Level of Service/ Case Management Inventory in Practice

Level of Service/ Case Management Inventory in Practice East Renfrewshire Criminal Justice Social Work Working towards a Safer Scotland

Contents 1. Introduction... 3 2. Summary... 4 3. Case materials provided.. 5 4. Case prioritisation... 7 5. Distributions of general risk/need factors..... 10 6. Overrides. 14 7. Assessment conclusions... 15 8. Resulting supervision levels 17 9. Frequency of assessments 18 10. Conclusion.... 19 2

Introduction This report is drawn from the analysis of aggregate data provided by East Renfrewshire Criminal Justice Social Work Services at the end of June 2013. It draws on the 308 records for 298 clients The purpose of the report is to provide an evaluation of information from the use of the LS/CMI system in East Renfrewshire to support the development of local evaluation and quality assurance measures. Within the report some initial comparisons of East Renfrewshire with the national data is provided for demonstration purposes. This will be more fully developed at a National level in the next stage of the study later in 2013 to support service planning and performance management. Additional feedback will be provided on case samples provided to inform local practice development and the objectives of the LS/CMI National Mentors Forum. The Risk Management Authority would like to thank East Renfrewshire Criminal Justice Social Work Services for their continued collaboration in providing data for this study. Risk Management Authority September 2013 1 1 This replaces the original (February 2013) report to reflect that the information labelled as disposals within the system report actually relates to preferred options for disposal. This report also updates the findings of the original as it contains an analysis of an additional seven months worth of data. 3

Summary Number of individuals on the system: 298 Offender History records: 308 Number initial assessments/screening version assessments: 273 Full LS/CMI started 112 Full LS/CMI completed to a risk/need band: 109 Of the 109 competed full LS/CMI assessments females 2 account for 15% (n=16) of the assessments; males 85% (n=93) Court Report is recorded as the reason for 91% of assessments. Out of 259 assessments where a preferred option for disposal is recorded, the majority (63%) opted for a Community Payback Order followed by community service (12%). Of the 109 LS/CMI cases that had reached a risk/needs band, 1 applied an override. Within the East Renfrewshire data, 106 LS/CMI assessments had reached the evaluation & conclusion stage. The management recommendations were distributed as follows: Routine case management: 74% (n=78) More intensive case management: 25% (n=27) RoSH assessment indicated: 1% (n=1) 2 Where assessments stopped at a Screening Version and did not progress to a full LS/CMI there is no indication of gender in the data. Therefore all references to male/female are based on completed LS/CMI assessments. At a local level the system reporting function can filter by gender and the next IT version of the LS/CMI will report on the sex of all being assessed, including screening version assessments without having to apply a filter. 4

Case materials provided The dataset provided information on 308 cases relating to 298 individuals recorded at end of June 2013. The broad practice process involves the application of the LSI-R:SV and an analysis of offending at the Criminal Justice Social Work (CJSW) court report stage to assist in the formulation of advice on sentencing. The LSI-R:SV is used as an aide-memoire or checklist to ensure that the assessment is grounded in a brief identification of the main risk/need factors and to provide an indication of the need for further intervention. This is followed by an analysis of the pattern, nature, seriousness and likelihood of offending and concludes with the need for supervision, and any identified child/adult/public protection issues. Figure 1. Cases on East Renfrewshire system East Renfrewshire system cases records on the system individuals 308 298 LSI-R:SV completed 273 LS/CMI started LS/CMI completed 112 109 0 50 100 150 200 250 300 350 number There were 16 females and 93 males recorded on the system for whom LS/CMI assessments had been undertaken. While age and gender are not determinants of the scoring they may have an influence on case management planning and interventions. Of the 308 records on the system the age distributions are displayed within table 1. Table 1. Age groups Age Group Frequency Percent 16 and 17 yr olds 7 2 18 to 21 years old 49 16 22 to 25 years old 36 12 26 to 30 years old 37 12 31 years plus 179 58 5

