LEICESTER S EARLY HELP & PREVENTION STRATEGY 2013-15
1. Introduction 1.1. Whilst the majority of our children and young people in Leicester grow up in a supportive environment that enables them to have the best start in life, far too many do not. Children do not come into this world with a predetermined life path but many face additional challenges and barriers at any point in their life that, unless addressed early, can cumulatively and negatively impact on their future well-being. These issues can be linked to parental needs (poor health, violence, substance misuse, a poor home environment), or to additional needs of the child or young person. 1.2. This strategy attempts to mitigate the effects of specific risk factors for children through a focus on the whole family, so that the well-being of children and young people can be properly addressed. The challenge in achieving this is to ensure that the voice and needs of the child are heard and clearly inform our work alongside assisting parents/carers. We also know that situations change for families; their lives are not static, and challenging issues can arise at any time. We need our services to be timely and responsive throughout a child s life, providing the right support early so that problems don t escalate. 1.3. Progress has already been made in many areas to deliver timely early help and prevention services that work well together, building on the strong commitment across partners set out in vision of the Children s Trust and the Children and Young People s Plan. The philosophy underpinning this strategy is that early help is everybody s business and this approach and strategy has been signed up to by the Children s Trust. 1.4. In 2013 the Children s Trust agreed Leicester s Early Help and Prevention Offer (Appendix I). This strategy sets out how we aim to strengthen implementation of the offer by joint working and consistency across partners providing early help and prevention services. Our ambition is to learn from the best and deliver high quality preventative services backed by evidence of success. 1.5. Opportunities remain to ensure more seamless, clearer and efficient pathways into and through services; to prevent the revolving door syndrome and improve tracking of cases; and to develop more integrated approaches to screening, assessment, planning and service delivery. If we intervene early with high quality coordinated services we should be able to reduce the number of families requiring higher cost and potentially more complex interventions. 2. What is early help and prevention? 2.1. The concept of early help reflects the widespread recognition that it is better to identify and deal with problems early rather than to respond when difficulties have become acute and demand action by more expensive services. There is now strong evidence of the factors that place children at risk of neglect or abuse, of developing 1
mental health problems, of failing in education, or of becoming involved in crime or anti-social behaviour. These negative outcomes are not only damaging to the children or young people concerned, to their families and the communities where they live, but also result in significant costs to the state. 2.2. Early help means providing help for children and families as soon as problems start to emerge or when there is a strong likelihood that problems will emerge in the future. Although research shows that the most impact can be made during a child s early years, early help is not just for very young children as problems may emerge at any point throughout childhood and adolescence. 2.3. Early help and prevention is about how universal and targeted services are coordinated to identify, reduce and prevent specific problems from getting worse or becoming entrenched. Early help and prevention gives families the opportunity to address their problems; ensuring children stay safe and achieve their full potential. 3. Principles underpinning Leicester s early help and prevention strategy Children and young people s needs are best met when addressed in the context of the whole family, including considering and addressing the needs of their parents or carers, which means services should work in an integrated and holistic way Children and young people who need extra help often succeed best if that help is offered in a universal setting, and within a socially mixed group Activities and services offered to children and young people should help to build and strengthen their resilience Reduce the need for more invasive and intensive services Parents have primary responsibility for, and are the main influence on, their children. Our role is therefore to strengthen parenting capacity, whilst remaining clear about our duty to safeguard vulnerable children and young people 3.1. Leicester s early help approach is based on the belief that children, young people and their families develop resilience if a number of key protective factors are in place: Children have a positive relationship with a significant adult, usually a parent or carer Children develop good literacy and communication skills particularly learning to read Children s attendance at school is good Parent/carers are in employment, are actively preparing to access employment or are ready for and seeking work 4. Objectives Build the capacity of vulnerable families to support their children effectively in achieving positive outcomes 2
