dfe exemplar project plan (tonic consultants matthew scott) families affected by substance misuse...

7/28/2019 DfE Exemplar Project Plan (Tonic Consultants Matthew Scott) Families affected by substance misuse and child protection

1/34

1

DRAFT PROJECT PLAN

Department for Education (DfE)

Essex Exemplar Project

Date: 27th May 2011

Author: Simon Legrand & Matthew Scott

Owners: Essex Drug & Alcohol Partnership

Basildon EssexFamily Project

For: Department for Education

Version: 0.3


2/34

2

CONTENTS Page

Executive Summary 31. Introduction 8

2. Aim & Principles 93. Local Context 10

4. Evidence of Need 125. The Process 16

6. Development & Delivery Process 18

7. Service / Intervention Design 198. Intervention Options 20

9. Governance Structure 2110. Project Monitoring 22

11. Evaluation Framework 2412. Outcomes 28

13. Project Timeline 30

14. Funding Breakdown 3215. Risk Register 33

16. Key Contact Details 34


3/34

3

EXECUTIVE SUMMARY

Community BudgetsOne of the aims of Community Budgets nationally is to test innovative models of delivery with families with complex needs andshare the learning more widely. The first phase of 16 Community Budget areas include ambitious plans to integrate and redesign

services, break down barriers between different professions, pool or align funding, develop new forms of partnership andgovernance and engaging families and communities. The widespread adoption of the new delivery models will depend crucially ontwo things: (i) Providing areas with convincing evidence of effectiveness, both in terms of outcomes and cost savings; and (ii)Effective dissemination of practice. Those two things in turn depend on gathering evidence that is rigorously evaluated andconvincingly presented.

In Essex, Community Budgets are being developed as part of the EssexFamily programme has a triple-track approach to:1. Securing better outcomes for families with the most complex needs in 5 places across the county through developing a

Community Budget approach2. Shifting the mainstream system to deliver more effective early intervention to families everywhere3.

Growing & embedding a robust infrastructure for innovative, responsive and cost-effective democratic public services

The working definition of complex families for the EssexFamily programme is where members of the immediate family have multipledisadvantages and/or vulnerabilities that impact negatively on both themselves and their children, and potentially other familymembers and the wider community. There are three working hypotheses for the EssexFamily programme:

It is possible to reduce the dependency of individual families & improve their long term outcomes, through whole familystrengthening interventions

It is possible to harness community capacity to improve long-term capability & resilience of families with complex needs It is possible to develop scaleable approaches that will improve outcomes, reduce immediate costs, and deliver significant

long-term savings

Basildon is one of the 5 localities taking forward Community Budgets for families with complex needs and will be the focus of thisDfE Exemplar Project.


4/34

4

DfE Exemplar ProposalThe overarching aim of our proposal is to enable families to thrive in independence from government intervention, in good healthand wellbeing, with a safe and nurturing environment for their children, and where possible economically active and engagedpositively in the community, we will seek to achieve this by developing targeted and timely interventions with families wheresubstance misuse affects parenting capacity, resulting in the likelihood of children being placed outside of their birth families and

kinship networks. Our proposal is based on EssexFamily principles to:

Involve families and communities as active partners Take a systematic learning approach Ensure approaches developed within the project are maintained beyondthe project Take a bold, non-traditional approach to resources and systems change Commitment to honesty and challenge

Problem AnalysisFamilies that have one or more parents with vulnerabilities such as alcohol misuse, drug misuse, mental health problems, domesticabuse or criminal involvement are shown to have poor outcomes for the children as well as the adults. These problems are often

overlapping, creating complex families that present a challenge for services to deal with effectively. These complex families cancost public services between 250,000 and 350,000 a year. To meet this challenge, the proposal will seek to address the followingproblems, gaps and barriers for families with parental substance misuse (including both drugs and alcohol), including;

Poor engagement with services Ad hoc delivery of evidence based interventions Poor integration of services for complex families Families that access multiple services but are not identified as complex Current actions and interventions to break the cycle are not meeting the needs of complex families

Further research and information can be found in the recent report by Essex Drug & Alcohol Partnership, Safeguarding Children ofParents with Substance Misuse and other Vulnerabilitiesproduced to inform the Essex Safeguarding Boards for Adults andChildren as well as future EDAP work.


5/34

5

Target GroupIt is envisioned that the target group criteria will consist of:

Pre-Birth or early years Substance misusing Mother and/or parents (1st Child) Substance misusing Mother and/or parents after 1st child is in care or resulting in children being placed outside of their birth

families and kinship networks Mother and/or parents with multiple children in care or placed outside of their birth families and kinship networks

Development ProcessThis document will support the development of a detailed project management approach, which will engage key families,stakeholders and services providers, to improve understanding of complex families in the local area and develop a collaborativepathway to implementation. We intend to recruit and commission a leading academic and local University to support and helpinterpret the above information and data, review the evidence base and provide recommendations for development. We aim tolearn and identify the most appropriate opportunity to intervene, evidence based intervention/s and create frameworks to capture,disseminate and capitalise on learning. Following this, we will bring families, stakeholders and service providers together to reviewthe recommendations, options for intervention and agree the way forward, including:

Delivery Model Intervention and Service Structure Managerial Processes and Supervision Ensuring robust adult and child safeguarding procedures are maintained and adhered to Project Monitoring Reporting infrastructure Outcomes Framework Evaluation

OutcomesThe DfE Exemplar Project will work closely with the Basildon EssexFamily programme to develop a rigorous project monitoring andoutcomes framework. This partnership will prevent duplication of interventions, establish appropriate baselines and promote sharedlearning from inputs/activities, outcomes and opportunities. The DfE grant investment will help to stimulate local partnershipinvestment in the Basildon EssexFamily programme.

