Family support

Introduction
Working in partnership to analyse local needs

Ensuring that services are available to meet a wide spectrum of need
Ensuring a good fit between individual assessments of need, and the service offered
Considering imaginative new service models
Developing services that provide alternatives to high cost interventions
Evaluating services to ensure that they are achieving good outcomes

Introduction

In England, the Performance Assessment Framework (PAF) indicator E44 measures the proportion of spend on children in need. However, the figure for spend does not indicate quality. A council may have a low figure in its comparator group for E44, but offer well planned and effective services to children in need. For England see National Performance Indicators, for Wales go to www.lgdu-wales.gov.uk.

Working in partnership to analyse local needs

The development of an effective range of family support services is a key objective for most Children's and Young People's Strategic Partnerships (in Wales these are called strategic frameworks). One of the key challenges is to achieve better co-ordination of services previously developed using different funding streams (e.g. Early Years Partnerships, Sure Start schemes, the Children's Fund, Cymorth [Wales] Connexions, etc).

Preventative strategies for children should be based on robust analysis of local need and current services. Mapping need and planning services is more effective if done across agencies. All key stakeholders should be involved throughout the process - this will help build consensus about shaping services to meet need. The active involvement of children and their parents in planning and delivering services is particularly important. Regeneration and Neighbourhood Renewal schemes (in Wales these are called Communities First) also need to consider how such schemes will fit with developments in children's services. See Partnership Module.

a. Analyse the needs of the population and plan services to meet need.

  • Use population data and projections and break them down into localities. Some councils have access to a Geographical Information System that can map need and services to ward and sub-ward level.
  • Use health data to help identify where the more vulnerable children and parents live - look at low birth weights, teenage pregnancies and parental ill health.
  • Use education data for children with special educational needs, absences from school and free school meals.
  • Use police data about patterns of youth crime such as taking cars without consent.
  • Map patterns of referrals and service users for social services. Look at types of referral as well as the numbers. What are the patterns? Think about the ages of the children and key reasons for referrals. For example, how important is substance misuse and domestic violence. Are these factors more significant in some areas than in others?

b. Consult extensively with parents, children, young people and community representatives. Seek to achieve a shared understanding of the main priorities. See Good Practice: Portsmouth (1). Talk about people's experience of getting access to help. Note that the families who most need support may be the most reluctant to seek help; how can services be made more available and acceptable to them?

c. Map services and identify where there are gaps, both geographically and in terms of particular types of service. Use the Children in Need census data.2

d. Jointly plan services to meet the range of identified need. This may involve pooling resources, reshaping existing services or commissioning new ones. Whatever funding stream will be used, think hard about the sustainability of new services, including agreements about who will be responsible and how budgets will be shifted over time. Some authorities have used Matching Needs and Services3 to assist in looking imaginatively at what services should be provided.

e. Use a 'Best Value' approach to identify the right provider or to encourage new providers into the locality. Involve users, and potential users, not only in designing but also in managing new services. The voluntary sector often brings specialist expertise and can give added value by being more acceptable to many potential users. (The most vulnerable families may have negative perceptions of the role played by the public sector in this area). The recent inspection of the Children's Fund pilots provides some evidence of the effectiveness of voluntary and community organisations in this area.

Ensuring that services are available to meet a wide spectrum of need

Whilst some services will be designed for all children in a locality, others will provide more specialist and targeted support. There is a very careful balance to be struck between these two broad types of intervention and both will be needed in most places.

  • Ensure that services to promote social inclusion reach those in greatest need. Some very vulnerable people may not feel that they 'fit in' to services where other people seem different from them. (Examples are teenage mothers - who can sometimes feel more comfortable with a peer group - and people with particular religious, cultural or communication needs).

  • Ensure that services do not leave gaps. For example, there is a risk that new services will address lower levels of need, with social services meeting the highest needs, and potentially, a gap between. Also, a concentration of services for the early years groups may leave gaps for vulnerable teenagers.

Ensuring a good fit between individual assessments of need, and the service offered

Some services will be targeted to achieve specified outcomes for families identified as having particular needs. In these instances, the key to success is effective systems for identifying families who need particular support and for assessing their needs and planning their services. See Assessment and care planning.