Reduce the number of children requiring intervention from statutory or specialist services Minimise the impact of child poverty and worklessness on vulnerable families where help is needed Target resources effectively so they assist children, young people and their families who require extra help and support at the right time 5. What works in early help? 5.1. Our analysis of what works in early help told us that the critical features of an effective early help and prevention offer are: a multi-disciplinary approach that brings a range of professional skills and expertise to bear a relationship with a trusted worker who can engage the child and their family, and coordinate the support needed from other agencies practice that empowers families and helps them to develop the capacity to resolve their own problems a holistic approach that addresses children s needs in the wider family context a simple, streamlined referral and assessment processes 6. Delivering the early help and prevention strategy 6.1. Leicester s Early Help and Prevention Strategy 2013-15 builds on the priorities and drivers contained in the Children and Young People s Plan, and sets out the way Leicester aims to meet these across a range of early help services delivered by partner agencies, commissioned or delivered directly by the council. 6.2. Delivering an effective early help and prevention approach is not a single agency responsibility; it requires a whole family approach by all those working with children, young people and their families. This includes: Health, Police, Probation, Schools, Children and Adult Social Care Services, Housing, Voluntary and Community organisations, and commissioned services. 6.3. Role of Universal Services: The role of universal services is vital. Effective universal services and easy access through universal services to targeted services at a locality level are both central to an effective early help and prevention approach and in reducing the need for specialist services. The following are examples which support the implementation of an effective early help and prevention approach: Effective universal protection /prevention that is available to and helps all families, for example, immunisation programmes and universal and accessible public health information that support better lifestyle choices. Pro-actively challenging non-engagement, such as missed health appointments, also facilitates early help School nurses deliver services for children of school age (5-19) and aim to reduce health inequalities and provide an equitable service across Leicester through a universal and targeted model of provision 3
Strategies that lead to improved access to universal services, an example of which is the Behaviour and Attendance Group, which aims to ensure that all children and young people secure a place in school Universal information, advice and guidance delivered through schools supports and equips young people with the knowledge and skills they need to access further or higher education, apprenticeships or training, and ultimately enter the labour market. The short breaks offer for families with a disabled child 6.4. Family Support Service 6.4.1. The local authority plans to implement a new integrated all age Early Help for Families Service in 2014 aimed at identifying and dealing with problems early in order to prevent difficulties becoming acute and demanding action by more expensive services. The work of the teams will support the development of capacity, independence and resilience of families, children and young people by engaging them in a way that builds on their strengths and that allows them to identify their own solutions and to take responsibility for their future. 6.4.2. The Early Help for Families Service will include geographically based multidisciplinary teams that will bring together staff with appropriate expertise such as family support, youth work, and early childhood development. The teams will also include Think (Troubled) Families workers. The teams will have the capacity to include those workers employed by partners, such as health visitors or Family Nurse Partnership workers. The multi-professional locality structure of the Early Help for Families Service will mean that they can link well with existing local resources and work closely with other agencies to provide holistic family centred support. Early identification will be facilitated by close, integrated working and regular discussion with those who have contact with children and young people such as schools, youth and health workers. 6.4.3. The teams will work with those who have needs below the statutory threshold for interventions under Children Act legislation, providing holistic support to a caseload of children, families and young people. Their role will be to deliver, broker and commission solutions to improve behaviour, family relationships, emotional health, learning, and employability. A designated worker will be responsible for coordinating a plan for the child or young person and their family, setting targets for delivery and outcomes. This will include working directly with children and young people who are on the edge of care. These cases will usually already be open to either the Early Help for Families Service or a Children in Need Team, but require a time limited intensive support to reduce the risk of children and young people coming into care. 6.4.4. The teams will also co-work some cases with children s social care, providing support and intervention to families with children on child 4