Our ambition is to decrease the number of children being referred to Children Looked After and permanency services, where one or


6/34

6

both parents misuse drugs and/or alcohol. To achieve this we recognise that reshaping services may be needed to currentprovision. The key outcomes will be:

The birth families that are affected will be at the centre of a range of proactive services, workers will motivate and engage birthmothers and the families to maintain them in their treatment and work with them towards a healthy recovery

More children will stay within their birth families and have the benefit of improved parenting and create better live-long outcomes

For the professionals involved, they will gain a far greater understanding of the impact that substance misuse and legalproceedings can have on children and families and the long-term outcomes

Partners and GovernanceThe DfE Exemplar Project Team will have representation from key families, stakeholders, service providers, the commissionedUniversity and a project manager, including Childrens Social Care (Child Protection, Leaving Care, Adoption etc), Essex Drug &

Alcohol Action Team (EDAAT), and Service Providers (Substance Misuse Services, Housing, Mental Health, Job Centre Plus etc).

The Project Team will report on progress and shared learning with the Basildon EssexFamily Programme and the Essex IntegratedSubstance Misuse Commissioning Group. Both of these groups will, in turn, report to the Essex Drug & Alcohol Partnership and the

EssexFamily County Steering Group. The Project Team will also report directly to DfE via Interface Associates.

DeliveryThe delivery model for this DfE Exemplar Project will be informed by the development process outlined above and will need to beboth scalable and sustainable. Expected timelines are for interventions to start in December 2011 and run to April 2013. We will belooking for elements of the delivery model to build community capacity.

EvaluationA University will be commissioned to undertake a robust evaluation. We aim to use a Logic Model in the monitoring and evaluationof this project. A logic model provides a robust yet flexible framework for identifying the pathways from inputs and activities throughto outputs, outcomes and impacts. It will enable the commissioned University to identify measures for each stage in the model anddesign an evaluation that tests whether desired impacts are being realised. However, the evaluation method and framework will beguided by the recommendation from the commissioned University. It is intended to continue the evaluation of families involved inthe intervention until April 2016 in order to better understand the real impact on certain key outcomes, which will be morerealistically measured over this time period, such as subsequent children being taken into care and children being returned fromcare to birth families. Interim reports will disseminate learning throughout the project.


7/34

7

Sharing learningThe DfE Exemplar Project Team and the commissioned University will develop and support the implementation of the evaluationand outcomes framework, to maximise the opportunities to discover learning and share innovative practice beyond the confines of

the initial DfE funding. This could include;

Lessons from the Active Learning Approach What worked well and did not work so well Opportunities for further investigation and analysis Developing approaches to replicate services / interventions Identifying sustainable approaches to funding new practice Unintended consequences

It is envisioned that accumulated learning will be cascaded to DfE and Essex stakeholders by the following methods:

Reporting procedures by the commissioned University during the development process to the DfE Exemplar Project Team An interim report (April 2013) and completed evaluation (2016?) by the commissioned University Countywide event to launch the findings from the project and opportunities for development Peer reviewed article by the commissioned University into the development process and the efficacy of the delivered

intervention/s to complex families

New and InnovativeThe DfE Exemplar project will aim to utilise the latest research and evidence around working with complex families affected bysubstance misuse, to test and prototype innovative ways of intervening earlier, using evidence based interventions to:

Enable complex families to break the cycle and reduce the potential for intergenerational transmission of problems Reduce dependency on substances and services Increase social capital and strengthen social networks Be strengthened as a family and more resilient Fulfil their potential as a family and actively contribute to improving their own outcomes and local community


8/34

8

1. IntroductionFamilies that have one or more parents with vulnerabilities or problems such as alcohol misuse, drug misuse, mental healthproblems, domestic abuse or criminal involvement are shown to have poor outcomes for the children as well as the adults. Theseproblems are often overlapping creating complex families that present a challenge for services to deal with effectively. Thesecomplex families can cost public services between 250,000 and 350,000 a year to deal with.

Following issues raised in the Joint Area Review, by the National Treatment Agency and in Serious Case Reviews, the Essex Drugand Alcohol Partnership and the Safeguarding Children Board in Essex County Council have been looking to improve the responseto children and families where there are substance misusing parents through better joint working and whole family approaches.

A steering group was established to focus on these issues and produce a report to: (i) raise awareness; (ii) develop a betterunderstanding among services of the issues and improve practice; and (iii) build a case for changing the approach to familiesaffected by these issues.

The current set up of services encourages the fragmentation of families into individual members (adults and children) with numbersof individual problems dealt with separately, in spite of research demonstrating how linked these problems are and that parentsaffect the whole familys outcomes not just those of the individual.

Intergenerational transmission, where many of these parental vulnerabilities mean that their children are significantly more likely toexperience similar problems, typified by local case studies we have been told about showing 2nd and 3rd generation drug misusersand children in care, demonstrates the need to adopt a never too late to intervene principle to ensure that services do not give upon families or pre-judge their ability to improve.

The evidence shows that you can have success and change the lives of vulnerable families by proactively engaging them, buildingtheir resilience, reducing their risk factors and strengthening the family to cope by themselves in the long term.

