Transcript Slide 1

Welcome to Integrated
Processes Training
Welcome and housekeeping
• Fire
• Toilets
• Refreshments
• Telephone
• Messages
• Smoking
What is integrated working?
Integrated working is when
everyone supporting
children, young people and
families works together
effectively to put them at
the centre, meet their
needs and improve their
lives.
Integrated working aims to
help identify needs early
and provide support so that
any problems do not
become more serious.
Working together to improve outcomes for
children and young people
Be healthy
Enjoy and achieve
Make a positive contribution
Stay safe
Achieve economic wellbeing
The policy context for integrated
working
• Every Child Matters and the 5 outcomes.
• Children’s Trusts.
• The National Service Framework for Children, Young People and
Maternity Services (2004).
• Youth Matters (2005) and Targeted Youth Support (2007).
• The Children's Plan (2007).
• 21st Century Schools: A World-Class Education for Every Child (2008).
• Think Family (2008).
• 2020 Children and Young People’s Workforce Strategy (2008).
• Recent policy updates.
Integrated working processes and tools
Tools and processes that support integrated working
Information sharing
CAF and
National eCAF
Lead professional
and TAC
Multi-agency
working
Contact Point
Common core
Improved outcomes:
• Be healthy.
• Stay safe.
• Enjoy and achieve.
• Make a positive contribution.
• Achieve economic well-being.
A continuum of needs and services
The benefits of integrated working
Earlier, holistic identification of
needs
It is what is best for the children that
counts and we feel this new way
forward is absolutely the best for our
children and young people
Earlier, more effective intervention
Improved information sharing
across agencies
You can’t be an expert in everything.
We now have a tool to consult others
– this saves huge amounts of time
trying to become an expert in every
subject
Better service experience for
children, young people and families
More effective practice for
practitioners and organisations
Everything is so exciting, but what is
most exciting is that all our new pieces
of work are now linked
Guiding principles for the workforce
Everyone in the children and young people’s workforce should:
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Work in partnership with children, young people and families.
Work in partnership with other practitioners.
Work in a child and young person centred way.
Share information appropriately and effectively.
Use a holistic approach.
Focus on strength as well as need.
Consider all potential sources of support.
Be proactive and accountable.
Promote the well-being of children and young
people and safeguard them from harm.
Common assessment
Framework
The CAF as part of integrated working
Tools and processes that support integrated working
Information sharing
CAF and
National eCAF
Multi-agency
working
Lead professional
and TAF
Common core
Improved outcomes:
• Be healthy.
• Stay safe.
• Enjoy and achieve.
• Make a positive contribution.
• Achieve economic well-being.
What is CAF?
Using the CAF will help us develop a
common understanding of strengths, as
well as needs and how to work together
to meet them.
The CAF will help us assess children
and young people’s additional needs
for services, earlier and more effectively.
The CAF is a shared assessment and
planning framework to help us in our work
with children, young people and families.
The CAF principles
Focused on
strength
as well as needs
Holistic
Voluntary and
only undertaken
with consent
A standardised
process
supported
by a form
Child and
young person
centred
Able to improve
links to specialist
assessments
Coordinated
(only ever one active CAF
episode per individual)
Not something services can
require before access to
provision – but is able to
inform better referrals
Who will use CAF and when?
Any practitioner can use the CAF with an individual child or young
person
Use the CAF when:
• There are concerns about
progress or wellbeing.
• Needs are unclear and not
being met.
• Needs are broader than
your service can address.
Do not use the CAF when:
• Progress is good.
• Needs are identified and
already being met.
• Needs are clear and all
can be met by one service.
• There is no consent.
If, at any time, there are concerns that a child may
be at risk of harm, then follow LSCB procedures without delay
Holistic Family Assessments - REFERRAL
Review the action plan to measure outcomes for the family until
they are back to universal services
Produce a multi-agency action plan to ensure a shared approach to
information sharing and improving outcomes
Team around the family (TAF) meeting to agree action plans and agree roles,
responsibilities and timescales, agree Lead Professional
Undertake a holistic family assessment to identify family needs and services required to
support better family outcomes
Identify initial concerns regarding family outcomes – consider
need for pre-assessment or signpost to other services
ACTIVITY
‘TO CAF OR NOT TO CAF!’
Scenario 1 – Chantelle
Chantelle moved to the area a month ago, with her brother and
her mum, Karen. They moved closer to Karen's mum, who now
looks after the children when Karen is at work. They do not
have much money and are currently living in a small one
bedroom, 8th floor flat that Karen says is a little damp. Chantelle
has not yet started at a new education provider since the move.
