Thinking Family Supporting families as whole systems

1
Thinking Family Supporting families as whole
systems

• Lia Borgese and Wendy Weal
• Families Division
• Department for Children Schools and Families

2
What is think family ?

• Developed by the Social Exclusion Taskforce in
  their Families at Risk Review
• Two key publications
• Reaching out Think Family - analysis and themes
  (June 2007)
• Reaching out Think Family policy
  recommendations (Jan 2008)
• Currently being tested by 15 Family Pathfinders
  launched in June 2008
• Funding to help every Local Authority develop the
  model from 2009-10

3
The Government is increasing parenting and family
support services across a spectrum of need
Increasing needs
Early signs of risk
High Needs
Parenting programmes
Whole Family Support

• Parenting Early Intervention Programme

• Parenting Experts

• Family Intervention projects

• Family
• Pathfinders

Of course some families need more than help with
parenting and this needs to be one element of
whole family support
4
Supporting local authorities

• In 2006 LAs asked to appoint single commissioners
  of parenting support and to develop a parenting
  strategy by March 08
• Majority of LAs have strategies in place and are
  now moving to an implementation phase
• Parenting Implementation Project to test
  effective practice in developing parenting
  strategies to develop a national framework for
  all LAs
• Developing plans for ongoing support for LAs

5
Parenting Early Intervention Pathfinder roll out
Increasing provision

• To support for the parents of 8 -13 yr olds at
  risk of negative outcomes
• 18 pilots 2006-2008 shown to be a success with
  high levels of gains for parents and their
  children
• An additional 24 LAs in 2008/9
• Currently working on plans for further roll out
• Expected that the majority of LAs will receive
  PEIP funding by 2010
• Improving delivery
• more firmly to the roll out of extended schools
• wider range of parenting programmes

6
Two parenting practitioners in each local
authority
Increasing provision

• Respect practitioners in 77 areas to support the
  parents of children and young people involved in
  or at risk of anti-social behaviour
• 34m Childrens plan commitment to build on this
  by putting 2 parenting advisers in every local
  authority
• Targeting parents with problems known to put
  their children at risk, for example, parents who
  are offenders, have mental health problems or
  with drug and alcohol problems.
• Currently being recruited

7
Why do we need to Think Family?

• The systems of support around families at risk
  are inadequate because they
• Are complex and highly fragmented
• Intervene too late
• Lack a focus upon/ability to engage the most at
  risk families

• We are still not doing enough to interrupt
• inter-generational patterns of social exclusion

• 63 of boys with convicted fathers go on to be
  convicted themselves
• Parental alcohol misuse is a factor in more than
  50 of child protection cases (and there are
  350,000 children with drug addicted parents/ 1m
  with alcohol addicted parents)
• 14 children witnessing domestic violence have
  serious social and behavioural problems
• Children from the 5 most disadvantaged
  households are more than 50 times more likely to
  have multiple problems at age 30 than those from
  the top 50 of households

8
We need more focus on the 2 or 140,000 families
with children experiencing 5 or more
disadvantages
Percentage of families with children experiencing
5 or more disadvantages
2.2
2.1
2
2
1.9

2001
2002
2003
2004
2005
The consistency of this figure over 2001 to 2004
suggests that improvements such as the reduction
in child poverty may not be reaching these
families

• Basket of indicators of disadvantages includes
• No parent in the family is in work
• Family lives in poor quality or overcrowded
  housing
• No parent has any qualifications
• Mother has mental health problems
• At least one parent has a long-standing limiting
  illness, disability or infirmity
• Family has low income (below 60 median)
• Family cannot afford a number of food and
  clothing items

9
Multiple disadvantage can cast a long shadow
10
This requires a big programme of systems reform
potentially as big as ECM
Every Child Matters is already transforming the
way services are delivered for 0-19 year olds.
Think Family extends this model to include
adults services and puts families firmly at the
centre

• Our transformation in children's services is
  having an impact on the opportunities of our most
  disadvantaged children
• But even the best childrens services can only
  mitigate the impacts of parental problems such
  as domestic violence, offending or substance
  abuse.
• We need to build on this success by recognising
  the role of adult services, in helping identify
  families at risk and tackling the adult problems
  that have damaging consequences for children
• This is about extending the logic of
  collaboration from Every Child Matters beyond
  childrens services to better coordinate all of
  the services working with families at risk
• .

