welcome to integrated processes training. welcome and housekeeping fire toilets refreshments...
TRANSCRIPT
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
Make a positive contribution Achieve economic wellbeing
Be healthy Enjoy and achieve Stay safe
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.
Improved outcomes:
• Be healthy.
• Stay safe.
• Enjoy and achieve.
• Make a positive contribution.
• Achieve economic well-being.
Integrated working processes and tools
Tools and processes that support integrated working
Lead professional and TAC
CAF and National eCAFInformation sharing
Common coreContact PointMulti-agency working
A continuum of needs and services
The benefits of integrated working
Earlier, holistic identification of needs
Earlier, more effective intervention
Improved information sharing across agencies
Better service experience for children, young people and families
More effective practice for practitioners and organisations
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
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
Everything is so exciting, but what is most exciting is that all our new pieces of work are now linked
Guiding principles for the workforceEveryone in the children and young people’s workforce should:
• 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
Improved outcomes:
• Be healthy.
• Stay safe.
• Enjoy and achieve.
• Make a positive contribution.
• Achieve economic well-being.
Tools and processes that support integrated working
Lead professional and TAF
CAF and National eCAFInformation sharing
Common coreMulti-agency working
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
Holistic
Child and young person
centred
Voluntary and only undertaken
with consent
Focused on strength
as well as needs
Coordinated (only ever one active CAF
episode per individual)
A standardised process
supported by a form
Able to improve links to specialist
assessments
Not something services can require before access to provision – but is able to
inform better referrals
Who will use CAF and when?
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
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.
Any practitioner can use the CAF with an individual child or young person
Identify initial concerns regarding family outcomes – consider need for pre-assessment or signpost to other services
Holistic Family Assessments - REFERRAL
Undertake a holistic family assessment to identify family needs and services required to support better family outcomes
Team around the family (TAF) meeting to agree action plans and agree roles, responsibilities and timescales, agree Lead Professional
Produce a multi-agency action plan to ensure a shared approach to information sharing and improving outcomes
Review the action plan to measure outcomes for the family until they are back to universal 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.
• Basic/background information.• Consent, at various stages.• Assessment in three domains
(see below).• Initial action plan.• Delivery plan and review.
What does the CAF consist of?Through the process standard information will be gathered and recorded:
Development of the child or young person
Parents and carers Family and the environmentAssessment domains
A good CAF discussion should…
Lead to a better understanding
of strengths and needs, and what
can be done to help
Build on effective engagement and communication
Not be too formal or a big event
Build on existing information
to avoid repetition
Fully involve the child or young person and their family
Cover relevant areas but look
beyond the surface
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.
What makes a good CAF assessment?Using an approach that is:
• Empowering.
• Accessible.
• Developmental.
• Transparent.
Leading to…
Identify initial concerns regarding family outcomes – consider need for pre-assessment or signpost to other services
Holistic Family Assessments - ASSESS
Undertake a holistic family assessment to identify family needs and services required to support better family outcomes
Team around the family (TAF) meeting to agree action plans and agree roles, responsibilities and timescales, agree Lead Professional
Produce a multi-agency action plan to ensure a shared approach to information sharing and improving outcomes
Review the action plan to measure outcomes for the family until they are back to universal services
Activity
Completing A CAF
Family risk factors for assessment
Economic well
being
Communities & staying safe Health and family
structures
Most Excluded Families
•Poverty and debt•Worklessness•Education and skills
• Crime and ASB • Alcohol and drugs• Poor housing and homelessness
Domestic violence Relationship conflict Mental and physical health
•KEY INDICATORS
What makes a good CAF plan?Good action planning is:
• Comprehensive.
• Efficient.
• Inclusive.
• Informative.
• Focused.
• Logical.
• SMART.
• Transparent.
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
Analyse Plan
The CAF reviewThe CAF review should gather and record:
• 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:
New assessment neededNew actions agreed and review date set CAF closed
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
Identify initial concerns regarding family outcomes – consider need for
pre-assessment or signpost to other services
Holistic Family Assessments - TAF
Undertake a holistic family assessment to identify family needs and services required to support better family outcomes
Team around the family (TAF) meeting to agree action plans and agree roles, responsibilities and timescales, agree Lead Professional
Produce a multi-agency action plan to ensure a shared approach to information sharing and improving outcomes
Review the action plan to measure outcomes for the family until they are back to universal services
Lead professional and team around the child as part of integrated working
Improved outcomes:
• Be healthy.
• Stay safe.
• Enjoy and achieve.
• Make a positive contribution.
• Achieve economic well-being.
