toxic/complex trio profile · 2018. 4. 6. · toxic/complex trio needs they have… 20% of those...

Bath and North East Somerset – The place to live, work and visit

Natalia Urry-Mackay, Business Intelligence Officer

Toxic/Complex Trio Profile

Executive Summary


• Purpose of the project

• Methodology used

• Key findings

• What the findings mean for the Council and other

relevant services

• What has already been done as a result of the findings

• Next steps

Contents


Purpose of the project

• To develop a better understanding of the prevalence of children in B&NES

where at least one parent/carer is experiencing one or more of the

Toxic/Complex Trio issues; mental health, domestic abuse and substance

misuse. With particular focus on those that are experiencing all three.

• To identify the support and safeguarding being provided.

• To identify strengths and weaknesses within the system to

help develop more effective, coordinated and targeted

support and interventions.

• To keep children in B&NES safe.


In line with the:

• Munro Review

• Children’s Act

• Adult’s Care Act

• Ofsted requirements

• Local Safeguarding Children’s Board’s (LSCB) commitment to keep

children in B&NES safe.

Relevant legislation, reports and commitments


• First Stage – Questionnaire To acquire contextual information. How services and agencies:

- define and record the Toxic/Complex Trio needs

- assess risk

- and intervene to help parents/carers and safeguard children.

• Second Stage – Collection of data Acquisition of parent/carer data from relevant services for those experiencing one or more of the

Toxic/Complex Trio issues, their level of risk and the support they and their children are receiving.

Before the data request went out a Privacy Impact Assessment was completed with the help of

Information Governance and a Fair Processing Notice was put up in One Stop Shops, Libraries and

Children Centres. Both the Privacy Impact Assessment and Fair Processing Notice were also published

online on the Joint Strategic Needs Assessment (JSNA).

The data request was sent by the Chair of the LSCB and LSAB. Data from external services was

provided via the secure data transfer tool, Globalscape and the raw data was saved in a protected data

folder, with access restricted to the Business Intelligence Team.

Methodology


• Third Stage – Data analysis Triangulation of data to identify individual parents/carers in B&NES with children, experiencing all three

of the Toxic /Complex Trio issues, alongside aggregate, anonymous and suppressed, statistics for all

households with one or more of the Toxic/Complex Trio needs.

• Fourth Stage - Distribution of data List of parents/carers with all three of the Toxic /Complex Trio issues provided to Connecting Families

so that they could ensure that these parents/carers and their children were getting the support and

protection they need.

Key findings and resulting actions presented to Local Safeguarding Children Board (LSCB) and Local

Safeguarding Adults Board (LSAB), sent to relevant services and agencies and published on the Joint

Strategic Needs Assessment (JSNA).

• Fifth Stage – Deletion of raw data On completion of the project, as stated in the Privacy Impact Assessment.

Methodology


Key findings

From the 22 services that provided suitable data there are 1,110 parent/carers with one or

more Toxic/Complex Trio needs …

Volume by number of needs


Key findings

Needs by type

and then substance misuse

with 33% (366).

The most common need type is…

mental health, known to be experienced by 72% (802) of the 1,110 parents/carers

followed by domestic abuse with 44% (487)


Key findings

Level of risk to parents/carers

Medium The proportion of parent/carers identified as being of risk with the number of

Toxic/Complex Trio needs they have…

20% of those with 1 need, 48% of those with 2 needs and 62% of those with 3 needs.

However…..

For 53% of parents/carers with one or more Toxic/Complex Trio needs services did not

identify their level of risk,

and for 32% of parents/carers with all 3 needs.


Key findings

Level of risk to parents/carers

Services are particularly poor at identifying the level of risk for parents/carers with

mental health needs,

not identifying the level of risk for 60% of the parents/carers with mental

health needs,

compared to 27% with substance misuse needs and 42% with domestic abuse

needs.


Key findings

Gender

Of the 1,110 parents/carers with one or more Toxic/Complex Trio needs …

compared to 23%

(253) who are male. 77% (857) are female

Of the 105 parents/carers with three Toxic/Complex Trio needs…

80% (84) are female compared to 20%

(21) who are male.


70% (689) are 25-44 years old,

37% (366) are

25 – 34 years old.

Key findings Age

Of the 979 parents/carers with one or more

Toxic/Complex Trio needs and a date of birth…

Of the 82 parents/carers with three

Toxic/Complex Trio needs and a date of birth...

83% (68) are 25-44 years old,

45% (37) are

25 – 34 years old.


