MASH Event

King’s Hall

28 February 2013

Welcome and Introductions

Eleanor Brazil

Interim Director, Children and Young People’s Services

Stoke-on-Trent City Council

Mick Harrison

Commissioner for Community Safety

Staffordshire County Council

Our Vision

Vulnerable people and their families within Staffordshire and Stoke-on-Trent are able to live safe lives, free from abuse and neglect or the risk of abuse and neglect through an integrated approach to sharing of information, collaborative decision making, in order that proportionate interventions are justified at the earliest opportunity across the partnership.

2002- Jessica Chapman & Holly Wells 1945 Dennis O’Neil 1984- Jasmine Beckford 2000 - Lauren Wright 1973 – Maria Colwell 2007 - Baby Peter 1994 - Rikki Neave 2000 – Victoria Climbié 6

MASH in Staffordshire and Stoke-on-Trent

• Over 1 million people • Increase in Adults / Children Referrals • Three key partners: – 2 upper tier authorities (SOT & SCC) – Staffordshire Police – Health architecture • Fiscal issues • Business case?

Key Issues

• Leadership (political / organisational) • Governance • Lead Commissioner • Information governance • Legal / Collaborative agreements • Relationship building / Partnership work

• Increase in demand • Integration / Interoperability • Continuing fiscal challenges • Performance management • Further integration • Provider / Commissioner split

Challenges

‘Hold your nerve’ ‘It’s worth it’

Project Management

Nichola Glover-Edge

Portfolio Manager

Staffordshire County Council

How did we make it happen?

• Strategic buy-in from all partners involved with leaders actively engaged in the project process.

• One Lead Officer across the partnership • Leads from each partner being held to account for the successful delivery of the MASH, ensuring the project progressed at pace.

How did we make it happen?

• Dedicated operational managers and staff making it happen, unblocking issues and mobilising resources to deliver the project. • Drive, passion and enthusiasm from operational staff within the MASH to make it a success. • Dedicated project management capacity to coordinate activity and resources to ensure that the project is delivered to cost, within budget and on time.

Project Management

• The Transformation Support Unit (TSU) is operated by the County Council and offers the delivery of high quality, professional design and project management services to facilitate the delivery of transformation within all service areas. • The resources that the TSU offered to the MASH project were as follows: Nichola Glover-Edge: Portfolio Manager Sanjeet Bains: Project Manager Mark Cocker: Senior Business Designer

Timescales

• The TSU inherited the MASH project in August 2011 and took remedial action to ensure its delivery date of December 2011.

• The MASH project was handed back to business as usual in July 2012.

Project Scope

The project scope for establishing a Multi-Agency Safeguarding Hub.

• Ensuring the MASH has a physical space to operate. • Set-up and ongoing costs between partners • Corporate governance arrangements are in place • HR issues are identified and addressed • Joint OD plan is developed and delivered

Project Scope

• Telephony infrastructure is designed and delivered for the MASH • ICT hardware and software is designed and delivered for the MASH • Information Governance procedures are in place • Operational procedures/flow are in place • The statutory duty of all partner agencies is met • All stakeholders are communicated with

Governance

Operations HR Strategic Leadership Group Steering Group Performance OD Workstreams Accommodation Information & Governance Communications Legal & Finance

Challenges

• Mechanism for sharing information • Building confidence in sharing information • IT and telecommunication infrastructure • Driving through issues • Culture and Organisation Development • HR and Vetting

Lessons Learned

• Fostering partnership and building a trusting relationship takes time.

• Earlier engagement of health.

• Resource commitment agreed from each partner agency.

Lessons Learned

• Recommend co-location prior to making the MASH operational – a one size does not always fit all. • Engagement with partner IT teams/Expertise is key to delivering ICT work packages • Ensuring attendees at groups have the delegated decision making authority.

Executive Summary Executive Summary (RAG) Overall Project Green

The transfer of the MASH to Business as Usual was completed on the target date.