LSI-R:SV and Initial Analysis For the majority of the 308 records an initial assessment comprising the LSI-R:SV and an initial analysis of offending has been undertaken (n=273; 89%). It is expected that this should correspond broadly to the number of CJSW court reports prepared in the reporting period. The system allows for a more in-depth assessment to be undertaken when it is clear to the user that this is merited by the nature or seriousness of the case. Aside from this, a fuller assessment comprising the LS/CMI and a further analysis of offending should be undertaken at the beginning of any period of supervision. LS/CMI The number of full LS/CMI assessments would be expected to correspond with the number of individuals made subject to statutory supervision in the area. Out of the 308 cases entered on to the East Renfrewshire system 109 (35%) have completed a full LS/CMI assessment which compares to an emerging national average of 32%. Of these, 28 started without conducting a screening evaluation (LSI-R:SV & Initial Analysis of Offending). There are a number of possibilities as to why assessors might go straight to the full LS/CMI; 1. Assessor may have judged that a full Risk Need Responsivity (RNR) assessment was necessary at court report stage; 2. First assessment may have been for supervision intake i.e. not to inform court report; 3. Assessor may have moved onto conduct full RNR assessment at court report stage by mistake (likely to reduce once users become familiar with the system). Only four of the 28 full LS/CMI assessments that did not include an initial assessment were for court report purposes. Most were recorded as being applied for post release supervision evaluations which suggests an appropriate use of the instrument. Reason for assessment At the start of the assessment process users provide an indication of the reason for the assessment. These details provide a reference point for the distribution of workloads and also, if the reason for assessment is accurately recorded, offers a point from which the supervision outcomes for offenders can be compared. Table 2. Reason given for assessment Assessment reason Frequency Percent 3 Community: Other 2 0.6 Youth Social Enquiry Report 2 0.6 Community: Reassessment 2 0.6 Community Supervision Intake 10 3 Post Release Supervision Intake 13 4 Court Report 279 91 As indicated in table 2, of the 308 records, 91% have indicated Court Report as the reason for assessment. 3 Totals may not always equal 100 throughout this report due to the rounding up or down of figures. 6

Case prioritisation Initial Assessments There have been 273 Initial Assessments incorporating the LSI-R:SV that have been completed to the point of providing an assessment outcome. The LSI-R:SV briefly reviews the major risk/needs factors to give a broad indication of the need for and focus of further assessment /intervention. This is relevant to the advice given in a CJSW report on the suitability of community based disposals. It is acknowledged that at the time of data analysis not all of the cases submitted will have the assessment process completed. The snapshot for the end of June is as follows; Figure 2. LSI-R:SV outcome distributions LSI-R:SV risk band distribution Minimum 39 Medium 43 Maximum 18 0 10 20 30 40 50 percent The data suggests that where an initial assessment has been undertaken to inform a court report a medium or maximum risk/needs level is indicated in 61% of cases. This information may be useful to those involved in service planning and resource allocation. Furthermore, it is to be expected that the likelihood of offending based on the risk/needs level is reflected in the advice given to the court. Out of the 273 initial assessments started, a total of 259 have been completed to the evaluation and conclusion stage. At that stage the assessor considers whether a community disposal is feasible and, if so, specifies their preferred option for disposal. A breakdown of the 259 options for disposal recorded on the system is provided below: 7