Key findings

Ward of residence

The wards of residence with the highest

proportions of the 702 parents/carers with one

or more Toxic/Complex Trio needs with an

identified B&NES postcodes are:

The wards of residence with the highest

proportions of the 97 parents/carers with three

Toxic/Complex Trio needs with an identified

B&NES postcodes are:

1. Twerton with 15%

2. Abbey with 7%

3. Peasdown with 6%

4. Westmoreland with 6%

1. Twerton with 14%

2. Westmoreland with 7%

3. Combe Down with 6%

4. Radstock with 5%


Key findings

Deprivation (2015 IMD)

Lower Super Output Areas (LSOAs) in the most deprived local quintile have by far the highest number

of the 702 parents/carers with an identified B&NES postcodes with …

There is a very strong

relationship with deprivation

Most deprived

Least deprived

1need (143 parents/carers),

2 needs (138 parents/carers)

and 3 needs (46 parents/carers)

(327 parents/carers in total, 47%).


Key findings

Deprivation (2015 IMD)

48%

of the 97 parents/carers with an identified B&NES postcodes with

3 Toxic/Complex Trio needs reside in an LSOA in the most deprived local quintile.


Key findings

Service users' children

The majority of the parent/carers with one or more Toxic/Complex Trio needs (72%) and three

Toxic/Complex Trio needs (62%) have…

one two children. or


Key findings

Service users' children

The majority of parents/carers with 2 (65%) or 3 (63%) Toxic/Complex

Trio needs have some or all of their children living with them.

The services did not identify whether a

significant proportion of the parents/carers

have any of their children living with them…

However…

1 2 Number of parental needs

52%

23%

10%

3


Key findings

Service users' children’s level of risk

The proportion of parents/carers’ children identified as being of risk with the

number of Toxic/Complex Trio needs the parents/carers have...

7% of children whose parents/carers have 1 need

22% of children whose parents have 2 needs and

44% of children whose parents have 3 needs.

However…

Medium

46% of the children have not had their level risk identified,

27% of the children of parents/carers with 3 Toxic/Complex Trio needs.


Key findings

How services define and assess needs

According to the questionnaire results….

The majority of services decide what needs their service users have via self-reporting:

70% in the case of mental health needs

82% in the case of domestic abuse

and 84% in the case of substance misuse needs.


Key findings


78% of parents/carers with 2 and 3 Toxic/Complex Trio needs have been

identified as having had a risk/needs assessment.

Compared with 48% of parents/carers with 1 Toxic/Complex Trio need.

According to the data received from the 22 services…


Key findings


The top six risk/needs assessments identified as

being carried out for parents/carers with one or

more Toxic/Complex Trio needs were:

• SafeLives Dash Risk Checklist

• SDAS Risk Assessment

• Family Support Play Service Assessment

• Connecting Families Risk Assessment

• Drug/Alcohol Treatment Service Risk

Assessment

• Care Programme Approach

The top six risk/needs assessments identified as

being carried out for parents/carers with three

Toxic/Complex Trio needs were:

• SDAS Risk Assessment

• SafeLives Dash Risk Checklist

• Drug/Alcohol Treatment Service Risk

Assessment

• Connecting Families Risk Assessment

• Care Programme Approach

• Family Support Play Service

Assessment


Key findings

Current interventions put in place to help service users' children

The top seven interventions identified as being

carried out for the children of parents/carers with

one or more Toxic/Complex Trio needs were:

• Family Support Work

• Parenting Assessment and Support

• Domestic Abuse Support

• Connecting Families

• Social Services

• Children Protection Plans.

The top seven interventions identified as being

carried out for the children of parents/carers with

three Toxic/Complex Trio needs were:

• Family Support Work

• Social Worker

• Southside’s IDVA Service

• Child In Need

• Children live with another family

member

• Domestic Abuse Support

• 1-1 Support Sessions


Key findings

Agencies service users are referred to for additional support

The top six agencies that parents/carers with

one or more Toxic/Complex Trio needs have

been referred to are:

• Multi-Agency Risk Assessment

Conference (MARAC)

• Avon and Wiltshire Mental Health

Partnership (AWP) Mental Health

Services

• B&NES Benefits Support

• Southside

• Voices

• GPs

The top six agencies that parents/carers with

three Toxic/Complex Trio needs have been

referred to are:

• Multi-Agency Risk Assessment

Conference (MARAC)

• Voices

• ASSIT (Adult Safeguarding and Adult

Social Care)

• B&NES Children and Families Team

• Developing Health and Independence

Housing Services (DHI)

• Stepping Stones


Key findings

Toxic/Complex Trio Training Needs

Responses from 15 services indicate that the most pressing unmet training need is for…

Toxic/Complex Trio training (7 services)

followed by mental health training (6 services).


What does this mean for the Council and other relevant services?