This proposal will complement the EssexFamily Community Budget Programme and build on work undertaken locally on bettermeeting the needs of families affected by parental substance misuse.


9/34

9

2. Aim & Principles

Aim To develop targeted and timely interventions to families where substance misuse may affect parenting capacity, resulting in

children being placed outside of their birth families and kinship networks

To enable families to thrive in independence from government intervention, in good health and wellbeing, with a safe andnurturing environment for their children, and where possible economically active and engaged positively in the community

Principles (Shared with the EssexFamily Programme) Families will achieve better long-term outcomes if they are able to identify and build on their strengths, capabilities and

confidence so they can thrive as a family, independent from the interventions of public service providers. Families will beinvolved as active partners in determining what will work for them.

Active involvement of communities is key to success. We will engage communities, as citizens, resources and neighbour, inshaping and contributing to local responses. Families with complex needs will become valued participants in their owncommunities.

We will take an intentional and systematic learning approach. In doing so we will grow a culture and processes that enableus to continuously adapt and learn, within a system that has fewer of the structures and hierarchies that impede innovation.

Approaches we develop within the project will be useful beyond the project, containing lessons and techniques that can beapplied, with appropriate local amendments, for families across the County. New approaches will be sustainable, facilitatinga shift in mainstream systems to deliver more effective early intervention for children and families.

We will support all this with a commitment to honesty and challenge; being brave enough to have the conversations thatmatter even when its difficult.


10/34

10

3. Local Context

Over the last 20 years all adoption agencies have reported a gradual increase in the number of children being placed for adoptionfrom chronic drug and alcohol misusing households.

Research by J Selwyn1 highlights that parental misuse of alcohol was a risk factor for 46 percent of the children in the study, oftenwith a combination of binge drinking as well as drug misuse leading to violence and neglect of children.

It is estimated that there are 250,000 to 350,000 children of problem drug users in the UK 2. Working Together to SafeguardChildren 2010 emphasises the need to improve cooperation between statutory and non-statutory organisations and individualswithin each should work together to safeguard and promote the welfare of children.

The Drug Strategy 2010 (Home Office) is clear in its messages, that there needs to be an organisational shift to deliver familybased services that communicate effectively and work together to ensure families recover and function appropriately.

One strand of this current strategy that supports this proposal is Building Recovery in Communities, to improve the recoveryjourneys to ensure that they become healthy individuals through person centred interventions and services where the full needs ofthe family are considered and undertaken through working together as a partnership.

The project outcomes will also fit well with two projects that Essex is developing. First, the EssexFamily Community Budget pilot,developing improved services to families with complex needs, those families that often have substance misuse, mental health,criminality and domestic abuse. Secondly, Schools, Children and Family services are also building a Social Impact Bond projectfocusing on preventing children and young people becoming Looked After, which will improve their long term outcomes and lifechances.

National and local research also suggests that there is a lack of interagency collaboration between adult and childrens services.

A small study within the Essex Adoption Service demonstrated that 67% of parents whose children were referred to the AdoptionService in 2009-, with adoption as a permanence plan, have issues which include drug and alcohol. A number of these parentshave already lost children to adoption or to the care system and this can range from one or two children to up to 10 children ormore over a number of years. The statistics also evidence that the majority of parents/mothers are still in their twenties or early

1Costs and outcomes of non-infant adoptions Selwyn J. 2006

2 Maternal and paternal drug misuse and outcomes for children: identifying risk and protective factors Scaife V. 2008


11/34

11

thirties leading us to assume that any subsequent children may be subject to similar experiences of care.

Between January to March 2010 12 childrens cases were considered by the South Adoption Panel (based in Basildon). Four out ofthe 12 cases did not involve drugs or alcohol. The other 8 cases involved 9 children who varied in age from 5 months to 5 years. Inmost of those cases, other children of these parents were either placed or with a plan for adoption, in foster care or being cared for

by other family members.

Within adult drug and alcohol services, women who present as or disclose that they are pregnant have care plans that reflect theiridentified needs with timely referrals to social care as demanded by the SET Procedures. However, where proceedings result inchildren being referred to permanency services including special guardianship orders and kinship arrangements there does notseem to be a parity of aftercare support services for the mother, father or wider family to help understand the trauma of losing achild and/or any support to identify effective coping strategies. These women often disengage from services and only present againwhen they are pregnant or in crisis.

Research tells us that outcomes for children experiencing inadequate parenting due to chaotic substance misuse are often verypoor, these families often have further complexities such as mental health; domestic violence and criminality which add difficulties

for developing the best care plan and interventions for the individuals and families. Where the children become subject to legalproceedings and permanency services, they often remain in services for longer and often experience placement breakdowns andchanges in social workers which again affect their ability to achieve a stable environment. Research tells us that children of parentalsubstance misusers are more likely to become misusers themselves which may lead them to mirror their parents lives and theproblems becoming inter-generational.