protection or child in need plans. There will be clear and safe pathways for children s social care to step down cases to the Early Help for Families Service as the needs of the family reduce. 6.4.5. There will be strengthened and closer working relationships between the Early Help for Families Service and Children in Need (CiN) Teams. CiN Teams will undertake all statutory assessments and interventions under the Children Act legislation which require a qualified social worker. The creation of the all age Early Help for Families Service presents the opportunity for managers and front line staff to work more closely together, leading to more integrated business and assessment processes for children, and may potentially include the co-location of CiN Teams in localities with Early Help for Families teams. This would improve understanding, joint working, and assist the child s journey through more integrated delivery. Cluster 1 Early Help for Families CIN Team Cluster 2 Early Help for Families CIN Team CIN Team Cluster 3 Early Help for Families CIN Team CIN Team Cluster 4 Early Help for Families CIN Team CIN Team Cluster 5 Early Help for Families CIN Team Cluster 6 Early Help for Families CIN Team 6.4.6. One of the aims of the early help strategy is for agencies to work with children and families at the lowest level of intervention, and families will be able to access early help services, for example, attend a stay and play session at a children s centre, without requiring any support or intervention from the family support service. Each of the six clusters will hold multiagency weekly Vulnerable Children, Young People and Families Meetings 5
which will look at children and young people who might be vulnerable to poor outcomes and consider the most appropriate response and intervention. Any intervention or service provided by the Early Help for Families Service will be time limited and based on the consent of the family. 6.4.7. Social workers in Duty and Advice and senior staff from the Early Help for Families Service will be co-located to ensure that any family referred that does not meet the child in need threshold but might be vulnerable to poor outcomes is identified and transferred to the right cluster for consideration at the weekly Vulnerable Children, Young People and Families Meeting. 6.5. Children s Centres and Early Years Education (0-4 year olds) 6.5.1. There is a substantial body of evidence to suggest that interventions in early childhood can make a significant difference in improving outcomes. The key message is that investment and interventions in the early years are more effective than those later in life. We will therefore continue to prioritise provision for the youngest children and their parents with the key objective that children, especially the most disadvantaged, have reached the appropriate stage of development by the time they reach school age. Our focus will be on ensuring that children are school-ready and in a position to learn and achieve in the school setting. 6.5.2. The core purpose for children s centres is to improve outcomes for young children and their families, particularly the most disadvantaged, in order to reduce inequalities in child development and school readiness, and to improve parenting skills and child and family health.the services required to deliver this purpose, known as the core offer, are: early education integrated with childcare family and parenting support child and family health services links with Jobcentre Plus to facilitate parents into employment 6.5.3. In relation to childcare, the Council s statutory duties are to: secure sufficient childcare for working parents, and for parents in training or education assess the sufficiency of childcare provision provide information, advice and training to childcare providers and prospective providers to help them deliver sustainable, affordable and high quality childcare that meets the needs of the community ensure that providers are registered with Ofsted and comply with the expectations of the Early Years Foundation Stage to meet statutory requirements for safeguarding and to promote effective practice in all areas of learning 6
6.5.4. This does not mean that the council is required to provide or deliver childcare itself; third or private sector providers may be better placed to deliver high quality childcare at lower cost. 6.5.5. In general terms, we will continue to secure provision that targets neighbourhoods with the highest levels of need, ensures that children are ready for primary school and have achieved the appropriate stage of child development when they reach school age. 6.5.6. For parents, we will secure provision that equips them with the skills and confidence needed to keep their children safe and healthy, to manage their children s behaviour, to support their learning and transition to school, and to further their social and emotional development. We will also prioritise provision that develops the skills and resilience parents need to cope with challenges, particularly where linked to problems of poor mental health, substance misuse, or domestic violence. Working with our partners, we will secure provision aimed at supporting parents into sustainable employment and at improving priority child and family health outcomes. 7. Early Help Assessment/Common assessment framework (CAF) 7.1. The Munro Review of Child Protection (2010) identified the Common Assessment Framework as the tool to support the early help offer. A key message of the Government s response to Munro was the need for greater transparency and coordination of local arrangements in order to deliver an effective early help offer to children, young people and families. In Working Together to Safeguard Children (2013), the pivotal importance of a common and shared framework for assessment agreed by all local partners was re-affirmed. 