Chantelle seems small for her age and has a rash on her arm
that she scratches a lot. Karen says it has been there a few
weeks and she will take her to the doctors once they register
with one. Chantelle is quiet and does not talk much.
Scenario 2 – Carlos
Carlos has a serious stutter that sometimes makes it hard for
others to understand him, but he is working with a language
therapist. Other than that, he is healthy, intelligent and popular
– but a little shy. He lives with his mum and dad and 2 siblings
in a 4 bedroom detached house.
Scenario 3 – Tammy and her baby
Tammy is 15 and lives with her Grandmother. She has recently
given birth to a baby girl. She says she wants to go back to
school as soon as possible so she can get an education and a
good job to support her baby. Her Grandmother is supportive,
but Tammy says she is considering applying to move into a flat
once she is 16 so she and the baby can begin life as a proper
family.
Scenario 4 - Pravin
• Pravin is having a few difficulties in education. He is not
keeping up with his peers and says he is being bullied. The
home situation seems loving and supportive. Both Pravin and
his parents say they do not want a common assessment to
take place
Scenario 5 – Paulette and Mickey
Paulette (14) and Mickey (3) live with their mum and her
boyfriend. Both Mum and her boyfriend are regular heroin
users and deal from the flat to support their habit. Mickey has
signs of bruising on his back and Paulette has what appears to
be a cigarette burn on her arm. Both seem undernourished and
are dirty.
What does the CAF consist of?
Through the process standard information will be gathered
and recorded:
• Basic/background information.
• Consent, at various stages.
• Assessment in three domains
(see below).
• Initial action plan.
• Delivery plan and review.
Parents and carers
Assessment domains
Development of the
child or young person
Family and the
environment
A good CAF discussion should…
Build on effective
engagement and
communication
Lead to a better
understanding
of strengths and
needs, and what
can be done to help
Build on existing
information
to avoid repetition
Not be too formal
or a big event
Cover relevant
areas but look
beyond the surface
Fully involve the child
or young person
and their family
What makes a good CAF assessment?
Using an approach that is:
• Empowering.
• Accessible.
• Developmental.
• Transparent.
Leading to…
An assessment that is:
• Focused on strengths as well as
needs.
• Valid and accurate.
• Clear and uses appropriate
language.
• Inclusive.
• Unbiased.
• Authentic.
• Professional.
• Solution focused.
• Practical.
• Evidence based with opinion
recorded as such.
Holistic Family Assessments - ASSESS
Review the action plan to measure outcomes for the family until
they are back to universal services
Produce a multi-agency action plan to ensure a shared approach to
information sharing and improving outcomes
Team around the family (TAF) meeting to agree action plans and agree roles,
responsibilities and timescales, agree Lead Professional
Undertake a holistic family assessment to identify family needs and services required to
support better family outcomes
Identify initial concerns regarding family outcomes – consider
need for pre-assessment or signpost to other services
Activity
Completing A CAF
Family risk factors for assessment
• Crime and ASB
• Alcohol and
drugs
• Poor housing
and
homelessness
•Poverty and debt
•Worklessness
•Education and
skills
Economic well
being
Most
Excluded
Families
Communities &
staying safe
Health and family
structures
Domestic violence
 Relationship conflict
 Mental and physical health
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•KEY INDICATORS
What makes a good CAF plan?
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CAF initial plan and delivery plan
should:
Build on strengths and help meet
needs identified through the
assessment.
Not promise support on behalf of
others.
Agree who will do what by when and
when review will happen.
State anticipated outcomes and how
progress will be measured.
Record consent to record and share.
Gather
information
Undertake
assessment
Good action planning is:
• Comprehensive.
• Efficient.
• Inclusive.
• Informative.
• Focused.
• Logical.
• SMART.
• Transparent.
Analyse
Plan
The CAF review
The CAF review should gather and record:
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Who is present.
Progress against each of the actions in the CAF delivery plan.
Next steps.
Review notes.
Child/young person and parent comments and where
necessary, additional consent .
Outcomes of the review
could be one of
the following:
CAF closed
New actions agreed and
review date set
New assessment needed
Activity
The CAF Plan
Closing a CAF
A CAF can be closed for many reasons, including:
• Additional needs met.
• Child or young person has moved to another area.
• Child or young person has made the transition into adult services.
• CAF assessment superseded by specialist assessment.
• Consent withdrawn.