12/34

12

4. Evidence of Need

Essex has a population of approximately 262,000 children aged 0-15 years. Using the latest methodology for generating estimatesof children of substance misusing parents3, Essex has an estimated:

73,000 (28%) children living with a binge drinking parent, of which: 57,000 (22%) live with a hazardous drinker 11,000 (4.2%) live with a problem drinker with concurrent mental health problems 7,300 (2.8%) living with a dependent drug user, of which:

o 6,000 (2.3%) children live where the only adult uses drugso 6,800 (2.6%) live with a drug user with concurrent mental health problems

3,4864 crack and/or heroin users in Essex and it is estimated that around 1,603 (46%) of these will be parents

58% of current court cases for the Permanency Teams were known to have at least one substance misusing parent 67% of Adoption service cases involved parental substance misuse 50% of children attending CAMHS had at least one parent with a mental health problem who either was or had been in contact

with adult mental health services, and 25% had a parent with a substance misuse problem Of the 1,465 children looked after in Essex, we conservatively estimate that at least 492 (33%) have a substance misusing

parent, 527 (36%) have parents involved in domestic abuse, 211 (14%) have alcohol misusing parents, 421 (29%) have at leastone parent with a mental health problem, and 386 (26%) have a parent involved in offending

Headlines from treatment data in Essex show that parents engage for less than half the average treatment duration than non-parents. There is an even greater difference for female parents who, on average, engage in treatment for only 37% of the averageduration than non-parents. Local treatment data also shows that over 50% of non-parents will complete treatment in a plannedway, compared to only 15% of parents.

When looking at a sample of cases of Children Looked After (CLA) in Essex, we found that the majority (83%) of cases had one or

more parental vulnerabilities identified, and 40% had two or more vulnerabilities. 69% of CLA had at least one other looked-aftersibling.

3Manning et al (2010)

4 Problem Drug User Estimates based on Glasgow Research


13/34

13

Four of the five districts of highest deprivation in Essex5 (Tendring, Harlow, Basildon and Colchester) are also among the fivedistricts with the highest number of open child protection cases. This project will be focussed in Basildon, with Colchester beingused as a control area.

There is a rising trend across Essex in the demand for child protection services, numbers of children going into care, adults seeking

drug treatment and adult safeguarding referrals.

Our interview programme revealed that there are identified gaps in service provision for complex families, and direct support forchildren of parents with substance misuse, mental health problems, offending and domestic abuse issues. Some of the views fromcomplex families included:

Social Services around here rush in and take the kids but in London (where Im originally from) they do try and keep the families together,across the board services struggle here to support families with lots of problems

Social Services work from a stereotype, especially parents who are drug users, they dont understand there is different types of drug use anddifferent risks involved. They need to be aware of this, its really important to understand not all parents are bad and have the skills to bring

their children up

At this time, Social Service put me under tremendous pressure, I had a room of strangers who had gone away to gather evidence on me,putting on me the spot I felt persecuted, they read their evidence like I was in court. This is not the way to help and I did not feel part of theprocess

Social Workers should be a lot more experienced. They are sending out students to very complex families, there is a real difference workingwith someone who is very knowledgeable, is non-judgemental and not completely reliant on asking set questions from their file. There shouldbe specialist social workers, with experience of working with drug users. For example, a drugs worker would not be questioning me on whether

I had relapsed, they are experienced enough to see that Im well, have good colour and getting I am healthy. A young Social Worker wouldnever know that, they see the drugs first and person second

(How to help families) Services should be a lot more honest with families and offer practical support. Social Services involvement shouldnt bethreatening or perceived to be a punishment, this actually stops parents going to treatment or services for help, making things worse

5 IDACI in 2007


14/34

14

To support the project and provide the partnership with proven evidence of success and outcomes we have had two preliminarymeetings with the Tilda Goldberg Centre, University of Bedfordshire which is one of the countrys leading centres in evaluating,challenging and influencing social work policy and practice. Donald Forrester, a lead researcher has a special interest in drug andalcohol issues and has been part of these initial discussions. We know that to influence policy and practice across the partnershipthe current culture needs to be challenged and this will take time and part of this project would need us to win hearts and minds of

those at all levels across the partnership. However, the timing of this project could prove advantageous given the ImprovementNotice that Essex is subject to. The following data was taken from the National Drug Treatment Monitoring System (NDTMS) forEssex:

PARENTAL STATUS* No

All the children live with client 189

Some of the children live with client 24

None of the children live with client 155

Children living with client (DataSet E) 1

Children living with other family member (DataSet E) 3

No Children (DataSet E) 10Not a parent 355

Total Responses 737

Number of Clients reporting children living with them 214 29%

PARENTALSTATUS**

Basildon Braintree BrentwoodCastlePoint

Chelmsford ColchesterEppingForest

Harlow Maldon Rochford Tendring UttlesfordTotalEssex

Total ValidResponses 106 77 27 36 102 86 38 80 28 13 78 18 689

TotalResponses

where clienthas some/allparental

responsibility 44 27 5 22 24 14 9 14 13 6 22 2 202

% 42% 35% 19% 61% 24% 16% 24% 18% 46% 46% 28% 11% 29%


15/34

15

4.1 Parental Status Responses Hotspot Analysis


16/34

16

5. The Process

The above starts to set out what the aims of the project would be, and begins to explore the importance of involving an academicresearch element to the project to analyse recorded data to be able to evidence the outcomes by examining the interventions beingdelivered to these families. To set up a collaborative project between adult and childrens services targeting pregnant women where

drug and/or alcohol misuse is the key factor, with the overall aim of maintaining children within their birth families and kinshipnetworks.

