The Director of Partnerships and Prevention was in attendance at the meeting to present a report providing an overview of the current Early Help and Prevention Services in Middlesbrough, including the current service structure; the responsibilities of each team; how services were delivered and who they were provided for.
It was highlighted that there was significant demand for Childrens Services in Middlesbrough. However, there was an increase in demand nationally and this was coupled with a decrease in funding. Early help was a critical element of demand management for Childrens Social Care and effective delivery was key to achieve the best outcomes for children and their families.
The report explained that the meaning of Early Help was to provide support as soon as a problem emerged at any point in a childs life, from the foundation years into their teens. Early Help could also prevent further problems arising if it was provided as part of a support plan, for example where a child had returned home to their family from care, or in families with emerging parental issues such as mental health problems or substance misuse.
The Early Help agenda was co-ordinated through the Childrens Trust Board and Local Safeguarding Childrens Board. The Trust worked to the objective of achieving a Fairer, Safer, Stronger Middlesbrough for children and the Board was governed by the vision "We will work together with you so that you can make the most out of your family life, to be healthier, to achieve, be safe, strengthen and enjoy your lives together."
Reference was also made to national guidance, "Working Together - July 2018" which outlined the responsibility of Local Authorities and their partners for the delivery of early help. The document stated that local areas should have a comprehensive range of effective, evidence-based services in place to address assessed needs early, drawing upon any local assessment of need, including the JSNA and latest evidence of the effectiveness of early help programmes. In addition to high quality support and universal services, specific local early help services would typically include family and parenting programmes, assistance with health issues (including mental health), response to emerging concerns and help for emerging problems relating to domestic abuse, drug or alcohol misuse by an adult or child. Services may also focus on improving family functioning."
The Director of Prevention and Partnerships explained that he was responsible for co-ordinating the work of the following areas in order to transform Childrens Services:-
Head of Partnerships-Youth Offending, Troubled Families, Risk and Resilience, Childrens Trust, Local Safeguarding Board.
Head of Prevention - School Readiness Team, Family Case Work, Family Partnership Team, Work Readiness Team.
Head of Strategic Services - Believe In Families Programme Management Team, Voice of the Child, Quality Assurance.
The Early Help and Prevention Service in Middlesbrough was called Stronger Families and was made up of four work streams:-
The Early Help offer in Middlesbrough was made up of many elements including pre-social work, taking a whole family approach to prevent the child from going further into the social services system. In addition, Childrens Centres and the Family Partnership Team, working with key partners such as schools and Police, formed part of the service as did Work Readiness, aiming to get young people into education, training and employment.
The Children and Young Peoples Plan, informed Service Plans and Team Plans and contributed to the Mayors Vision of a Fairer, Safer, Stronger Middlesbrough with the aim of reducing the numbers of children becoming looked after.
The report outlined the work undertaken by each of the Teams as follows:-
School Readiness Team
The School Readiness Team provided universal and targeted early help for families who had children aged 0-5 years. This was delivered as follows:-
- Eight Childrens Centres in Middlesbrough helping children prepare for nursery and primary school. The centres provided a range of activities that any parent could attend, along with targeted school readiness interventions, delivered jointly with the health visiting service, including pre-birth activities such as Pregnancy, Birth and Beyond programmes and midwifery services. The offer following birth included speech and language support, access to local health visiting services, physiotherapy drop-ins, housing advice, welfare advice, access to parenting programmes and family support.
- The Centres worked closely with libraries, encouraging parents to share books with their children to improve speech, language and early literacy. The Early Years Support Service was an integral part of the Childrens Centre offer comprising joined up support to families with children under five, tailored to specific needs and delivered from a local point of access.
- The Early Years Team provided access to good quality childcare, including free early education for two and three year olds.
- The Team worked actively with childcare settings to ensure high standards of safeguarding, policies and procedures were in place. This included a qualified teacher working with the settings to increase their Ofsted ratings and the Council would only fund children in settings rated as good or outstanding by Ofsted.
Family Casework Team
The Family Casework Team helped families in Middlesbrough who required additional help due to problems such as domestic violence, mental health and substance misuse. Families were able to refer themselves into Childrens Services via 'First Contact'. Alternatively, other agencies or professionals could make the referral. There were Stronger Families staff working within First Contact who would signpost families into the correct early help service which could include Stronger Families, or a range of partner agencies, to ensure children received the right help at the right time.