Tools and processes that support integrated working
Lead professional and TAF
CAF and National eCAFInformation sharing
Common coreMulti-agency working
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 meetingsInitial meeting
Share information to gain a fuller picture
Initial meeting
Agree a lead professional
Agree achievable goals
Agree and record actions to meet goals
Set date for review meeting (within three months is
recommended)
Review meetings
Discuss progress
Share any new information
Update plan
Agree achievable goals
Agree new actions, OR close, stating reasons
Activity
Convening an initial TAF Meeting
Identify initial concerns regarding family outcomes – consider need for pre-assessment or signpost to other services
Holistic Family Assessments - PLAN
Undertake a holistic family assessment to identify family needs and services required to support better family outcomes
Team around the family (TAF) meeting to agree action plans and agree roles, responsibilities and timescales, agree Lead Professional
Produce a multi-agency action plan to ensure a shared approach to information sharing and improving outcomes
Review the action plan to measure outcomes for the family until they are back to universal 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
Identify initial concerns regarding family outcomes – consider need for pre-assessment or signpost to other services
Holistic Family Assessments - REVIEW
Undertake a holistic family assessment to identify family needs and services required to support better family outcomes
Team around the family (TAF) meeting to agree action plans and agree roles, responsibilities and timescales
Produce a multi-agency action plan to ensure a shared approach to information sharing and improving outcomes
Review the action plan to measure outcomes for the family until they are back to universal 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:
Coordinate the delivery of the
actions agreed by the practitioners
involved.
Act as a single point of contact for the
child, young person or family.
Reduce overlap and
inconsistency in the services
received.
“Myth Busting” – the lead professional
Does not have to be an ‘expert’ in
everything
Is not automatically the person who
initiated the CAF
Does not need any particular
qualifications
Will not be expected to work outside their usual
remit
Is not responsible or accountable for actions by other practitioners or
services in the TAF
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
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
Build a trusting relationship to
secure engagement
Continue support if appropriate,
if specialist assessments are needed
Convene the TAF meetings to enable
integrated multi-agency support
Identify where others may need to be
involved and broker involvement
Support the child/young person
through key transition points
Ensure a safe and planned ‘handover’ if a different LP is agreed and more
appropriate
Coordinate delivery of solution focussed actions and ensure
regular reviews
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.
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.
Knowledge and skills underpinned by:• Effective communication.• Planning, organisation and coordination.• Critical and innovative thinking.
Activity
Exploring the Lead Professional task, knowledge and skills
Criteria for selecting a lead professionalCriteria for selection could consider:• 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 professionalsLine 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.
• Communication.
• Others?
Resolve problems quicklythrough clear local systems:
• Between the parties.
• Line manager support and/or other local support systems.
• Negotiation between agencies at senior management level.
• Children’s Trust coordinated arrangements at strategic level.
• Director of Children’s Services.
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
Note: This training is about information sharing and not data sharing
Improved outcomes:
• Be healthy.
• Stay safe.
• Enjoy and achieve.
• Make a positive contribution.
• Achieve economic well-being.
Tools and processes that support integrated working
Lead professional and TAF
CAF and National eCAFInformation sharing
Common coreMulti-agency working
Sharing information as part of early intervention and preventative services
• Effective partnership working between universal and targeted specialist services.
• Active processes for identifying those at risk of poor outcomes.
• Sharing between adult and children’s services.
• Sharing to support transitions.
Success depends upon…
Increased emphasis on
integrated working across services to better identify and
meet needs
Sharing information if concerned about significant or serious harm
Always consider referring concerns to children’s social care or police, following LSCB procedures
Seek advice if unsure what to do
Practitioners must: Issues to consider:
Confidential information can be shared without consent if justified in the public interest
Timely sharing is important in emergency situations
Significant harm to children and young people or serious harm to adults can arise from a number of circumstances
It is good practice to seek consent and/or discuss concerns, unless this would increase the risk of harm
Information sharing decisionsDecisions about information sharing should be based on an assessment of benefits and risks to the child, young person or family.
You must assess:
• What are the benefits of not sharing information?
• What are the risks if information is shared?
You must assess:
• How would sharing information benefit the child, young person or family?
• What are the risks if information is not shared?
Decision to shareDecision not to
share
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 makingIs 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
The common law duty of confidentiality
Legislation containing express powersor which imply powers to share:
• 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.
The Human Rights Act 1998
The Data Protection Act 1998
What is confidential information?
Confidential information is…
Can be shared if….
• Personal and private or sensitive, and…
• 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
• 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
Distinguish between fact and opinionShare in secure way
Share only what is necessary for
purpose
Understand the limits of consent
Check information is accurate and
up-to-date
Share only with those who need to
know
Inform person to whom it relates,
and/or who provided information if safe to
do so
Record reasons for sharing; what
shared; with who
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
Evaluations
Any Questions?