Pregnancy or the birth of a child often provides an opportunity to change which often can lead women to seek treatment but wealso need to recognise that pregnancy can also lead to increased tensions in relationships. The five main project strands to deliverand achieve this project would be:

1. Identify preferred model and interventions: the model would start when a client enters drug and alcohol services that areidentified/or disclose as pregnant. Adult drug services will identify a specialist worker with the skills to engage and motivatethe woman, her partner and wider family where appropriate. All workers involved in the case will actively work together toseek out, meet with and not take no for an answer about wanting to comply with their treatment programme. A

comprehensive care plan will be established with them with regard to treatment, prescribing regime and appointments will bemore frequent throughout the pregnancy, appointments will be offered off site, in places more comfortable for the womanand her family including domiciliary visits. When other services become involved there will be regular meeting andcommunication between them. The plan will include maternity and social care service requirements which will be madeclear to the whole family. Additional needs, such as parenting programmes and couple counselling services can also beplanned and delivered.

Following the birth the comprehensive plan will continue, depending on the success of the pregnancy, treatment/ recovery plan andfamily engagement with all services. The mother and family will continue to have intensive support from their substance misuseworker and social worker, they will be monitored and supported to attend relapse prevention work, family meetings and contactvisits where appropriate.

Where the pregnancy ends with the child being referred to permanency services and/or the treatment is not successful then furtherappropriate and safe opportunities should be offered to the client and family, including relapse prevention, sexual health andcontraception work.


17/34

17

2. Identify area and control area: Basildon has been identified as the area to take on the delivery of the project because ofthe existence of a comprehensive range of treatment services. Also, the Assessment and Family Services and Adoptionservices are co-located in the same building, which would obviously make communications and joint working arrangementseasier. It is suggested that Clacton acts as the control area, because of having similar demographic features and availableservices to Basildon

A project plan will scope the need, it will analyse all data available to them from social care and drug/alcohol services to identifyprevalence of families affected by substance misuse where children are referred to permanency services and the number of femalesubstance misusers who disclose pregnancy or male clients that have pregnant partners or young families.

3. Data, recording and monitoring: we would work with the researchers to construct a monitoring system, preferably one thatutilises the existing recording and data sources available in Essex. These will include the NDTMS (National Drug TreatmentMonitoring System) and social cares ICS/Protocol system and health data sources. There will need to be an agreed processfor communicating and sharing relevant data with each other and the researchers. The setting up will include a review andagreement of gaining consent from families and services.

Clients and families will be given an opportunity to share their experiences of the services, to identify what interventions they havefound useful and those that have caused a barrier to remaining engaged with services.

4. Research model: there is a need to investigate developing a family risk calculator to identify the females and families withan increased risk profile such as mental health, low parenting ability, criminality and or living with domestic abuse. TheFamily Intervention Project savings calculator may support the project in acknowledging the efficiency savings that theproject could potentially bring to Essex County Council and the partnership.

5. Future commissioning & contract aspirations: the findings/evaluation from the actual service delivery and interventionswill influence future commissioning expectations, specific specialist interventions such as family and psychosocialinterventions and support for joint posts between social care and EDAAT commissioned services. Existing contracts may

require varying to ensure that these clients & families are maintained in treatment and all support services. To ensure andpromote the use of off site and domiciliary visits and appointments to support families recovery.


18/34

18

6. Development & Delivery Process Map

2. Problem Framing 3. Solution Design 5. Evaluation1. Proposal

May June - July April (2013)Aug Sept - Oct

1. Rapid Literature Review

2. Local Data analysis

4. Criteria Targeting

5. Engaging Stakeholders &Families

6. Child Protection ProcessMapping

3. Problem Hypotheses

1. What works(as identifiedin the literature)

4. Service / InterventionDesign

3.Problem Solution

2. Identification of problemfamilies

6. Identified interventionopportunity

5. Stakeholders andFamilies involved

EngageUniversityInterim report by the

University

Investigation and recommendations for

development by the University

Tender and

CommissioningProcesses

Delivery

SpecificationDevelopment

Nov - Dec

4. Implementation

Submitted 30/5

Project Management University


19/34

19

7. Service / Intervention Design

The service / intervention design will be informed by the following process:

Development of tender specification, recruitment and commissioning of a local university

University undertakes a programme of work including; Rapid assessment of the literature Identification and engagement of complex families (Interview programme) Assessment of current child protection and social care processes Data analysis and targeting of families (Including criteria for intervention development) Development of outcomes monitoring framework Recommendations for development (Including highlighted opportunities to intervene and evidence based intervention) Development of an evaluation framework

Based on the above findings, the DfE Exemplar Project Team will; Review findings from the commissioned report In conjunction with the commissioned university, stakeholders and complex families design the service / intervention In conjunction with social care, service providers and other stakeholders implement the intervention Initiate monitoring processes (ensure that the service / intervention maintains the project aims, principles and expected

outcomes) In conjunction with the commissioned university, begin evaluation processes

Interim Report (April 2013)

Final Report (April 2016)


20/34

20

8. Intervention options

This proposal is innovative because it seeks to provide an effective early intervention to a group whose needs have been shownnot to be met by traditional service responses such as substance misusing mothers, and in particular those who are pregnant.The intervention will look and feel radically different from responses offered by the usual arrangement of services, and will be basedon the best available evidence of effectiveness with this particularly vulnerable group including Option 2, Families First, Kent

SMPP, Family Pathfinders, FIP, FDAC and Strengthening Families. Families who are highly likely to be at risk over the longer termwill be identified earlier and be partners in an intensive intervention designed to surface their capabilities and strengthen the familyunit in order to engender a safe and nurturing environment for children whilst also improving the outcomes for adults, especially interms of reduced substance misuse.