7.2. In Leicester the Common Assessment Framework (CAF) is the tool used by all agencies. CAF is used when a practitioner identifies that a child or young person has unmet needs which are more than can be provided by one service; the CAF is the tool for ensuring the information is shared, action plans are clear and coordinated and a lead professional identified. CAF covers the needs of the child/young person and wider family. 7.3. CAFs are not needed when a child/young person is progressing well or has additional needs which can be effectively met by a universal/existing service or in a situation where an immediate statutory assessment or specialist assessment is required. The Thresholds for access to services for children and families in Leicester, Leicestershire and Rutland document (guidance on threshold for children and families services which was revised in early 2014) describe levels of need and gives guidance to partners when assessing a child/young person s level of need. 7.4. Work is underway in 2014 on streamlining the CAF process and developing one single assessment for early help and statutory services; this will include rebadging the CAF as the early help assessment. 8. Quality of Practice 7
8.1. The overall ownership of the strategy sits with the Leicester Children s Trust. 8.2. Quality assurance and challenge is provided by the Leicester Safeguarding Children Board (LSCB). Working Together (2013) asserts the LSCB s role in scrutinising and quality assuring the early help and prevention offer. This will be done through the Safeguarding Effectiveness Group interrogating a range of quantitative and qualitative information. 8.3. Quality Assurance Framework 8.3.1. There is an established Quality Assurance Framework across early help and children s social care services which is designed to assist those with leadership, management or wider scrutiny responsibilities to gain an understanding of how safe children are across the service, and the work undertaken to improve children and young people s outcomes. This includes a systematic process for regularly quality assuring CAFs/early help assessments and the quality of front line practice across early help and prevention services. 8.4. Signs of Safety 8.4.1. In line with the new Working Together statutory guidance, in 2014 Leicester will roll out the Signs of Safety approach, which will underpin the assessment framework for all of Children s Services. This will lead to the development of a more consistent approach to undertaking assessment to ensure that all family members needs have been addressed, including a stronger focus on the needs of children. 8.5. Supervision and Practice Development 8.5.1. Consistent and robust management supervision is crucial to ensuring good quality casework with children and families. A leadership and practice development programme to span early help services will support managers with observing practice and ensuring consistently effective and reflective case supervision. 8.5.2. This will include ensuring that systems and processes across early help capture the lived experience of children and young people in assessments, planning and case work. A common approach to systems and workforce development will be implemented to ensure that the voice of the child is heard and evidenced in case records. Opportunities for practitioners from across the workforce to meet, network, share best practice and discuss issues that affect their work will also be embedded through the way in which the Early Help for Families Service and Children in Need Teams work together. 9. Benefits 8
9.1. The intended key benefits are: a reduction in the number of children requiring specialist or statutory services and a consequent reduction in expenditure on these services maximum efficiency and effectiveness in delivering priority outcomes 9.2. The intended benefits for children, young people and families are: enhanced life chances as a result of the well documented benefits of Early Help in preventing issues later in life an all age integrated service providing continuous support across age groups and for the whole family an easy to access one stop service with an integrated front door co-ordinated support resulting in maximised opportunities and outcomes for children, young people and families a relationship with a known and trusted key worker, whilst benefiting from the pooled knowledge and skills of a range of professionals 10. Measures of success Increased engagement at an earlier stage with universal and targeted services A reduction in the number of children needing the support of statutory safeguarding services. A reduction in the number of children needing to be taken into care. A decrease in the number of parents on out of work benefits. Improved outcomes for priority vulnerable groups identified through the Children and Young Peoples Plan, Health & Joint Strategic Needs Assessment 11. Implementation of the strategy 11.1. This Strategy sets an ambitious vision and direction of travel for early help and prevention provision in Leicester. Delivering this strategy at a time of reducing resources across the public sector means we need to work together and combine resources, with an even greater focus on services that make a critical difference to children, young people and families and especially to those at greater risk. 11.2. This high-level strategy will be underpinned by a delivery plan that sets out how the key actions will be implemented. A performance management framework will measure our progress against the key outcome measures identified and help us better understand where we may need to divert additional resources as we tackle the various challenges we face in the future. 9