Whilst a few deliverables remain outstanding, it was recognised that these cannot be completed within restricted timescales and are an ongoing evolutionary process. The closure was approved with these outstanding deliverables being handed over to newly appointed MASH Development Officer.

Timescale Green

The project was closed as planned.

Cost Risk Issues Benefits Green Green Green Amber

Whilst no formal budget was agreed for the MASH, project costs remained within acceptable levels as defined by the governance structure.

Risks were managed throughout the project.

The remaining open risks relate to the ongoing operational delivery of the MASH and will be managed by the MASH Development Officer and the BAU governance structures implemented.

No outstanding issues are retained on project closure. The MASH Development and Handover Plan referenced to in this report will resolve outstanding actions.

Benefits for the MASH project were not articulated from outset of the project. The identified benefits have been derived from ongoing work on the Performance Framework and inherited details articulated on the origination Project Initiation Document. Work is scheduled to complete and baseline performance figures by September 2012, test the performance framework in the fourth quarter of 2012 and then implement at the beginning of the 2013 financial year.

Culture/ Integration/ Development

DCI Helen Jones

Protecting Vulnerable People

Staffordshire Police

• Police • Social Services • Health

Culture

• Red to Green • Statistics not outcomes • Internal status • Conflict in ‘performance’ • But..

Police

Executive Officer support, the profile of Safeguarding is being promoted at every opportunity.

Vital ingredients to a successful and harmonious working environment.

• Escalation Policy • User Group meeting

Maslow

Maslow’s hierarchy of needs. Abraham Maslow ‘A Theory of Human Motivation’ 1943

Motivator

• Motivator – Hygiene theory • Motivator Factors – Achievement , Recognition, Work Itself, Responsibility, Promotion, Growth • Hygiene Factors – Pay and Benefits, Company Policy and Administration, Relationships with co workers, Physical Environment, Supervision, Status, Job Security

Herzberg

Integration – some history

Integration, some history…..

• 2009/10 • Co-location • Ethos – One Team, One MASH • Open communication in real time under agreed MoU

Integration – the challenges

Integration, the challenges….

• IT • Individuality Interoperability, a more realistic position for the medium term

DI Dan Ison

MASH Officer

Staffordshire Police

• Purpose • People • Location • Systems/Processes • Performance

Organisation Development

• Vision Statement • 5 year Vision • Single Organisation?

Vision and Strategy

Values and Culture

• Relationships • Joint Training • Staff Engagement/Joint Communications

• Escalation and Resolve • Information Sharing Protocols • One Defined Leader?

Style and Leadership

Structure

• Governance – Decision Making • Parent Policy vs MASH Policy • MASH Future Development Plans

Systems

• Communications • Incompatibility • Operating Principles/Performance Framework

• Resource Numbers • Cohorts of Work • Staff Engagement • Skills – Mutual Understanding

Staff

Lunch

Ingredients for success

David Stringfellow

Head of Responsive Services

Staffordshire County Council

The MASH concept … Easier said than done

• Challenge of coordinating change  No one agency can act unilaterally

•

How is change managed in this environment

Establish the means of communication  Create methods to enable immediate review and decision-making  Involve interested people • • MASH - weekly operational meetings  Service managers and key operational staff represented Managing Risk  Responsiveness vs Inclusivity  Dynamic and responsive leadership is critical

Trust the operational teams

• Autonomy to lead on a day-to-day basis  Practitioners empowered to make decisions • Bottom up approach  Support given from above where needed  Stakeholder inclusion achieved and maintained

Other Considerations

• Get the right personalities in the right place  Need to see the bigger picture  Good interpersonal skills required • Need to understand the detail of each other’s business

Other Considerations

• Common Language  Agencies use the same words and phrases to describe very different things  Global communications need careful consideration • MASH – a doing word  Not a place but a verb?