Substance Misusing Parent (or those who are pregnant)

Parent identifiedwith SM

Child in need Child protectionprocedures and plans

Child taken into Care Child permanentlyremoved (adopted)

Informed byfindings

Informed byfindings

Informed by findings (i.e. Option 2) (i.e. Family NursePartnership Model)

Underpinned by a strengthening families approach, multi-agency support and improved access into specialist treatment

Aims: To develop targeted and timely interventions to families, where substance misuse may affect parenting capacity, resulting

in children being placed outside of their birth families and kinship networks. Families thriving in independence from government intervention, in good health and wellbeing, with a safe and nurturing

environment for their children, and where possible economically active and engaged positively in the community

Potential intervention options (subject to support from commissioned findings by the University and aggregated expertise from the project team)

Event Continuum (Commissioned findings to identify the most appropriate time (or multiple opportunities) to intervene and deliver targeted intervention


21/34

21

9. Governance Structure

The DfE Exemplar Project will be owned and led by the DfE Exemplar Project Team, the following departments/individuals will playa key role in the monitoring, development and implementation of the project. Also, the project team will receive support andoversight from both the Community Budget Pilot and the ISCG to ensure that the service/intervention is integrated across allstrategic objectives around complex families. This approach will ensure the service/intervention compliments existing services and

does not duplicate any existing or planned services/interventions by other commissioning groups or pilots.

Essex Drug and Alcohol Action Team (EDAAT) Strategic Manager Young Peoples Commissioning Manager Treatment Lead Carer, User, Family Lead

Childrens Social Care Adoption Manager Head of Permanency

Director for Vulnerable Children Head of Assessment & Family Support

Providers Community Drug and Alcohol Team (CDAT) Managers Open Road Drug & alcohol open access service provider Westminster Drug Project (WDP) criminal justice services

Other Stakeholders Fostering Manager Legal Services and Court Midwifery and Health visiting Job Centre Plus

EssexFamily Basildon(Community Budget)

Essex Family SteeringGroup

Department forEducation

Essex Drug & AlcoholPartnership (EDAP)

Integrated SubstanceMisuse Commissioning

Group

Reporting to

Reporting to

Interface Associates

DfE Exemplar Project Team (Project Lead: M. Scott)Including participants from EDAAT, Social Care, Providers and other stakeholders


22/34

22

10. Project Management

The DfE Exemplar Project Team will be responsible for the managing and monitoring the pilot, the composition of the group willinclude individuals from Social Care, Essex Drug & Alcohol Action Team, service providers and the commissioned University. Theteam will perform a range of important functions throughout the lifetime of the pilot from inception through to evaluation and theprocess below describes how this will be integrated:

(i) DfE Exemplar ProjectProposal

Design and development of the proposal, project initiation document (PID), project plan andgroup Terms of Reference

(ii) Proposal and Fundingagreed by DfE

Project Plan implemented and monitoring processes are initiated, including project reviewmeetings, ensuring safeguarding procedures and management structures

(iii) Tender and recruitment ofa local University

The group will develop the specification and provide oversight for the appropriate recruitmentof a local University

(iv) University is commissionedand undertake the work

The University will work directly with a designated officer from the group and report findingson a regular basis

(v) University delivers reportand supports implementationof recommendations

The group reviews recommendations for development and cascades findings across socialcare (so safeguarding processes are ensured) and the Community Budget pilot (to preventduplication of services, interventions etc)

(vi) Tender and recruitment ofintervention practitioners

The group will provide the specification and oversight for the recruitment of practitioners,including work locations, management processes and initiating the evaluation

Action Project Management Process


23/34

23

(vii) Service / Intervention isimplemented

Practitioners and the commissioned University will provide regular reports to the group, whichwill be cascaded to DfE (via Interface Associates), Social Care, Integrated Substance MisuseCommissioning Group, Essex Drug & Alcohol Partnership, Community Budget pilot (Basildon: EssexFamily). Also, the group will regularly liaise with professionals in social care andacross service providers to ensure unforeseen negative impacts are mitigated

(viii) Service / InterventionMonitoring to the group

Practitioners, Project Managers (including those will direct managerial oversight of theintervention) University officers and service providers will report directly and regularly to thegroup at agreed intervals, to:

Review new data findings and conclusions

Track progress of the intervention and research against the project plan and

allocated budget

Anticipate risks and formulate mitigation plans/actions

Sharing best research and practice

Problem solve

(ix) Service / Interventionmonitoring from the group

The group will be monitored and report to: Integrated Substance Misuse Commissioning Group Essex Drug & Alcohol Action Group Basildon: EssexFamily (Community Budget Pilot)The group will provide information on: Adherence to the agreed project plan Completed milestones Risks (and mitigating actions) Finance and budgetary compliance

Opportunities for development Intervention Monitoring and Evaluation Framework

(x) Evaluation

The University provides regular reports (trend data, interim findings etc) to the groupthroughout the duration of the intervention / service and this information is cascaded to allappropriate services, partners and memberships


24/34

24

11. Evaluation Framework

The DfE Exemplar Project Team aims to implement a Logic Model in the monitoring and evaluation of the service / intervention. Alogic model provides a robust yet flexible framework for identifying the pathways from inputs and activities through to outputs,outcomes and impacts. It will enables the University to identify measures for each stage in the model and design an evaluation thattests whether the desired impacts are being realised (or will be realised in the future). The logic model approach is core to ensuring

robust and meaningful outputs from the evaluation. Rather than simply aggregating the activities being delivered by social care andother providers and making a judgement on their value for money, effectiveness, this approach collects data that evidences theoutputs and outcomes being generated by investment; and crucially allows the University to provide an informed assessment ofwhether the indicators suggest the activities being funded will deliver lasting impact in the longer-term. Ultimately, a logic model is atool that will enable the University and Project team to define an intervention in terms of:

The rationale for intervention what problems and gaps the intervention seeks to address The inputs or resources (human, time and financial) used to deliver the interventions The activities delivered The immediate outputs of the intervention for example the number of families supported by the practitioners The intermediate outcomes of the intervention, that themselves lead to longer term impact e.g. reduced drug and alcohol

related harms leading to better parenting capacity and improved family functioning The ultimate, longer term impact of the intervention (see Outcomes Framework)


25/34

25

11.1 Evaluation Framework

Objectives Inputs &Activities

Outputs Outcomes OutcomeIndicator

s

InformationCollectionMethods

When andby whom

How toreport and

use1. To developtargeted and timelyinterventions tofamilies, wheresubstance misusemay affectparenting capacity,resulting in childrenbeing placedoutside of their birthfamilies and kinshipnetworks

To be directed bythe commissionedfindings andrecommendationsby the University

To beassessed

Improved engagement ofparents and familiesthroughout their substancemisuse treatment andrecovery journey

Earlier interventions withsubstance misusingparents and their families

Improved aftercareservices to those familieswho have lost children topermanency servicesbecause of substancemisuse

(Including OutcomesFramework)

To beformulatedand guidedby theintervention

To beconfirmed bythecommissionedUniversity

CommissionedUniversity

Directreporting tothe DfEExemplarProject Team

2. Families thrivingin independencefrom governmentintervention, ingood health andwellbeing, with asafe and nurturingenvironment fortheir children, andwhere possibleeconomically active

and engagedpositively in thecommunity

To be directed bythe commissionedfindings andrecommendationsby the University

To beassessed

Improved strengths,resilience & self-esteem ofparents whose childrenhave been taken in to careas a result of substancemisuse, leading toimproved contact betweenbirth families & children

Cost and efficiencysavings of this approach

Prevention of subsequent

children being placed foradoption or taken into careunnecessarily

(Including OutcomesFramework)

To beformulatedand guidedby theintervention

To beconfirmed bythecommissionedUniversity

CommissionedUniversity

Directreporting tothe DfEExemplarProject Team


26/34

26

11.2 Example overview of the Logic Model

Aim:To develop targeted and timely interventions tofamilies, where substance misuse may affect parentingcapacity, resulting in children being placed outside of

their birth families and kinship networks.Families thriving in independence from governmentintervention, in good health and wellbeing, with a safeand nurturing environment for their children, and wherepossible economically active and engaged positively inthe community

(Possible) Outcomes: Improved engagement of parents and

families throughout their substancemisuse treatment and recovery journey

Earlier interventions with substance

misusing parents and their families Improved aftercare services to thosefamilies who have lost children topermanency services because ofsubstance misuse

(Possible) Outputs: Evidence based service /

intervention, using local data andinformation to target the mostappropriate families

Activities: Stakeholder and family

engagement Rapid Literature Review Local data collection and analysis Activities commissioned by

recommendations by theUniversity

Inputs: DfE Funding Time Expertise Facilities Materials

(Possible) Impact/s:1. Decrease the number of children beingreferred to Children Looked After andpermanency services including those

eventually who are adopted where one orboth parents misuse drugs and/or alcohol2. Innovation enables complex families tothrive and reduces the burden on localbudgets3. Learning is captured and disseminated

Feedback Loop


27/34

27

11.3 Disseminating learningWe will use an action research approach to share learning of what is working well and what does not work, as set out in thediagram below:

CollaborativeAction Planning

Monitoring andReview

Feedback ofResults

ExperimentalInnovation

PermanentImplementation

CollaborativeProblem Definition

Feedback of DataIn-house DataCollection

Problem Re-definition

OR OR


28/34

28

12. Outcomes

Our ambition is to decrease the number of children being referred to Children Looked After and permanency services includingthose eventually who are adopted where one or both parents misuse drugs and/or alcohol. We recognise that a reshaping ofservices may be needed to current service provision to achieve this. The outcomes will be:

The birth families that are affected will be at the centre of a range of proactive services, workers will motivate and engagebirth mothers and the families to maintain them in their treatment and work with them towards a healthy recovery. They willbe provided with opportunities to develop parenting skills and positive parenting strategies. They will gain the ability to havebetter control of their lives, whilst gaining confidence and resilience within themselves and their relationships. They will gaina better understanding of the loss and trauma they have experienced and will be supported to make full use of theopportunities to remain in contact with their children where appropriate.

More children will stay within their birth families and have the benefit of improved parenting. They will live in families that areresilient, positive, safe and stable. The outcomes for the children would continue to improve by having increased stabilityand they would perform better at school, have less involvement with criminal activity and have improved emotional & mentalhealth.

For the professionals involved, they will gain a far greater understanding of the impact that substance misuse and legal

proceedings can have on children and families and the long-term outcomes. They will cooperate together; learn to shareinformation and skills and resources that need to be used effectively to keep children within birth families, to support familiesto manage trauma and bereavement alongside their addiction. They will develop a range of interventions that maintainthese families in treatment and recovery services during and following all proceedings once they have been concluded.