• 375 fewer infant deaths per year
• 2000 fewer children killed or seriously injured
  on the roads each year
• 27,000 more children achieving 5 good GCSEs
• 600 thousand children lifted out of poverty
  between 1998 and 2007

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ECM and Childrens Trusts have introduced a
dynamic for increased collaboration between
childrens services. However, systems around
families facing multiple disadvantages are still
highly fragmented
DAT
Advice services
LSC
Probation
LSC
DAT
Housing
Adult Health
Adult Social Serv
Leisure
YOT
Child Health
Child Social Serv
Adult
Housing
Child
Leisure
Youth
JC
CAMHS
AMHS
Police
Police
Vol orgs
Schools
Private orgs
Specialist Serv
Specialist Serv
Vol orgs
Prison
12
Think Family an opportunity to extend the logic
of cooperation from ECM to encompass all services
working with the family
DAT
Advice services
LSC
Probation
LSC
Housing
Adult Health
Adult Social Serv
DAT
Leisure
YOT
Child Health
Child Social Serv
Parent
Family
Housing
Child
Leisure
Youth
JC
CAMHS
AMHS
Police
Police
Vol orgs
Schools
Private orgs
Specialist Serv
Specialist Serv
Vol orgs
Prison
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What does this mean practically?

• Planning and delivering support for families as a
  whole
• Effective provision that responds to how risk in
  families inter-relates. For example
• Improving childrens behaviour may require
  support with parenting
• Enabling a parent to consider returning to work
  may require tackling a child's school absenteeism
  
• Ensuring whole family support packages are
  available at different levels of intensity,
  including very intensive support ( the FIP model)
  for the most risky families

• 2. Reforming LA systems to Think Family
• Changes to delivery systems and workforce culture
  to ensure consideration of the family context to
  need
• In order to identify and intervene early with all
  families at risk

14
Embedding Think Family as part of the next phase
of ECM reform
15
Implementing this locally requires changes on a
number of levels, from the front line through to
local planning, commissioning and governance
structures
Identification
Better systems for identifying and engaging
families at risk
Whole family assessment
Building on the CAF, which looks at the needs,
strengths and interrelation of problems of the
whole family
Multi agency support plan
Managed by lead workers who case work families,
working directly with them and co-ordinating
other service involvement
Improved information sharing
To enable early identification, effective
assessment and interventions
To ensure the full range of evidence based
programmes and interventions to meet family needs
Joined up planning commissioning
Integration between adult and childrens
services
at all levels of the LA such as clear
accountability for families through joined-up
governance to and a common vision and agreed
outcomes for families across services as part of
the LAA process.
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So what does this mean in practice?
Better systems for identifying and engaging
families at risk, including links and information
sharing between childrens and adult services,
Workforce training e.g. assessing risk in
families etc
Identification
In the morning my mum used to do breakfasts and
everything when she was sober. But when it got
towards the (end of) the dayshe used to drink
more and more.if I didnt cook for myself I
would have just starved.. I was surprised that
the social workers didnt do anything.even talk
about putting me into foster care. When we were
living with my mum and I were looking after her
and she was drinking a lot and threatening to
take her own life, they came up to visit
sometimes to see how she were, but they never
ever mentioned even thinking about putting me
into foster care. They didnt say, oh youre in
danger or anything

• 46 of those in adult drug treatment are parents
• Services working with these adults need to think
  about the children in the household action that
  needs to be taken to ensure their needs are
  addressed
• Workforce need better training and incentives to
  engage proactively and work with at-risk families

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So what does this mean in practice?
Whole family assessment
Building on the CAF, which looks at the needs,
strengths and interrelation of problems of the
whole family
Improved information sharing
To enable early identification and interventions
Shared assessments and information across
agencies give a full picture of a families needs
and help ensure the right support is in place.
18
So what does this mean in practice?
Managed by lead workers who case work families,
working directly with them and co-ordinating
other service involvement
Multi agency support plan

• Support plan which meets the needs of the whole
  family and is subject to regular review
• Lead worker (building on lead professional and
  Family Intervention Project Key worker roles)
  with assertive working style responsible for
  ensuring families engage, turn up for
  appointments and that agencies meet their
  commitments.
• Possibly involving a contract which sets out what
  is expected in return for the support provided
  and may include the possibility of sanctions
  (where appropriate)
• Delivery of multi agency support may be backed by
  some sort of multi agency structure e.g. multi
  agency team (team around the family?) involving a
  range of relevant co located agencies e.g.
  health, YOT, Parenting practitioner, drug and
  alcohol and domestic violence specialist etc

19
How we plan to support this from the centre

• Supporting local areas national roll out over
  2009-11
• Need to generate and build on learning from the
  15 Family Pathfinders
• Guidance and regional events
• DCSF plans to drive this across government
  critical partners DH, HO, MOJ, CLG, DWP.(how,
  what, when?)
• Performance management frameworks (local
  authorities, PCTs, police etc)
• Do we need a national level vision or framework
  of outcomes for families??

20
Where do we need to get to?
A integrated and appropriate service response to
all families at risk
How will this be achieved ?

• Joined up Family Intervention Project and
  targeted interventions sufficient to meet the
  needs of the most challenging families (whatever
  their combinations of problems)
• Changes in attitudes, culture and behaviour at
  local level and on the front line (achieved by
  Think Family, workforce reform and Children's
  Trusts) to identify and intervene early with all
  families at risk

High
Medium
Low
However need to be realistic. This involves a
real culture change, but the potential gains are
huge.