Mental health needs and risk/needs assessments

It supports raising awareness of mental health needs and their potential impact on parenting.

This is a particular issue in relation to long-term accumulative impacts, the impacts on children and in relation to mental health needs.

It indicates that more work could be done to ensure a wide range of agencies and services are assessing risk levels.

It suggests more could be done by services to upskill staff so they are better able to assess mental

health needs and support or refer people to relevant services as appropriate.



Women and men

It supports targeting more preventative programmes at women aged 25 - 44 years old.

It also indicates that more could be done to focus on the needs and role of

fathers/male carers.

The comparatively smaller proportion of fathers/male carers recorded with

Toxic/Complex Trio needs suggests fewer men access services and/or that services

tend to focus on women as the care givers of children



Deprived areas

Twerton

Radstock

Combe Down

It supports targeting of preventative services towards most deprived communities

particularly in …



Service users’ children

It suggests more could be done to find out whether parents/carers are

living with their children.

It indicates that more work could be done to ensure services are assessing the level of risk

to service users’ children.



Acquisition and analysis of Toxic/Complex Trio data in the future

Recording practices and databases ill-equipped or completely unable to extract

data on the Toxic/Complex Trio needs of parents/carers.

Examples of services that found it difficult or impossible to provide us with the data

we requested are:

• Children Social Care

• Youth Connect

• Most GP Surgeries

• Police

• Probation

• Heath Visitors and Family Nurse Partnership (Virgin Care)



Acquisition and analysis of Toxic/Complex Trio data in the future

…recording practices and data bases need improving to ensure Toxic/Complex Trio needs

data can be accessed and analysed in a much more timely manner.

Consequently…

This will mean that the data is a more effective resource for safeguarding

adults and children experiencing and affected by Toxic/Complex Trio issues.



Review of contracts and working practices

It supports a review of Council and CCG contracts with relevant services to make

sure they stipulate the full recognition, recording and reporting of service users with

Toxic/Complex Trio needs.

Service users with

Toxic/Complex Trio

needs

That all services could benefit from making sure their staff recognise,

record and report the following for service users with Toxic/Complex Trio

needs:

• whether they have children,

• referrals,

• and the risk/needs assessments and interventions carried out.


What Has Already Been Done?

Amendments to recording practices

Amendments to recording practices have been carried out by a number

of services…

• Children’s Social Care have added Toxic/Complex Trio factors to Child

in Need Plans and Child Protection Plans in Liquid Logic Children’s

(LCS)

• Julian House have added a Toxic/Complex Trio flag to their reporting

database.



The families with all three Toxic/Complex Trio needs

The list of 105 parents/carers with three Toxic/Complex Trio needs has been checked

to make sure they are receiving the appropraite support and protection.

• All but 5 of the parents/carers on the list are currently receiving or

have received Social Care support within the last 6 months.

• Actions have been taken to ensure that these remaining 5

parents/carers are receiving the appropriate support.

• A note has been added against the children linked to the 105

parents/carers in Liquid Logic Children’s so that the key people

have this information.

• Checks have been done to gain assurance that these

children are receiving the appropriate level of support

and safeguards.



Toxic/Complex Trio training need and peer review on neglect

Information about available training has been sent to the services that

identified unmet training need.

Toxic/Complex Trio

Some of the Toxic/Complex Trio Profile Report was provided to another

Local Authority as part of a Peer Review on Neglect.

The key findings of the Toxic/Complex Trio Profile

and resulting actions have been published on the

Joint Strategic Needs Assessment (JSNA).


Next Steps

Quality assurance and review of contracts

Letters will be sent to relevant services and agencies requesting assurance from

them that they have the right checks in place to ensure they meet the

long-term safeguarding needs of their service users.

A review of Council and CCG contracts with relevant services will be

conducted to make sure they stipulate the full recognition, recording

and reporting of service users with Toxic/Complex Trio needs.

The Toxic/Complex Trio Profile Steering Group that consists of representatives from a wide range of

services including Safeguarding, Connecting Families, Children's Social Care, CCG and AWP has

outlined that the following steps will now be taken…


Next Steps

Toxic/Complex Trio flag in Liquid Logic Children’s

To purchase the functionality to add a Toxic/Complex Trio flag to

records in Liquid Logic Children’s.


Next Steps Dissemination of information and training

The key findings will be presented/provided to other relevant groups such as

the Health and Wellbeing Board and Domestic Abuse Partnership.

There will be a review of Toxic/Complex Trio related training to make sure there

is sufficient training available and that this training is fit for purpose.

toxic/complex trio profile · 2018. 4. 6. · toxic/complex trio needs they have… 20% of those...

Documents