Services. Identify a LP with child / young person and family ASAP. With consent identify and invite relevant agencies to TAF meeting, sharing CAF securely with practitioners. Using TAF paperwork bring forward priorities, goals from Pt 3 of CAF assessment and develop action plan from Pt 3 of CAF assessment, ensuring where appropriate actions/objectives align with the Troubles Families outcome plan. Review progress every 6 8 weeks with CYP and family using TAF paperwork. If needs / risk are at Level 1 close CAF with agreement from CYP/family and case work manager. Submit CAF/TAF paperwork at each point to caf@lancashire.gov.uk. Level 3: Assessment / evidence indicates Higher Levels of Unmet Need and Medium Risk. A Children's Social Care Statutory Single Assessment is required. Level 4: Assessment / evidence indicates Significant Unmet Needs and High Risks. A Children's Social Care Statutory Single Assessment is required. Discuss with line manager / DSO referral to Children's Social Care and agree future role of WPEH service. 8

10 Completed assessments Agree content of CAF with child / young person and family, ensure the family sign the copy. Give the child / young person and family a copy of their CAF assessment. Complete an electronic copy, in consent box identify that a 'Signed copy is held on file'. File paper copy securely. Submit electronic copy to caf@lancashire.gov.uk (You will receive an alert 20 days after a URN has been issued ) Checkpoint: Has contact with the family & CYP been made and a home visit undertaken within 7 working days of allocation? Has the CAF been completed within 6 weeks? Has appropriate Star(s) been completed? Is there evidence TFU criteria has been considered or identified? Is management oversight and decision making evident? Intervention and Contacts Where worklessness has been identified as an unmet need and with consent, contact with an employment advisor must be made to offer specialist support and guidance as part of the TAF process. A range of supportive interventions should be planned and delivered with the family/ CYP in order to address the identified unmet needs. Identified outcomes and actions should be recorded in action plans and reviewed at 6-8 weeks as part of the TAF. Once the CAF process is initiated or in progress complete appropriate Outcome Star(s), this should be repeated at 12 week review and/or closure. Before undertaking visits practitioners must be clear about the purpose and focus for the visit. This will reflect and support the needs, outcomes and actions identified through the assessment process and planned for in the CAF and TAF action plan. Practitioners must refresh themselves with information from the previous visit, review home visit / lone working risk assessments where needed. The purpose of the visit should be explained clearly to family/cyp at the start of each contact, including a recap and follow up from the previous visit acknowledging any actions, developments or progress made(positive or negative), these should reflect and be linked to the action plan and be CYP focussed. 9

11 The contact should be finished with a summary covering the main areas of discussion/ learning and any actions, where possible a record of the contact is completed with and signed by the parents/cyp. If the planned purpose/actions of the visit could not be achieved this should be acknowledged within recordings with actions carried forward to the next visit. Practitioners must be mindful of the CYP throughout the visit and observations should be made within records, if CYP are not present a reason why must be recorded. Where families/cyp are accessing universal open access services in addition to targeted support effective communication, information sharing and record keeping needs to be in place. Progress Reviews and Closure of Cases It is important that progress is monitored and the effectiveness of interventions are reviewed with the family/ CYP. This will be through use of the review of TAF action plans and outcomes star(s). The CAF/TAF process should be open until needs are met, if needs are not met continue to support identifying new goals as required and reviewing progress through TAF process at approximately 6-8 week intervals. TAF paperwork should be submitted at each review to caf@lancashire.gov.uk. Where family/cyp needs escalate to Level 3 or 4 on the Continuum of Need 'Step up' processes and safeguarding procedures must be followed and discussed with line manager/case work manager. The decision to close a case will be made within the TAF process and in casework supervision with agreement of the caseload manager. The decision for closure must be underpinned by the evidence of the progress made and outcome(s) achieved and clearly recorded with TAF review paperwork, caseload and management records. A final outcome star(s) should be completed to evidence progress made and the effectiveness of the intervention. Where the remaining unmet is in relation to worklessness the employment advisor will hand over to the Job Advisor, this needs to be evidence in the final TAF plan prior to closure. Inform caf@lancashire.gov.uk when CAF is closed. Ensure relevant MIS systems are updated in a timely manner, after each review when a need has been met and closed and/or the CAF is closed. Checkpoint: Is there evidence of management oversight of the quality, timeliness of the TAF? Is progress being made? Is there clear evidence that unmet needs have been met and case can be closed? Evidencing Long Term Outcomes 10