Table 3. Preferred options for disposal Preferred Option Number % Structured Deferred Sentence 1 0.4 Admonition 1 0.4 Probation 1 0.4 Restriction of Liberty Order (RLO) 1 0.4 Supervised Attendance Order (SAO) 2 0.8 Probation with Unpaid Work 3 1 Probation with conditions 7 3 Other 7 3 Fine/Compensation Order 9 3 Drug Treatment & Testing Order 11 4 Deferred Sentence 20 8 Community Service 32 12 Community Payback Order 164 63 As table 3 indicates a Community Payback Order was the preferred option in most cases (63%) followed by community service (12%). Further assessment on case allocation The second stage of assessment provides information that allows for more detailed analysis that is of interest to the service planner/practitioner/researcher: how do assessments undertaken on LSI-R:SV correspond to those later undertaken using the LS/CMI? To understand this, the risk bands obtained from the LSI-R:SV were compared to the risk bands obtained from the LS/CMI. It should be noted that this analysis can only use the information from cases in which both the initial assessment and full LS/CMI assessment stage has been completed. In the East Renfrewshire data, of the 273 screening version assessments 81 also went on to have a full LS/CMI applied. The data in tables 4 to 6 indicate how the two variables compare: Table 4. The LSI-R:SV Minimum group (n=20) LS/CMI risk/need band Percent Very Low (n=7) 35 Low (n=6) 30 Medium (n=6) 30 High (n=1) 5 Very High (n=0) 0 There were 87 cases within the minimum group that did not go on to have a full LS/CMI applied. Table 5. The LSI-R:SV Medium group (n=45) LS/CMI risk/need band Percent Very Low (n=1) 2 Low (n=5) 11 Medium (n=23) 51 High (n=13) 29 Very High (n=3) 7 There were 72 cases within the medium group that did not go on to have a full LS/CMI applied. 8

Table 6. The LSI-R:SV Maximum group (n=16) LS/CMI risk/need band Percent Very Low (n = 0) 0 Low (n = 0) 0 Medium (n = 0) 0 High (n = 13) 81 Very High (n = 3) 19 There were 33 cases within the maximum group that did not go on to have a full LS/CMI applied. The expectation with this type of comparison would be that when a minimum screening version is the outcome then within that group there should be few if any with a high/very high LS/CMI outcome. Conversely a maximum outcome group from the screening version should reflect few if any low/very low LS/CMI outcomes. Comparing figures 2 and 3 provides the risk/needs grouping for each instrument as used within East Renfrewshire. Figure 3. Distribution of LS/CMI Bands LS/CMI risk/need band distribution Very Low 10 Low 17 Medium 35 High 28 Very High 11 0 10 20 30 40 percent It would be of interest to managers to consider the proportion of those cases assessed as minimum/low risk needs who end up on statutory supervision, the reasons for that and at what level of supervision intensity. It would be expected that minimum/low cases would be unlikely to attract intensive reporting requirements. The use of a clinical override, or the nature/seriousness of index offences that add to intervention decisions would provide context to local offender management decisions. 9

Distributions of general risk/need factors The LS/CMI provides a risk/need profile for the individual being assessed. This helps identify what the greater offending related needs are to guide case management planning. The same profile can be used with the aggregate data to show profiles for the caseload in a particular area or nationally. This will be of interest to Service Managers, Team Leaders and practitioners from a quality assurance, performance management and service planning perspective. The average score for each of the subsections of Section 1, for the 109 LS/CMI assessments are provided in table 7. Section 1 Table 7. Central 8 Risk Factors - average scores Risk/Need East Renfrewshire Scoring Range average score Average score in Scotland Criminal History 0-8 3.5 3.6 Education / Employment 0-9 4.9 5.3 Family / Marital 0-4 1.0 1.4 Leisure / Recreation 0-2 1.3 1.4 Companions 0-4 1.5 1.9 Alcohol / Drugs 0-8 2.9 3.5 Procriminal Attitudes 0-4 1.1 1.0 Antisocial Pattern 0-4 1.2 1.4 Table 7 provides an indication of East Renfrewshire s average score for each risk/need factor which is not dissimilar to that from across Scotland. The data can also be used to show the risk/need profile for the different risk/need levels as shown below in table 8. This can be a useful guide to service planners in establishing the likely intervention targets for offenders of varying overall risk/needs levels. Table 8. Distribution (in percentages) of risk/needs according to the Central 8 Factors. Risk/Need Level CH EE FM LR CO ADP PA AP Very High 3 21 2-18 9 11 1 High 14 25 9 60 9 24 6 19 Medium 37 27 23 14 19 14 12 14 Low 28 10 23-14 35 22 27 Very Low 19 17 43 27 39 18 49 39 CH= Criminal History Co= Companions EE= Education/Employment ADP= Alcohol/Drug Problem FM= Family/Marital PA= Procriminal Attitude/Orientation LR= Leisure/Recreation AP= Antisocial Pattern Reading down each column through very high to very low this table produces a profile of the individuals being assessed as a group. The largest percentages are highlighted indicating where the highest proportion of needs are for each risk/need level. 10

