Assessment of the impact of the services provided in Community Support Centre – Veliko Turnovo on the children and families within the system for maintaining and improving service quality

Interactive Discussion Forum, HRD OP, BG051PO001-7.0.02-0006

SANA SPA HOTELHISSARIA

26-27.2015

Dr S. Sabeva, International Social Service Bulgaria

Internal system for control (self-assessment) of the service quality

Developed in 2006 and implemented in 2007 in the Complex for Social Services for Children and Families (CSSCF) – Targovishte on the basis of EU good practices. Applied in all services and conducted on an annual basis;

Self-assessment is conducted along the following lines:

1. What is the impact of the services on their user?

2. Does the organisation have in place a strategic quality approach?

3. Do we show strong leadership and commitment for quality?

4. Do we have corporate culture for continuous personnel qualification and continuous quality improvement?

5. Do we give the children and their families a say on the services they are provided with?

6. Do we work effectively with the partners?

7. Do we make the best use of resources?

8. Do we maintain the service quality?

Objective of the good practice

By measuring the effect of the services “foster care” and “prevention of the separation of children from their biological family” to inform the service provision practice about the quality of the individual assessment of the case, the objectives of changing at child, family, environment level set on the basis of the assessment and the intervention carried out.

Compliance with national and European objectives and priorities

Social Protection Committee: A Voluntary European Quality Framework for Social Services SPC/2010/10/8 and A Quality Framework for Services of General Interest in Europe, Brussels, 20.12.2011 COM(2011) 900

Regulatory documents specifying the child protection activities and the social services, as well as in the National Strategy “Vision for Deinstitutionalisation of Children in Bulgaria” and the Action Plan for its implementation /24 November 2010/

Framework for evaluating the effect

Developed under the project “Partnership for effective and accessible services aiming at prevention of children institutionalisation” financed by the Bulgarian-Swiss Cooperation Programme under the Thematic Fund “Reform Fund Linked to Civil Society Participation”. The project is implemented by ISS Bulgaria in the period 1.09.2013 – 31.08.2015, in partnership with ISS Switzerland and Association “Samaritans”, Stara Zagora.

Target Group

Children placed in foster families for 12+ months;

Children and families at risk of separating the child from the family. Cases must have been closed up to 6 months before the study.

Study of the impact Time frame of the study: January and February 2014 for

foster care March – April 2015 for the cases of prevention of the

separation of children from their biological family. Studied children: 9 children aged 1 – 14, placed in foster

families located on the territory of Veliko Turnovo Municipality and Gorna Oriahovitsa Municipality and supported by the team of the Community Support Centre (CSC) in Veliko Turnovo. They are part of the studied total 71 children aged 2 – 17 placed in foster families supported by the CSCs managed by ISS Bulgaria on the territory of the municipalities Targovishte, Sevlievo and Smolian and by Association “Samaritans” in Stara Zagora.

Area/Sub-area/Indicators

Area: Child WelfareSub-areas:1. Physical developmentIndicators: • Height• WeightRelative share of children placed in foster care who develop in accordance with their age or whose physical development parameters /height and weight/ register improvement. 2. HealthIndicators: • Frequency of seeing a doctor for diagnostics and treatment; • Frequency of illnesses and duration of the illness /information from the medical

card of the child/.; • Prophylactic examinations carried out depending on the child’s age;• For children with chronic illnesses – there shall be no exacerbation of the illness

and there shall be no cases of untreated illnesses• Vaccination in accordance with the age  

Sub-area: Education and бразование и стимулиране на развитието.Indicators: In pre-school age:• 0-3 – the psychological development is tested using the Manova-Tomova scale• 4-6 – the intellectual development is tested using the Binet-Terman test In school age:• Number of children who are in the grade corresponding to their age;• Number of children receiving resource assistance;• Performance at school

Sub-area: Emotional condition and conductindicators: • Relative share of children with diagnosed mental problems;• Relative share of children with behavioral problems;• Results of the strengths and difficulties test;

Area: Secure and safe environmentIndicators: • No alerts for incidents or violence against the child for a period of 12 months before the present

assessment;• Relative share of children transferred to another foster family or residential service

Strengths and Difficulties Questionnaire (Goodman,1997/

Brief screening questionnaire for children aged 3-16 which reveals the potential risk of development of mental disorders:

Targeted at parents and teachers. Each version includes 25 questions distributed among 5 scales:

Emotional symptoms Conduct problems Hyperactivity Peer relationship problems Prosocial behaviour

Impact Supplement – questions aiming to clarify the impact of the problem on the child, the family and their environment.

Challenges and difficulties

Lack of generally accepted methods for studying the cognitive and the emotional development, standardised for the Bulgarian context

Specialists are underprepared for applying diagnostic methods

There is lack of an elaborated data collection system enabling comparison of results with the general population

Results by area

Area: Welfare

Sub-area: Physical development:• All children develop within the standard, but at the lower

limit

Sub-area: Health• 86% of the children are clinically healthy;• 14% suffer from different chronic diseases such as

asthma, chronic bronchitis, epilepsy, etc.. • 10% are frequently ill (more than 4 times per year)

Area: Education and stimulating development

Sub-area: Cognitive development 13% (9 children) are with diagnosed intellectual and

cognitive problems By age:

• 2 -3 years - 10 studied children - 1 underdeveloped, the others are normally developed by at the lower limit of normal

• 4 - 8 years – 30 studied children - 26 children are within the standard, 2 children are intellectually underdeveloped, 2 are with marginal values;

• Age 8+: 31 studied children – 27 are in the mainstream school, 4 go to auxiliary school, 9 receive resource assistance in the mainstream school. Their grade point average is Very Good 4.85

Sub-area: Emotional condition and conduct

6 children (9%) are diagnosed with “Emotional and conduct problems”, including :-Emotional disorder during childhood – 2 children -Hyperkinetic disorder – 4 children

The results of the Strengths and Difficulties Questionnaire Study show that a great portion of the children have high levels of emotional and conduct problems.

Area: Secure and safe environment

There are no children among the studies ones who have been transferred to another social family or another social service in 2013.

There are no alerts of incidence and violence against the studied children in 2013

Conclusions and recommendations

1. The impact assessment framework we have developed and the indicators set for measuring the impacts are:

Valid – measure the effect sought Credible - they can be relied on over time Accurate – measurement level Viable – the information looked for is easy to find Price – developed within the funding of CSC

2. Foster parents take good care of the children under their custody.

Conclusions and recommendations -2

3. It is very useful to measure the impact , provided that this is done on a regular basis by every provider within the year concerned.

4. On the operation of ISS Bulgaria – A need to change the case assessment method has been identified. For the children placed in foster care ISS Bulgaria decided that the set of indicators for assessment of the child development shall be applied up to 1 month after placement and every 12 months or at the separation of the child from the family in case of placement of not less than 3 to 6 months, depending on the age of the child.

Conclusions and recommendations - 2

5. Impact measurement is very useful for: Foster parents because it provides them with feedback on the

result of their work; Foster Care Teams – shows the areas where FF encounter the

greatest difficulties and, accordingly, need targeted support, periodic training and supervision;

FC service provider – areas in which teams need additional qualification and competences; provides guidance on improving the practical guides for the work of the teams and for collecting and documenting data. Providers can compare their achievements.

Conclusions and recommendations-3

Municipalities and State: Shows the need to develop specific highly specialised services in

support of the children and the FF caring for the children. Establishes a framework for setting priorities and allocating

resources, mainly in the child welfare system; Makes it possible to measure and assess effective programmes and

the measuring and to share the results with legislators, NGOs, service providers, media, courts, local authorities