Appendix 1 What is early help and prevention? Early help and prevention is about how different agencies work together to help children, young people and their families at any point in their lives prevent or reduce difficulties or problems occurring, or stop them from getting any worse. The concept of early help and prevention reflects the widespread understanding that it is better to identify and deal with problems early rather than to respond when difficulties have become acute and require action by more intensive services. The purpose of Early help and prevention is to improve outcomes for children and young people at all stages of their development; from pre-birth, through the early years stage, throughout their school careers and on into their transition to adulthood. Difficulties may emerge at any point throughout childhood and adolescence. Early help and prevention is about how universal and targeted services are coordinated to identify, reduce and prevent specific problems from getting worse or becoming entrenched. Early help and prevention gives families the opportunity to address their problems; ensuring children stay safe and achieve their full potential. Principles underpinning early help Children and young people s needs are best met when addressed in the context of the whole family, which means services should work in an integrated and holistic way. Children and young people who need extra help often succeed best if that help is offered in a universal setting, and within a socially mixed group. Activities and services offered to children and young people should help to build and strengthen their resilience. Intervening earlier prevents longer term, more costly and damaging problems occurring later. Parents have primary responsibility for, and are the main influence on, their children. Our role is therefore to strengthen parenting capacity, whilst remaining clear about our duty to safeguard vulnerable children and young people. Objectives Build the capacity of vulnerable families to support their children effectively in achieving positive outcomes. Reduce the number of children requiring intervention from statutory services. Address the impact of child poverty and worklessness on vulnerable families. 10
Target resources effectively so they assist children, young people and their families who require extra help and support at the right time. Links to Leicester City Council Strategic Commissioning Review Developing the early help and prevention offer links to the Council s Strategic Commissioning Review of provision for 0-19 year olds, which aims to put in place a core offer of high quality, evidence based activities and interventions that make a positive difference at the right time and to the right children, young people and families. Vulnerability factors The wellbeing of families, young people and children may be affected by individual, parental or family circumstances. These vulnerability factors can mean that something about the child, parent or family is creating a risk of poor physical or mental health and development, which could impact on children s outcomes. Examples of factors that may lead to vulnerability are poverty, single parenting, unemployment, relationship problems, depression, drug and alcohol use, and social isolation. Simply having a characteristic of vulnerability does not mean that children s health or development will suffer. Some vulnerabilities are brief, others are on-going sometimes there are several factors which together cause greater vulnerability. It is important for those professionals working with families to always try and understand what the impact of particular circumstances are for the child by giving them plenty of opportunities to explain things in their own words, and target the right activities to achieve the best outcomes for children and young people. Key activities that make up the Early Help and prevention Offer A range of the types of activities that make up the early help offer in Leicester is summarised in the table at the end of this document. This is not a definitive list and will be subject to change over time, however, it does present a broad range of the different activities that are evidence based and make a positive difference to the lives of children and young people. The activities are structured along a continuum spanning all children and young people aged 0-12 and 13-19, covering universal, targeted, targeted/specialist and specialist provision. The continuum of support reflects the range of activities available for families depending on their level of need with aim of providing a seamless service for families. Alongside, and contributing to the activities listed, there will be a range of other services and activities delivered by the voluntary and community sector that can also be classed as early help. There are different coordination points running along the continuum. Coordination points are meetings, processes or services that play a key role in identifying and 11