Strengths The instrument provides an opportunity to divert from an entirely problem focussed approach through the inclusion of identified client strengths that may assist with desistance from offending. The identification of strengths had arisen as an issue in the LS/CMI learning evaluation research that followed the national LS/CMI training. The data was examined to evaluate the presence of strengths in the assessment process. Table 9 indicates how many strengths were indicated according to the age group of the client. Table 9. Number of cases where a strength was present according to risk factor and age 16-17 18-21 22-25 26-30 31 plus Total years years years years Criminal History - 4 1-7 12 Education/Employment - 4 3 1 10 18 Family/Marital - 6 7 3 13 29 Leisure/Recreation - 3 3 0 10 17 Companions - 5 5 2 22 34 Alcohol/Drug Problem - 4 3 2 7 16 Procriminal Attitude - 4 5 1 15 25 Antisocial Pattern - 1 3 0 11 15 The risk/needs factor where most strengths have been identified is companions. The trend for identifying strengths appears to indicate they are more likely to be found in the 31 plus age group where 57% of all instances of a strength was recorded. However, this age group also account for 58% of the entire sample so this is possibly to be expected. In considering the risk/ need sub categories a number of points of interest were found. The proportions indicated are taken from the 109 completed full LS/CMI assessments: Section 1 - General Risk/Need factors Criminal History 75% of all individuals had two or more episodes of offending. 27% had breached previous supervision orders 20% had been arrested or charged under the age of 16. Education/Employment 68% are currently unemployed 63% left school at minimum leaving age 69% score a 0 or 1 (unsatisfactory situation) for Peer and Authority interactions. Family/ Marital 32% have an unsatisfactory marital or equivalent situation 29% have criminal family/spouse relationships 26% have unsatisfactory parental relationships 20% have unsatisfactory relationships with other relatives Leisure/Recreation 67% have an absence of organised activity. 66% indicated a better use of time was warranted. 11

Companions 60% have some criminal acquaintances. 22% have few anticriminal acquaintances 43% have an unsatisfactory situation for some criminal friends. 29% have an unsatisfactory situation for few anticriminal friends. Alcohol/Drug Problem 66% had an alcohol problem at some point 38% recorded a current alcohol problem 50% had a drug problem at some point 23% indicated a current drug problem. Where a current alcohol/drug problem exists; 98% involved law violations. 82% the problem had affected the marital/family situation. 37% education/work had been affected. Procriminal Attitude 38% have an unsatisfactory attitude toward being supportive of crime. 29% have a poor attitude toward their sentence. 23% have an unsatisfactory attitude toward convention. 20% have a poor attitude toward their supervision. Antisocial Pattern 78% with an official record of assault/violence 37% indicated a pattern of generalised trouble 31% indicated early and diverse antisocial behaviour 1% have required a specialised assessment for antisocial pattern Section 2 Specific Risk/ Need Factors The most frequently identified personal problems with criminogenic potential are: Problem solving deficits 50% (n= 54) Underachievement 39% (n= 43) Anger management 36% (n= 39) Section 2 History of Perpetration Sexual Assault With regard to the items for sexual assault the numbers were very small which makes percentages less relevant. Internet, grooming, indecent images n= 6 Non-contact exposure child male victim n= 3 Extrafamilial child male victim n= 3 Intrafamilial child female victim n= 3 12

Nonsexual Physical Assault and Other Forms of violence Physical assault, extrafamilial male adult victim 51% (n= 55) Physical assault, intrafamilial partner victim 23% (n= 25) Physical assault, extrafamilial female adult victim 10% (n= 11) Assault on an authority figure 21% (n= 23) Knife use 32% (n= 35) Other forms of antisocial behaviour Driving under influence 29% (n= 32) Theft/housebreaking 29% (n= 32) Shoplifting 18% (n= 20) Section 4 - Other client issues Financial problems 44% (n= 48) Victim of physical assault 44% (n= 48) Low self-esteem 30% (n= 33) Evidence of emotional distress 26% (n= 28) Section 5- Special responsivity consideration Denial / minimisation 47% (n= 51) Motivation as a barrier 29% (n= 32) Interpersonally anxious 21% (n= 23) To summarise, outwith the scored section of the tool, the East Renfrewshire data has indicated: Half of the sample indicated problem-solving/self-management skill deficits Internet / indecent image offences account for most sexual offending Physical assault is most commonly perpetrated against extrafamilial males Knife use is indicated in around a third of the cases Financial problems and victim of physical assault appear in over a third of cases Denial, minimisation and motivation as a barrier are common responsivity issues 13