Families that met the threshold for level three services and had complex needs were referred to the Family Casework Team and allocated a lead practitioner to work with the family (and other agencies as appropriate), to assess the familys needs (using the My Family Plan early help assessment) and to agree what support was required. Support was co-ordinated by the lead practitioner.
A 'whole family' approach was taken by the Team using various evidence-based interventions and tools focussing on the voice of the child to engage the family and resolve the issues identified. The lead practitioner held a family review meeting every 4-6 weeks to discuss progress and agree actions to continue to address/resolve issues.
Once work with the family was complete and their needs had been met (usually within a three to six month period), prior to the case being closed, the lead practitioner would hold a final family review meeting and complete a Crisis Card with the family which they would use to help them identify when issues might be arising and to help them manage situations before they escalated into a crisis.
It was explained that a number of families were moved into maintenance where a plan was completed with the family, including steps to take and contact details of who would provide support if they needed help with specific issues. The family would be contacted at regular intervals without the case necessarily needing to be referred back to the Family Casework Team.
The report provided data in relation to the number of re-referrals into Childrens Social Care. The Director advised that, during the latest 12 month period, 86% of the children worked with across the 12 month period did not progress into the care system in the following 12 months as a result of the support received via the Team. This was seen as a very good impact measure.
During the course of discussion, the following issues were raised:-
In response to a query as to the actual number of children that the 86% related to, the Panel was advised that this number varied continually, however, the current figure was approximately 1,152 children that were being supported by Early Help. In terms of targets for the Service, the Panel was informed that there was demand for the service therefore the key consideration was to ensure that caseloads were not exceeded.
A Panel Member referred to issues for which families might require additional help and highlighted that gambling had not been one of the issues listed. The Director clarified that no issues requiring additional support or help would be excluded. Once the My Family Plan assessment had been completed, taking into account the views expressed by the child and the family, where need for specific support was identified, the appropriate teams would become involved regardless of the issue. The agency best placed to support the issue would lead on the case, ie whatever the greatest need was within the family.
It was queried whether the service was pro-active in trying to engage with families that had historical problems. The Director stated that a national troubled families study highlighted that where there was a prevalence of a particular issue within a family historically, members of the family would be more likely to repeat those problems/issues in the future and those families were targeted for support. Work around Adverse Childhood Experiences was currently being developed to address this.
In response to a query regarding how many issues families must present with in order to be eligible for additional support, the Director confirmed that there was no prescribed criteria for receipt of early help support and that the family would be helped by the appropriate service. However, work was currently ongoing in relation to a pilot programme, Adverse Childhood Experiences (ACE) where families needed to present with certain issues from the defined list in order to receive specialist help as part of the ACE pilot. The Service (with partners) had defined its own list and was looking to work in partnership with two schools to identify families that were affected by adverse experiences (such as domestic abuse, bereavement, etc) and would benefit from early support.
Clarification was sought in relation to the point where statutory support was triggered and what happened to the families that did not quite meet the threshold for needing support. The Director confirmed that statutory support was provided by Social Care and would be triggered where issues within the family had escalated to Tier 4, child protection issues, and the needs of the child were placed before everything else. The levels of support offered ranged from universal - being open to all, primarily activities offered by Childrens Centres where parents voluntarily attended with their children - through to complex. There was no cut off point and the response from the service was determined by the familys level of support need.
Reference was made to the escalation of family casework numbers. A Panel Member commented that it was difficult to know whether the increase in numbers was based on the fact that there were more families in need or whether the service was picking up the families before the needs became too serious. The Director stated that the ADCS (Association of Director of Childrens Services) had produced a report outlining a £2 billion shortfall in funding for childrens services coupled with an increase in demand. The Director added that he would provide an illustrative information graphic to Panel Members. The LGA responded to the report on how certain areas were under greater pressure than others causing demand to be driven up.
It was queried how the Service would be able to identify when it had sufficient resources to deal with the demand.
The Director responded that staff caseloads and quality of practice were closely monitored. Other factors such as staff turnover and the number of complaints received were also monitored.