29/34

29

12.1 Outcomes Framework

Key Impacts1. Decrease the number of children being referred to Children Looked After and permanency services including those eventually who are adopted where oneor both parents misuse drugs and/or alcohol2. Innovation enables complex families to thrive and reduces the burden on local budgets

3. Learning is captured and disseminated across services to drive continual quality improvements in social care

Aims1. To develop targeted and timely interventions to families, where substance misuse may affect parenting capacity, resulting in children

being placed outside of their birth families and kinship networks2. Families thriving in independence from government intervention, in good health and wellbeing, with a safe and nurturing environment for

their children, and where possible economically active and engaged positively in the community

Confident andauthoritative parenting

Reduction insubstance misuse

Improvement in mentalhealth

Ready and able to

work with improved lifechances

Stability of suitablehousing

Reduced reliance onbenefits

Reduced criminalactivity / reoffending

Better overall healthand wellbeing

Improved social capital

Contribute their ideasand ambitions

Fully engaged in theshared problemframing

Co-designed betterand more responsive

services / interventionswith practitioners

Tangibleimprovements in thequality of life ofresidents within thecommunity

Increase in sharedaccountability

Removal of inefficiencies

that do not improveoutcomes

Reduction in crisisspending throughinvestment in earlyintervention

Reduction in childrenlooked after orpermanently removed byservices andinterventions deployed toimprove and strengthencomplex family outcomes

Reduction in cost toother services such asPolice, Health andHousing

Development ofsustainable andreplicable services

Innovation drivesefficiency and reducesthe impact of complexfamilies

disproportionately onlocal budgets

Development of amore porous andflexible market fordelivering improvedpublic outcomes

Essex SystemPublic ServicesCommunitiesChildren & YPAdults (Parents)

Outcomes Framework support the realisation of project aims

Better attendance andattainment at school

Better physical andemotional health andwell being

Safeguarded andprotected

Able to play a positivepart in their localcommunity

Ready for the world ofwork with improved lifechances


30/34

30

13. Project Timeline (May Dec 2011)

Action May June July Aug Sept Oct Nov DecWeek 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4

DfE Exemplar Project Team(Governance, Monitoring & Reporting)Project Management1. DfE Project Proposal

2. Development of Project Plan &Project Initiation Document

3. DfE Project Exemplar Team Terms of Reference Invite and recruit partners (Social

Care, Service Providers) Consultation with stakeholders

(including families)

Development of tenderspecification (University)

Agree Project Report andMonitoring

4. Tender (Research andDevelopment) & Advertisement5. University is recruited andcommissioned to: Review the evidence base

(Literature Review) Active Learning Approach Problem Analysis Review local data Recommendations include,

Intervention/s, Delivery Model,Timing, Criteria, Outcomes &


31/34

31

Evaluation Framework Intervention Design (including

partners and families)

6. Implementation of the DfEExemplar Project Intervention: Managerial Processes /

Supervision agreed Project & Outcomes Monitoring

and Reporting agreed Practitioner Recruitment Practitioner induction and training

7. Intervention / Service is initiated

8. Outcomes Monitoring andEvaluation

9. DfE Exemplar Project InterimReport

April 2013

10. Cascading Learning (Reports,Events etc) May 2013

11. Future Commissioning ofservices influenced by outcomes andlearning from the DfE exemplarproject

June 2013 - Onwards


32/34

32

14. Funding Breakdown

We are asking the Department for Education for 150,000 per year for two years (Total of 300,000) in order to resource theintervention and part fund its evaluation. The exact use of the funds will be determined by the initial research and scoping phase ofthe programme. However, to inform our modelling work, the following assumptions have been used:

Expenditure Year 1 Year 21. Key worker role with family intervention/substancemisuse/health visiting/midwifery skill set (estimated 50k perworker)

E.g. 2 FTE Workers =105,000

E.g. 2.5 FTE Workers =125,000

(Including an additional 0.5 FTE)2. Estimated caseload per worker (per 12 months)

10 (20 Families) 10 (25 Families)3. Research and Development Phase (University)

25,000 04. Project Management (calculated at 8% of total)

25,000 05. Evaluation (To Interim Report Stage)

0 25,000Sub Total 150,000 150,000

Total 300,000


33/34

33

15. Risk Register

Risk Probability

(1-5)

Severity

(1-5)

Score

(P x S)

Action to Prevent/Manage Risk

1. Short lead time to recruitappropriate academic staff toundertake identified work

2 3 6 To be reviewed by the project team atnext meeting

2. Implement (with stakeholders)the recommendations fordevelopment and interventionwithin the identified timescales

1 2 2 To be reviewed by the project team atnext meeting

3. Recruiting staff to deliver

recommended interventions, asidentified in the University report

2 4 8 To be reviewed by the project team at

next meeting


34/34

34

16. Key Contact Details

Name Organisation Contact

Ben HughesStrategic Manager - Essex Drug & Alcohol ActionTeam

[email protected]

Mike Gogarty Director of Strategy and Public Health North EastEssex PCT

[email protected]

Judith Adams Children & Young Peoples Manager Essex CountyCouncil

[email protected]

Terri Sargent Elected Member, ECC and Basildon Council [email protected]

Sally Hills YP Peoples Commissioner - Essex Drug & AlcoholAction Team

[email protected]

Matthew Scott EssexFamily Programme Team [email protected]

Paula Mason Basildon Council [email protected]

Tony Sharp Service Manager (Adoption) Essex County Council [email protected]

Simon Legrand Project Manager [email protected]

dfe exemplar project plan (tonic consultants matthew scott) families affected by substance misuse...

Documents