Overrides According to the LS/CMI authors, if the frequency of overrides exceed 10%, this would trigger a need to have a closer to look to ascertain why 4. There is no issue with the frequency of override within East Renfrewshire. Of the 109 full LS/CMI assessments 1% (n=1) had an override applied and approved. The single case for which an override was approved lowered the risk/need level from high to medium. 4 D.A. Andrews, J.L. Bonta, J.S. Wormith. (2004) LS/CMI User s Manual. Multi-Health Systems. Toronto 14

Assessment conclusions After completing the first 6 sections of the LS/CMI and producing a risk/needs profile and suggested risk/needs level for offending generally, the assessor is led through an analysis of the pattern, nature, seriousness and likelihood of offending (Section 7.3.1) to consider the relevance to the risk of harm to others posed by offending before evaluating this against criteria for further action. The conclusion criteria are: routine case management; intensive case management with close supervision, intervention and monitoring; or fuller assessment for risk of serious harm. There are a slightly different range of options for prison based assessments. These conclusions were compared with the supervision intensity levels indicated in Section 9.1.4 Reporting Requirement to consider how consistent the conclusions and supervision outcomes were. LS/CMI screenshot Evaluations & Conclusions Within the East Renfrewshire data the indications were that the 106 Evaluations & Conclusions for management were distributed as follows: East Renfrew Scotland Routine Case Management 74% (n=78) 66% More intensive case management 25% (n=27) 31% RoSH assessment indicated 1% (n=1) 2% 15

For the 78 cases where routine case management focussing on desistance is indicated the recommendation of supervision intensity distribution is shown below 5 : Level of supervision for the 78 cases: Low 17% (n=13) Medium 77% (n=60) High 5% (n=4) Very High 0% No recommendation 1% (n=1) For the 27 cases that merit more intensive case management involving close supervision. Level of supervision for the 27 cases: Low 0% Medium 40% (n=11) High 48% (n=13) Very High 0% No recommendation 11% (n=3) There was 1 case where a risk of serious harm assessment had been indicated. Level of supervision for the 1 RoSH case: Low 0% Medium 0% High 100% (n=1) Very High 0% No recommendation 0% At the 7.3.2 stage of the LS/CMI, if the option to complete a fuller risk of serious harm assessment is selected then the level of detail in the assessment process becomes extensive and places greater demands on the assessor s time. The few assessments that are conducted at this level have the potential to require detailed risk management plans. 5 It is presumed that the numbers that have no indication of supervision intensity are instances where, following a conclusion in Section 7.3.2, the cases have not as yet progressed to Section 9 case management planning. 16