A Member highlighted that Universal Credit would be introduced in Middlesbrough in October, and it was queried whether anything was in place to help families that it might negatively impact on. The Director stated that the service would always seek to gain the voice of the child and any support required would be focussed on supporting the parents. The Family Teams would be able to signpost families to the appropriate services to help them, eg financial inclusion, etc.
In response to a query regarding the number of families re-referred to the service following closure of their case, the Panel was advised that currently approximately 14% of cases escalated to Childrens Social Care.
Family Partnership Team
The Panel was informed that the Family Partnership Team was a family support service established to ensure early help at the earliest possible opportunity was provided to children and their families. All services that had direct contact with adults, children and young people that were likely to identify problems/issues that were negatively affecting a member of the family or household were aware of the My Family Plan and, where appropriate, undertook the assessment.
As a result, if a parent, child or young person needed help, those services could help them, for example a GP, teacher, special educational needs worker, health visitor, childrens centre or a worker from any community service. Such services often worked together as a team to help families depending upon the complexity of the familys needs.
Families and/or services could request help by contacting the Family Partnership Team who would ensure that families received the right support by involving the right services. The Team provided information, advice and guidance to families and services to help them work together. The Team had strong working relationships with other local community services, the voluntary sector, church sector and adult services.
During the course of discussion, the following issues were raised:-
In response to a query, the Panel was advised that 512 families were currently receiving support through the Family Partnership Team.
When asked about the reason for the increase in the number of child cases open in 2018, from 227 cases in January to 516 in June, and the increase in the number of family cases from 105 in January to 246 in June, the Director explained that these were positive increases as it was linked to the creation of the new team and meant partners were providing help and support at an earlier stage before more complex support was required.
The Director had introduced case work audits with staff on a monthly basis and this was replicated by the Head of Service and Team Managers to ensure caseloads and work was effectively monitored.
The Work Readiness Team was responsible for tracking and following up all young people aged 16-18 years, and up to 25 years if they had special educational needs or were a care leaver, and recorded their current post-16 destination. The Team offered careers information, advice and guidance and personalised support to help young people into education, employment or training.
The Team aimed to reduce the number of young people not in education, employment or training (NEET) in Middlesbrough by offering:-
Impartial careers information, advice and guidance for Year 12 and 13 young people and for Year 11s excluded from school.
To ensure Year 11s and Year 12s had an offer of learning for September - known as the September Guarantee.
To track and follow up all 16 and 17 year olds and those in targeted groups.
Support to teen parents, young mums and young people with special educational needs or disabilities to get into education, employment or training.
A dedicated worker to support care leavers into education, employment or training and help sustain their placement.
Dedicated support to the Youth Employment Initiative.
Complete a My Family Plan where appropriate to support the needs of the young person and their family.
Early identification of those young people at risk of dropping out of education, employment or training.
To work with partners, including MAP, to reduce the number of young people in Middlesbrough not in education, employment and training (NEET).
The Director advised that there had been a significant improvement in the NEET rates, with Middlesbrough performing better than its national, regional and statistical neighbour. This meant that there were less young people in Middlesbrough that were not in employment, education or training than at any other recent time. In addition, Middlesbrough had also improved its rates of ensuring a September Guarantee from 93.3% in 2013 to 97.1% in 2017.
The Panel wished to congratulate the Work Readiness Team on the work it had undertaken to ensure improved outcomes for young people in Middlesbrough.
In conclusion, Middlesbroughs early help approach was built on national best practice and had benefitted from learning through the Partners in Practice model be working in partnership with other local authorities with identified good practice.
The Panel discussed how it wished to proceed with the review and determined future lines of enquiry. The Panel identified it wished to receive more detailed information about the work of the four teams within stronger families, including relevant data, and that it wished to visit several Childrens Centres in order to see how they operated first-hand and to speak to service users.
It was suggested that the Panel may wish to prepare a series of questions that could be asked during the visits to the Childrens Centres and any suggestions should be forwarded to the Democratic Services Officer.
The Chair thanked the Director for attending and for the information provided.
AGREED as follows:-
1. That the content of the report, and the information provided at the meeting, be noted and considered in the context of the Panels review.
2. That arrangements be made for Panel Members to visit a selection of Childrens Centres.
3. That the Managers of the Family Casework Team and Family Partnership Team be invited to a future Panel meeting.
4. That the Work Readiness Manager be invited to a future Panel meeting.