• Others?
The team around the
family (TAF) and the
lead professional
Holistic Family Assessments - TAF
Review the action plan to measure outcomes for the family until
they are back to universal services
Produce a multi-agency action plan to ensure a shared approach to
information sharing and improving outcomes
Team around the family (TAF) meeting to agree action plans and agree roles,
responsibilities and timescales, agree Lead Professional
Undertake a holistic family assessment to identify family needs and services required to
support better family outcomes
Identify initial concerns regarding family outcomes – consider need for
pre-assessment or signpost to other services
Lead professional and team around
the child as part of integrated working
Tools and processes that support integrated working
Information sharing
CAF and
National eCAF
Lead professional
and TAF
Common core
Multi-agency
working
Improved outcomes:
• Be healthy.
• Stay safe.
• Enjoy and achieve.
• Make a positive contribution.
• Achieve economic well-being.
The Team around the family (TAF)
The TAF is a multi
disciplinary team of
practitioners
established on a
case by case basis
to support a child or
young person and
their family.
Practitioners in the
TAF can come
from across the
workforce and will
focus on strength
as well as need.
The model does not
imply a team that is
located together or
who work together
all the time.
Forming the TAF
• Where a multi-agency response to the CAF assessment is required,
a TAF should be arranged by the person who initiated the CAF
assessment.
• The child or young person and/or their parent/carer must be a full and
active part of the TAF at all stages and be invited and encouraged to
attend meetings.
• Invite relevant practitioners, as identified through the CAF
assessment.
• TAF practitioners might include those from statutory as well as
voluntary/third sector organisations and include:
• Universal services.
• Targeted services.
• Specialist statutory services, if appropriate.
TAF meetings
Initial meeting
Review meetings
Share information to gain a
fuller picture
Discuss progress
Initial meeting
Share any new information
Agree a lead professional
Update plan
Agree achievable goals
Agree achievable goals
Agree and record actions to
meet goals
Agree new actions, OR close,
stating reasons
Set date for review meeting
(within three months is
recommended)
Activity
Convening an initial TAF
Meeting
Holistic Family Assessments - PLAN
Review the action plan to measure outcomes for the family until
they are back to universal services
Produce a multi-agency action plan to ensure a shared approach to
information sharing and improving outcomes
Team around the family (TAF) meeting to agree action plans and agree roles,
responsibilities and timescales, agree Lead Professional
Undertake a holistic family assessment to identify family needs and services required to
support better family outcomes
Identify initial concerns regarding family outcomes – consider
need for pre-assessment or signpost to other services
TAF practitioner responsibilities
• The lead professional coordinates delivery of the plan.
• Each practitioner in the TAF is responsible/accountable to
their home agency for the services they deliver.
Jointly responsible for
developing/delivering
the CAF delivery and
review plan
Responsible for
delivering the planned
activities
Responsible for
monitoring and keeping
TAF informed about
their progress
Attend TAF meetings
and contribute to taking
minutes, chairing and
other tasks
Support the lead
professional, including
providing information
and offering guidance
and advice
Contribute actively and
positively to problem
solving and resolving
difficulties in a child
centred way
Remember the ‘T’ in TAF stands for team
Holistic Family Assessments - REVIEW
Review the action plan to measure outcomes for the family until
they are back to universal services
Produce a multi-agency action plan to ensure a shared approach to
information sharing and improving outcomes
Team around the family (TAF) meeting to agree action plans and agree roles,
responsibilities and timescales
Undertake a holistic family assessment to identify family needs and services required to
support better family outcomes
Identify initial concerns regarding family outcomes – consider
need for pre-assessment or signpost to other services
The role of the lead professional
The lead professional is a set of functions to be carried out as part of
the delivery of effective integrated support, when a range of services is
involved with a child or young person following a common assessment.
The lead professional will:
Act as a single point
of contact for the
child, young person
or family.
Coordinate the
delivery of the
actions agreed by
the practitioners
involved.
Reduce
overlap and
inconsistency
in the services
received.
“Myth Busting” – the lead professional
Does not need any
particular
qualifications
Does not have to
be an ‘expert’ in
everything
Is not responsible
or accountable for
actions by other
practitioners or
services in the TAF
Will not be
expected to work
outside their usual
remit
Is not automatically
the person who
initiated the CAF
Will have support
mechanisms in
place to resolve
any issues
Does not become
responsible for the
needs of the entire
family
May use more time
in one area, but
save time
elsewhere
Who can be a lead professional?