 An unhelpful generic label

• The right location • IT Infrastructure • User groups • Communication

The practicalities

Things to watch out for

• Prepare for change • How to eat an elephant – in small bites  Gradual introduction of cohorts of cases  Design of the physical exchange of information sharing

Things to watch out for Things to watch out for

We view full information sharing as a compliment to already established systems.

Things to watch out for

Introducing a wave of multiagency demand through a single point of information sharing is likely to result in a monumental bottle neck.

Steve Dale

Adult Protection Co-ordinator

Staffordshire County Council

Why Why Why Adults?

• National cases – Police calls should be linked – Information sharing vital – Stop working in silos – Regular calls to emergency services 6 years on 5 years on

Why Why Why Adults Continued

• Local problems pre 2012 – Limited access for police to hold strategy discussions – Police involvement in investigations – Priority given to children – Risk assessment criticised – Threshold consistency

Allocate for investigation

What do we do?

Information gathering and risk assessment

• Referrals • Threshold decisions • Documentation • Proportionate response • Police response

What is the impact?

Challenges

• Demand – High referral rates • Expectations – Realistic?

• Outcomes – links in a chain • Multiple partnerships – • Mental Health

Future Developments

• Greater integration • Resilience • Learn from experience • Focus on outcomes

Information Sharing/Cohorts

John Maddox

MASH Development Officer

Staffordshire County Council

Information Sharing

Information Sharing

What did we do?

• Fundamentally questioned what we were doing and challenged thinking • Applied some science to support a bold approach…Project Newton • Lessons learned from serious case reviews

• Stoke SCR • Agencies: Police Social Care Health Visitors GP’s Courts Probation

The Evidence 2010

• Staffordshire SCR • Agencies Police Health Visitors Education Social Care GP Mental Health

• Constructed a MOU • Agreed to open our systems to each other • Accepted professional disagreement existed • Agreed on appeals/ escalation process • Ensured safety measures existed

How we changed

• Two stage process of Reveal & Disclose controlled • Fought the battles • Culture • Silo mentality • Trust • Knowledge • Fear

Outcome

• Fundamental change to information sharing • Confidence across agencies (including ISO) • Safer children and adults • Organisational protection • MORE WORK…Dare you lift the stone?

• More information sharing = More opportunity to safeguard

• Clarity on how MASH should work • Record what you do • It must service your front line • Walk into this…slowly • Only do what you can • Market with care

Process

•Face-to-face sharing •Professional judgement •Joined up risk management Diversity of rationale

Elements

Cohorts/ Populations

• High risk children referrals (Safeguarding and above) • Vulnerable adult (No secrets) referrals • Domestic abuse-victims and perpetrators and repeat cases • Domestic violence screening for children and vulnerable adults

Cohorts/ Populations

• Missing persons • Child sexual exploitation • Hate crime • Some professional concern cases (issues raised by professionals but not clear as to the cohort at referral stage)

Governance

David Stringfellow

Head of Responsive Services

Staffordshire County Council

Staffordshire

Governance Structure

Who owns it?

• A co-operative • MASH Development Officer  Jointly funded  Supports general development  Maintains inclusivity of all stakeholders

Who pays for it?

Who is accountable for MASH

• All agencies  Have statutory duties and requirements of service  Are accountable for the population they serve • Performance framework  Responsibilities  MASH is a provider of information packages and so is accountable for the quality and timeliness of information

Who takes the day-to-day eadership issues?

• Key representatives from the partnership work collaboratively • The future?

• Inter-operability

Agency Perspective

Question and Answer Session

Lessons Learned

John Maddox

MASH Development Officer

Staffordshire County Council

What is the impact?

• Have a vision • Map/Assess your strategic buy in • Use project Management • Be clear on your process • Agree Information sharing • Be prepared to deal with cultural change • Market what you Do & Don’t Do..clarity

• Have strong Governance • Get Vetting right • Eat the Elephant – one piece at a time

Thank You and Close