  • Ensure children and parents are fully involved in assessment, care planning and review. Services will never be effective if families are not engaged in them.
  • Ensure that care plans are specific about need, inputs, timeframes and outcomes and who is responsible for each area.
  • Review care plans to ensure that the right outcomes are being achieved.
  • Ensure that staff are aware of the range of services including those in the independent sector and how to access them.
  • Collate the needs of assessed children, and the outcomes of services, to feed into service planning.

 

Considering imaginative new service models

The most effective models are likely to be those that tap the skills of a range of staff and volunteers, and which achieve the full engagement of disadvantaged children and families. Some examples are:

  • Resource centres (for example, for under 5s) where a range of services are available under one roof.
  • Specialist services, including helplines, for troubled teenagers.
  • Services designed to re-engage children who are frequently absent or excluded from school.
  • Home-based services, providing practical help, including out of hours.
  • Weekend services, including crisis services.
  • Holiday clubs.
  • Self-help groups, relaxation classes, outings and leisure groups for parents.
  • Short term intensive help, including multi-disciplinary assessment, for very troubled children and young people.

Developing services that provide alternatives to high cost interventions

a. Children with disabilities 4

It is good practice to look at ways of supporting children with disabilities in mainstream family support services, so they are not isolated and can develop with their peers. Services for this group are addressed in a separate section of this module. See: Services for disabled children and their families

b. Alternative to care

  • Family Group Conferencing5 can assist in helping families to find solutions for themselves and to achieve changes with the support of family members. See Good Practice: Hull (3).
  • Specialist assessment is helpful when a family breakdown is likely. This should be carried out by staff who have access to resources and services.
  • Services need to be available at short notice. Outreach services and respite fostering can give families necessary space to find their own solutions.
  • Specialist adolescent services are often a neglected area. Entry to the care system is more likely for adolescents and the outcomes less likely to be successful - so investment in diversion can produce better outcomes and save money. See Good Practice: Milton Keynes.

c. Joint services for children and young people with high levels of need

  • Child and Adolescent Mental Health Services (CAMHs) can play a critical role and need to be planned and developed jointly with health. See Good Practice: Leeds, and reports on the Beacon councils.6



Evaluating services to ensure they are achieving good outcomes.

It is essential to seek and collate feedback from parents and children and to find innovative ways of doing this. However, this evaluation method needs to be underpinned by other methods, designed to test whether the service is actually achieving its stated objectives. The aim must be to ensure that services are not only welcomed by those using them, but also reaching the right people, delivering the desired volume of activity, responding within the right timescales, achieving the desired outcomes and offering Best Value.

  • Be clear and specific about the outputs and outcomes to be achieved.7 Build in monitoring and evaluation systems when the service is being designed and ensure that all stakeholders understand the importance of this. (Effective monitoring systems do not have to be overly bureaucratic). Where services are primarily geared to respond to social work referrals, use care plans and reviews as one tool for measuring success.
  • There is a growing body of research evidence about the effectiveness of different models of family support, which can be drawn upon to support evaluation.8
  • Include in the evaluation the unit cost of services - is the service providing value for money? Could the same or similar outcome be achieved more cheaply? Would more/different resources improve the outcomes? Have you got the right skill mix?


2.  Available at http;//www.doh.gov.uk/cin/cin2001/htm
3   Little, M., Madge, J., Mount, K., Ryan, M. and Tunnard, J. (1999) Matching Needs and Services, 2nd Edition, Dartington, Dartington Academic Press. http://www.dartington.org.uk/pages/publications.shtml
4  See Quality Protects research briefing 6 from http://www.dartington.org.uk/pages/publications.shtml
5  The Family Rights Group has a Family Group Conferences Project http://www.frg.org.uk/Projects/projects.asp
6  CAMHS Beacon authorities 2003 are Darlington, Kensington and Chelsea, Surrey and Wirral.
The report of the advisory panel gives information about the services in Annex G and is available here

7  See The Portsmouth Partnership: programme outcomes on page 10 of the report on Children's Fund First Wave Partnerships 2003 available here
8  Some sources of research are:
Social Care Institute for Excellence (SCIE) http://www.scie.org.uk/
Research in practice http://www.rip.org.uk/
Quality Protects Research briefings available at http://www.rip.org.uk/mainmenu.html are:-
1. Education of children looked after; 2. Placement stability; 3. Young people's participation; 4. Sport and the Arts; 5. Adoption and permanence; 6. Children with disabilities; 7. Leaving care; and 8.Youth Offending.
Children and families Research Unit, De Montfort University http://www.dmu.ac.uk/faculties/hcs/research/cfru/index.jsp