Resulting supervision levels Where an individual is subject to supervision and a case management plan is being devised, the case manager specifies the supervision intensity level within Section 9.1.4 of the LS/CMI. There were 104 records with a supervision intensity recorded. The majority of which were recommended for a medium level. Supervision Intensity ratings: Low Intensity 12% (n=13) Medium Intensity 69% (n=72) High Intensity 18% (n=19) Of these, 103 included both supervision intensity level and a final risk/need category. 6 The association between the assessed risk/need level and the supervision intensity rating is presented in table 10. Table 10. Comparison of supervision intensity ratings with LS/CMI risk/need categories << Supervision Intensity rating >> Final LS/CMI Medium High Very High Low intensity Risk/Need Category intensity intensity intensity Very Low 54% (n= 7) 3% (n= 2) 11% (n=2) 0 Low 31% (n= 4) 17% (n= 12) 11% (n=2) 0 Medium 8% (n= 1) 43% (n= 31) 26% (n= 5) 0 High 8% (n= 1) 26% (n= 19) 32% (n= 6) 0 Very High 0 10% (n= 7) 21% (n= 4) 0 No Risk/Need recorded 0 1% (n= 1) 0 0 There are a small number of supervision decisions in the East Renfrewshire data that warrant a closer look: One individual is assessed as having a high risk/needs level but is recommended for a low intensity supervision. In contrast, four individuals assessed as having very low or low risk/needs are recommended for high intensity supervision. In terms of satisfying a proportionate response to client management these extremes appear to conflict somewhat with what would be expected. This does not suggest the decisions are wrong but would require some supporting rationale. 6 The slight disparity between the number of records where a final risk/ need level is recorded and a supervision intensity level is specified will be due to 1 case where full reassessment is underway but not yet complete at the point where the dataset was submitted to the RMA. 17

Frequency of assessments There were 9 instances where more than one assessment on the same individuals has been applied. There are a range of possible reasons why multiple assessments are being applied - some of which will be appropriate and are to be expected whilst others may be due to misunderstanding/users becoming familiar with the IT system. The reasons include: A further initial assessment on the same individual with a different case number. This situation would arise where the first assessment has been completed and closed then a new case created some time later. This would be expected and appropriate where: - Initial assessment #1 applied to inform a court report and the outcome from court record was closed because the outcome from court did not involve community supervision at that stage; - Initial assessment #2 applied some time later to inform a new court report. This appears to have been the reason for 6 instances within the East Renfrewshire dataset. A further full assessment on the same individual with the same case number. Applying a further, full LS/CMI on the same case could occur for a couple of reasons: - a further full assessment is warranted because a significant event has occurred or a significant period of time has elapsed which could result in significant changes to the original risk/ need level or management plan; - the assessor has selected to re-assess in error. There were 3 instances where a further full assessment in an open case has been applied, all of which had court report recorded as the reason. This suggests that some users of the system are not yet aware of the need to change the reason for assessment when a full reassessment is being applied (for example, when the first full LS/CMI is being applied to inform a case management plan, the reason for assessment should be changed to community supervision intake or post release supervision intake ). 18

Conclusion The screening version of the assessment process has shown consistency with the full LS/CMI outcomes. However, the cases indicated as needing managed at a far greater or lesser intensity level than the assessed risk/ need level would be worth monitoring to ensure the management planning decisions are proportionate. Another area that would be of interest to follow up is the matter of the assessing social worker s preferred option for disposal and to compare those to the actual court disposals. Currently this can only be achieved through local information systems. There were 28 (26%) full LS/CMI assessments undertaken that had not begun with an initial assessment/lsi-r:sv. The majority of these were for supervision intake which is an appropriate reason for conducting a full LS/CMI without an initial assessment. The data has the potential to contribute to service planning using the distribution and prevalence of risk/need factors and responsivity issues identified across the client population. Given the functionality of Version 2 of the IT system a more robust analysis with regard to gender will be possible with the implementation of Version 3. The same data distributions can be used to spot anomalies in assessments and establish some quality assurance points for monitoring. An example of this may be the high proportions indicating compliance and pro-social attitudes within the procriminal attitudes subsection. The East Renfrewshire data indicates a slightly different distribution of management intensity than has been found in the national data set. There are more cases on routine management and fewer with more intensive supervision in the local authority. A more complete and representative national use of the LS/CMI is planned for 2013. This will provide a fuller comparison point for local authorities. A summary of the issues identified in the data from East Renfrewshire which may be useful for managers and/ or those with a quality assurance role are: Maintain oversight of reasons for assessment to ensure it is accurately recorded; Monitor how assessors evaluate the presence of procriminal attitudes. Monitoring supervision intensity levels with regard to risk/need levels to ensure proportionate client management is in place. 19

Risk Management Authority St James House 25 St James Street Paisley PA3 2HQ tel 0141 567 3112 fax 0141 567 3111 email info@rmascotland.gsi.gov.uk www.rmascotland.gov.uk 20