coordinating need, activities and services. They all play a pivotal role in coordinating the early help offer for children, young people and families in Leicester. Links to Meeting the Needs of Children and Families in Leicester (guidance on thresholds for children and families services in Leicester) The Leicester Safeguarding Children Board and Children s Trust have agreed guidance on the thresholds for children and families services in Leicester. This assists professionals within the Leicester children s workforce identify suitable responses to needs and issues they encounter amongst the children, young people and families they are working with. The thresholds for services is based on the same continuum as the early help and prevention offer, with the needs of children, young people and their families considered on a case by case basis. Responses should be based on robust assessment and sound professional judgement. There are four levels of needs in the threshold guidance as below: Level 1 Universal: Level 2 Targeted: No identified additional services. Response services are universal services. This level allows for temporary multiagency involvement where it is anticipated that the multiagency involvement will be brief and time limited. Child s needs are not clear, not known or not being met. This is the threshold for beginning a common assessment. Response services are universal support services and/or targeted services. Level 3 Targeted/Specialist: These needs are likely to require longer term intervention from statutory and/or specialist services. High level additional unmet needs this will usually require a targeted specialist response, which will usually include a specialist or statutory service. This also includes the threshold for child in need which will require children s social care intervention. Level 4 Specialist: Specialist needs requiring statutory intensive support. This in particular includes the threshold for child protection which will require children s social care intervention. Some measures of success Increased engagement at an earlier stage with universal and targeted services A reduction in the number of children needing the support of statutory safeguarding services. A reduction in the number of children needing to be taken into care. 12
A decrease in the number of parents on out of work benefits. Improved outcomes for priority vulnerable groups identified through the Children and Young Peoples Plan, Health & Joint Strategic Needs Assessment 13
What s my role as a practitioner in ensuring engagement in early help? If you encounter a child or adult with additional needs that your agency cannot address, you should be pro-active in seeking that alternative support on their behalf. All staff across agencies has a role to play in helping children, young people and families to access help early to avoid difficulties becoming severe and entrenched. Whether you work in an agency that provides services to support families, or you work in a service area where you come into contact with families, but provide other services, e.g. Housing, Police, you could be in a vital position to recognise that there are needs that are not being met. Issues to consider: Talk to a Family Support Manager through Children s Centres (for children aged 0-12) or Integrated Services manager (for young people aged13-19) about what activities and services might be appropriate to engage the child/yp and family Look at what you can do within your own agency s role Consider the different options of how to get the support required for the child/adult/family (e.g. whether to raise a CAF) If you believe that a child or young person is experiencing or is at risk of harm, then make a referral to Children s Social Care and Safeguarding Encouraging and enabling children, young people and families to take up activities, and to access support and services when they are at an early point of experiencing, difficulties is vital. Investment to engage those families who most need support into the right activities and services is key to enabling them to take up the support being offered and to build skills and resilience. It is also important for both individual staff, and services to understand what the barriers are for children, young people and families to take up the offer of early help and prevention, and to actively work to remove those barriers. 14
Leicester City s Thresholds level 0-12 Coordination Points 13-19 NHS Early Help Framework 1 2 & 3 4 Universal Targeted & Targeted/Specialist Specialist Types of Activities Types of Activities Types of Activities Midwifery Health Visiting Services Services promoting learning, development and well-being through children s centres and others School Nursing Parenting Advice Information on activities and services Children centre liaison meetings Positive activities for young people Drug and alcohol advice Relationships and Sex Education School Nursing Information, advice and guidance Bullying prevention Community & Universal levels Welfare rights Promoting children s early learning Parenting and family support Supporting parents into work and training Specialist midwifery Targeted health visiting Early support for disabled children Support for young parents through the Family Nurse Partnership School Nursing health checks Improving school attendance Emotional and mental health support Common Assessment Framework/ Team Around the Child processes Youth CC Panel Think Family Panel Think Family Allocation Panel Ill Children Education Panel MARAC Duty & Assessment in Children s Social Care (Child in need) Improving school attendance School Nursing health checks Support to young carers Targeted youth support Mentoring/counselling School Nursing Accommodation advice and support Parenting and family support Emotional and mental health support Universal Plus Parenting and family support Short breaks provision Prevention of entry to care system Emotional and mental health support Duty & Assessment in Children s Social Care and Safeguarding (child protection, LAC) Leicester Access to Resources Panel Police Referral Desk Parenting and family support Prevention of entry to care system Emotional and mental health support Universal Partnership Plus 15