Core tasks of the lead professional
Build a trusting
relationship to
secure engagement
Be a single point of
contact for the
child, young
person and family
Be a single point of
contact for all
practitioners working
with the child
Convene the TAF
meetings to enable
integrated multiagency support
Coordinate delivery
of solution focussed
actions and ensure
regular reviews
Identify where others
may need to be
involved and broker
involvement
Continue support
if appropriate,
if specialist
assessments
are needed
Support the
child/young person
through key
transition points
Ensure a safe and
planned ‘handover’
if a different LP is
agreed and more
appropriate
Knowledge and skills of a
lead professional
Knowledge – understand:
• CAF and integrated working.
• How to access services.
• The child/young person’s strengths
and needs.
• Information sharing, consent and
confidentiality.
• Safeguarding.
• Boundaries of own knowledge.
Knowledge and skills underpinned by:
• Effective communication.
• Planning, organisation and coordination.
• Critical and innovative thinking.
Skills – ability to:
• Establish relationships.
• Support, empower and
challenge children and young
people.
• Convene inter-agency meetings.
• Work with practitioners from a
range of services.
Activity
Exploring the Lead Professional
task, knowledge and skills
Criteria for selecting a lead professional
Criteria for selection could consider:
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The wishes of the child or young person, and their family.
Any statutory responsibility to lead on the work.
The level of trust built up.
Any previous or potential ongoing relationship.
Who has primary responsibility for addressing the needs.
The main needs (as assessed through the CAF).
The skills, ability and capacity to provide leadership and
coordination in relation to other practitioners involved.
• The ability to draw in and influence universal and
specialist services.
• An understanding of the surrounding support systems.
Activity
Selecting a Lead Professional
Management for lead professionals
and the TAF
Lead professionals should expect managers to ensure:
• Lead professional responsibilities are taken into
account when setting caseloads.
• Performance in delivering the lead professional
functions is recognised and recorded.
• Clear communication between agencies to
support lead professional practice.
• Appropriate and up to date training and supervision
is provided along with coaching and mentoring
where appropriate.
TAF practitioners should also expect support
to fulfil their responsibilities
Supervision for lead professionals
Line management supervision for lead professionals:
Managerial
Focused on effective delivery of services
and the lead professional functions
Support
Focused on reflection and evaluation of lead professional
practice (could be from line manager and/or local support
functions)
Training and
development
Focused on continuously assessing strengths and
identifying training and development needs for
practitioners acting as the lead professional
Resolving disagreements and disputes
Could arise over:
• Selection of the lead
professional.
• Roles and
responsibilities of TAF
members.
• The need for action
and by whom.
Resolve problems quickly
through clear local systems:
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Between the parties.
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Line manager support and/or other local
support systems.
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Negotiation between agencies at senior
management level.
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Children’s Trust coordinated
arrangements at strategic level.
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Director of Children’s Services.
• Communication.
• Others?
Transfer and endings for the lead
professional
• Being a lead professional is not a permanent thing:
– Children and young people’s needs change
(in their level, extent and focus).
– Situations and relationships change.
– Practitioners change.
– Children and young people get older.
• Transfer and endings of the lead professional functions,
where appropriate, need to be carefully planned and managed.
Information sharing
Information sharing as part of
integrated working
Tools and processes that support integrated working
Information sharing
CAF and
National eCAF
Multi-agency
working
Lead professional
and TAF
Common core
Improved outcomes:
• Be healthy.
• Stay safe.
• Enjoy and achieve.
• Make a positive contribution.
• Achieve economic well-being.
Note: This training is about
information sharing and not
data sharing
Sharing information as part of early
intervention and preventative services
Increased
emphasis on
integrated working
across services to
better identify and
meet needs
• Effective partnership working between
universal and targeted specialist
services.
Success
depends upon…
• Active processes for identifying those
at risk of poor outcomes.
• Sharing between adult and children’s
services.
• Sharing to support transitions.
Sharing information if concerned
about significant or serious harm
Practitioners must:
Issues to consider:
Always consider referring
concerns to children’s social
care or police, following
LSCB procedures
Significant harm to children and young
people or serious harm to adults can arise
from a number of circumstances
Seek advice if unsure what
to do
Confidential information can be shared
without consent if justified in the public
interest
It is good practice to seek consent and/or
discuss concerns, unless this would
increase the risk of harm
Timely sharing is important in emergency
situations
Information sharing decisions
Decisions about information sharing should be based on an
assessment of benefits and risks to the child, young person or family.