12 To evidence the longer term outcomes a system should be in place to follow up with the family after a specified timescale. This could be a general contact to see how the family/ YP are doing and that outcomes are being maintained and CYP needs are being met. 11

13 Wellbeing, Prevention and Early Help Service Guidance for Professional Recording. This is additional guidance to support the delivery of targeted Wellbeing, Prevention and Early Help Services and should be viewed alongside the Pathway and Guidance for the delivery of targeted Wellbeing, Prevention and Early Help Services and YPS Policy and Guidelines for Professional Recording. Good recording is about accountability and responsibility. Investigations and enquiries held over the years into cases with tragic outcomes have shown inadequate recordings to have been a significant problem. Many such difficulties can be avoided by timely, routine recording. Records are written accounts either on paper or held electronically of any work/contact with families/cyp/agencies and should describe the circumstances and needs, provide analysis, explain decision-making, prioritisation of need and management of risk. All records and contacts must be maintained in a chronological order from the receipt of the request for service including any significant event (s) relating to the person(s) identified in the case notes: this includes telephone calls, s, visits, significant discussions or meetings. The Chronology should contain a brief description of the contact and cross referenced with the more detailed contact recordings, assessments, plans, reviews or other correspondence. (Children's Centres only ) Contact/intervention recordings should be used to provide a more detailed account of contacts or visits made and should be linked as far as possible to the purpose of the visit, which in turn should link to the action plan. In addition records should be CYP focused evidencing if the child/yp has been seen and a reason recorded if not. Recordings should legible and concise include, date, time venue, purpose of visit and who were present and key points from the contact. Where appropriate contact reports should be completed with and signed off by parents/yp. Records must be accurate and distinguish clearly between facts, opinions, assessments and decisions. Opinions should have clear indication as to their foundation clearly distinguishing between first-hand information and information obtained from third parties. Unsubstantiated comments have no place on case records unless the source and truth of comment are also recorded as far as they can be determined. If information received is from an anonymous source, this fact must be recorded together with a record of the attempts to verify the information and the extent to which it was successful or unsuccessful. Records must be relevant, pertinent to the situation, family context and the work being undertaken. Monitoring and Reviewing of Records The overall responsibility and accountability for ensuring all records are maintained appropriately rests with managers with day-to-day responsibility for case management. Evidence of management oversight and decision making should be clearly identifiable throughout the records. For example: recordings of worker /management discussions with decisions and actions taken, evidence of regular case load supervision management sessions, evidence of casefile audits being undertaken. Children, Young People and their families must be informed about their records They have a right to be informed about the records kept on them, the reasons why, and their rights to confidentiality and of access to their records, and so records should be written with this in mind. Families must routinely be involved in the process of gathering and recording information, be provided with opportunities to express their own views and wishes and contribute to assessments, reports and to the formulation of plans. It should always be remembered that families have a right of access to their records It is anticipated that as much information as possible will be shared as part of a transparent and supportive working relationship between practitioner family/cyp and where possible and 12

14 appropriate recordings should be made at the time of the contact and where possible 'signed off' by the parent or young person as evidence information has been shared. Generally, CYP and their families must be asked for their agreement to the sharing of information about them with others with the exception of where there are safeguarding concerns and where gaining consent may put the CYP or someone else at risk of harm. Information obtained about CYP and their families should be shared with them unless: Sharing the information would be likely to result in serious harm to the child or another person, or The information was given in the expectations that it would not be disclosed, or The information relates to a third party who expressly indicated the information should not be disclosed The information is relevant to the prevention of detection of a crime and to release it would prejudice the investigation. Records should be kept securely All members of staff have a responsibility to ensure that the information, contained in all case records, is kept securely. This involves preventing unauthorised access by keeping passwords secret and protecting electronic records from corruption caused by hardware faults or a virus. Paper records should be stored in a locked cabinet, in an office which only staff have access to. Other day-to-day records, such as diary contact sheets, CAF, TAF, should also be kept securely in a manner authorised by the relevant manager. These records should not be left unattended when not in their normal location. Paper records should not normally be taken from the location where they are normally kept. The manager must be satisfied that adequate measures are in place to ensure the security of the records(s) whilst they are off site. For example, records must never be left in unattended vehicles. 13

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