Decision to share
Decision not to
share
You must assess:
You must assess:
• How would sharing information
benefit the child, young person
or family?
• What are the benefits of not
sharing information?
• What are the risks if
information is not shared?
• What are the risks if information
is shared?
Activity
The Benefits and challenges to
information sharing
Seven golden rules for
information sharing
• Remember the Data Protection Act is not a barrier to sharing information.
• Be open and honest with the person from the outset.
• Seek advice where in doubt.
• Share with consent where appropriate and where possible, respect the
wishes of those who do not consent to share (unless there is sufficient need
to override the lack of consent).
• Always consider the safety and well-being of the person and others.
• Ensure information is accurate and up to date, necessary, shared with the
appropriate people, in a timely fashion and shared securely.
• Record the reasons for the decision – whether it is to share or not.
Key questions to inform decision making
Is there a clear & legitimate purpose to share the information?
Does the information enable a living person to be identified?
Is the information confidential?
Do you have consent to share?
Is there sufficient public interest to share?
Are you sharing information appropriately and securely?
Have you properly recorded your decision?
The law
Legislation containing express powers
or which imply powers to share:
The Human Rights
Act 1998
The common law
duty of confidentiality
The Data Protection
Act 1998
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The Children Act 1989 and 2004.
Local Government Act 2000.
Education Act 1996 and 2002.
Learning and Skills Act 2000.
Education (SEN) Regulations 2001.
Children (Leaving Care) Act 2000.
Mental Capacity Act 2005.
Protection of Children Act 1999.
Immigration and Asylum Act 1999.
Crime and Disorder Act 1998.
National Health Service Act 1977 and 2006.
The Health and Social Care Act 2003.
Criminal Justice Act 2003.
Adoption and Children Act 2002.
What is confidential information?
• Personal and private or sensitive, and…
Confidential information is…
• Not already in the public domain, and…
• Shared in confidence.
• Consent is given by the person who
provided the information or the person to
whom it relates.
OR
Can be shared if….
• It can be shared without consent if justified
in the public interest.
• Reasonable cause to believe that a child is
suffering or at risk of suffering significant
harm
• In the prevention and detection of a crime
• Or information is subject to a court order
What constitutes consent?
Consent is key to information sharing, it is good practice even
where the law does not demand it.
Consent:
• Must be informed.
• Should be explicit but can be
implied in some circumstances.
• Is preferably written, but can
be verbal.
• Must be willing and not inferred
from a non response.
• Must be sought again if things
change significantly.
• Can be withdrawn and have limits.
• Should be recorded and stored.
When gaining Consent:
• Explain it at the start, using suitable
language.
• Explain the limits to confidentiality.
• Be aware of relevant legislation.
• Follow local policies and
procedures.
Do not seek consent where it would increase risk
Whose consent should be sought?
• People aged 16 and over –
generally presumed to have
the capacity to understand and
may give (or refuse) consent.
• Children aged 12 or over –
may generally be expected to
have sufficient understanding
to give (or refuse) consent.
• Younger children may also
have sufficient understanding.
Sufficient understanding is indicated if they
can:
• Understand the question.
• Understanding what might be shared,
why and implications of sharing/not
sharing.
• Appreciate and consider alternative
actions.
• Weigh up aspects of the situation.
• Express clear, personal, consistent view.
Record the decision and try to balance the wishes of the
child or young person and the parent/carer
Activity
To share or not to share?
What to share and how to share it
Share only what is
necessary for
purpose
Share in secure way
Distinguish between
fact and opinion
Share only with
those who need to
know
Check information
is accurate and
up-to-date
Understand the limits
of consent
Record reasons for
sharing; what
shared; with who
Inform person to
whom it relates,
and/or who provided
information if safe to
do so
Establish whether
recipient will pass to
others – ensure they
understand limits of
consent given
Support for practitioners
Practitioners need:
• A culture that supports sharing.
• Secure processes for sharing.
• Processes for explaining information sharing.
• Effective training, supervision and support.
• Mechanisms for monitoring, advice and conflict resolution.
Organisations should:
• Fulfil duties under sections 10 and 11 of the Children Act 2004.
• Establish an information sharing governance framework.
Main web links
The following national websites hold further information and overviews,
as well as links through to guidance and training materials, for all of the
processes and tools of integrated working:
• CWDC – www.cwdcouncil.org.uk/integrated-working
or
www.cwdcouncil.org.uk/sharestreet
•[email protected]
Evaluations
Any Questions?