positive family futures transformation june 2014
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www.portsmouth.gov.uk
Positive Family Futures Transformation
June 2014
James HillTroubled Families Coordinator
www.portsmouth.gov.uk
Agenda
• What has happened so far?– Background– The current system– Redesign – A new way of working
• Objectives, tracking progress and impact?
• Next Steps
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www.portsmouth.gov.uk
Background – Change the Mainstream
• The troubled family’s agenda isn’t about doing more of the
same. As Louise Casey has said, “The initiative will be different
because it will focus on individual families and their needs,
rather than individual services.”
• Opportunity to use a ‘Systems method’ with no preconceived
ideas
• Scoping Exercise – December 2012
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Public Service Board Members
Police
DWP
Portsmouth University
PCC
Probation
Fire Service
Navy
Voluntary Sector
Health
HMP Winchester
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• The Public Services Board have embraced the troubled
families opportunity to think about change and
sponsored a review in 2013
• A multi-agency team used a ‘systems method’ to look at
services from the families perspective
• The team were then given the opportunity to work
together in a different way and that has shaped a
recommendation to develop the work in a locality
• The ‘new way of working’ is being introduced in
PaulsgroveDoing things better or doing better
things?
The journey of families
Multiple Missed Health Appts –DNA and Discharged
Parents taking children to A&Einstead of GP / Dentist Parent in Prison
Children Disclosing parental Drug use, physical harm …
Frequent changes in school oraddress
Parents decides tohome educate
Specialist Services Close due to DNAs
Eviction / Housing difficulties
A Common Journey of Missed Opportunities
Missed Opportunities
Patient responsibility. Discharge as Ineed to worry about the next patient.
No longer our problem. Needto focus on children at hand
Parents are the problem.
Not enough to charge, info notshared, voice not heard
Child not mentally ill, parents do not bring, therefore close
A&E treats and discharges. No one coordinates.. Parent problem
not child problemFully entitled.
Child Disappears
Case 8 – Old System
School Nurse
GP
Consultant Paediatrician
Speech & Language
Tenancy Support
x3
DisabilityEnabability
MEND
Community Dietician
CookerySure Start
Community Paediatrician
Training
Learning & Disability Services
CAMH’s
O .T.
Community Nurse Job
Centre
Housing Officer
Children’s Social Care
Housing benefit
Health Visitor
Counselling Bereavement
HospitalAdvocacy
Service
Keep Safe Work
Care Management Assessment
x2
Stars in the Sky
Police
Family Group Conference
Health Development
Worker
Education Provision
Family Champions
Parenting Support
FADSMini Mend
Psychologist Report
Work Plan
Priority B service FMF X
Home Skills FADS
Priority B service FIP X
Adults' Social Care
DWP
CDG
Family
Doing things better or doing better things?
Minimum 50 Professionals involved.Focus on youngest child’s weight only.
Jigsaw of Information
Health
Police
Social Care
Domestic Abuse
Housing
Missing Piece(s) of Information
Family Schools
Doing things better or doing better things?
I need a lot of help
I need some help
I can sort myself out with family / community support
Current SystemHigh dependency
Low dependency
Low resilience
High resilience
I need a lot of help
I need some help
Current services tends to move people to high dependency / low resilience
www.portsmouth.gov.uk
Some of the redesign areas• Clear Purpose and Operating Principles to keep the
family at the centre of our work.• No assess and refer on, open and close cases.• All pieces of the jigsaw are brought together to create a
multi-dimensional view of the family• Team around the worker brings support, knowledge and
expertise together• Use of Reflective practice, supervision and the Team
Leader working alongside the team
Doing things better or doing better things?
Case 8 – Old System
School Nurse
GP
Consultant Paediatrician
Speech & Language
Tenancy Support
x3
DisabilityEnabability
MEND
Community Dietician
CookerySure Start
Community Paediatrician
Training
Learning & Disability Services
CAMH’s
O .T.
Community Nurse Job
Centre
Housing Officer
Children’s Social Care
Housing benefit
Health Visitor
Counselling Bereavement
HospitalAdvocacy
Service
Keep Safe Work
Care Management Assessment
x2
Stars in the Sky
Police
Family Group Conference
Health Development
Worker
Education Provision
Family Champions
Parenting Support
FADSMini Mend
Psychologist Report
Work Plan
Priority B service FMF X
Home Skills FADS
Priority B service FIP X
Adults' Social Care
DWP
CDG
Family
Doing things better or doing better things?
Minimum 50 Professionals involved.Focus on youngest child’s weight only.
Case 8(Whole Family = Right Problem(s) to Solve)
Navigator
DWPHealth
TrainersLearning & Disability
Team
Children’s Social Care
(Co-navigator)
Job Centre
Work Plan
Training CDG
Doing things better or doing better things?
Now only 5 Professionals involved.Holistic approach to eating, shopping,
exercise, weight management for whole family.
Also helped with money management, job seeking and future housing needs. Daughter now has voluntary job (not
worked since 2010).
www.portsmouth.gov.uk
A New Way of Working
• Work with children and their families - including their extended families at the earliest point to achieve positive outcomes e.g. reduce and prevent risks to health, education, accommodation, offending behaviours
• Use triggers or ‘wobbles’ from data and information held in current systems to proactively identify families who require support at the earliest opportunity e.g. initial missed health appointments, school exclusions and work
• Develop a Navigator role. The purpose of the Navigator will be to support families as a single point of contact to ensure the right service is offered to the family at the right time. The Navigator will be the single case holder of a family and will 'pull' on other services when their expertise is needed.
Doing things better or doing better things?
www.portsmouth.gov.uk
Objectives of Positive Family Futures Transformation
• Eliminate the refer and assess cycle in the current system in order to increase capacity and avoid duplication
• Work with families to prevent escalation into high cost services and de-escalation when families leave high cost services to prevent the 'revolving door‘
• Work in a location in collaboration with e.g. GP Cluster Groups, School Clusters, Community health provision
• Develop an innovative approach to information sharing for the benefit of children, young people
Doing things better or doing better things?
Progress and Impact
Location Paulsgrove
Identification of the
Families
Information Sharing
Assessment & Referral
Cycles
Joined up case
management
Suite of Measures
Locality Partnership / Governance
Structure
Doing things better or doing better things?
Community
School / Health Cluster
Childrens Centre
Social Housing
Other Initiatives
Positive Family Futures
Transformation
Childrens Trust
Strategy
Safer Portsmouth Strategy
Health & Wellbeing Strategy
www.portsmouth.gov.uk
Next Steps
• Focus on a location – Paulsgrove & Wymering• Set up the Local Governance• Increase volume of cases with small core team
supported by team leader and supervision • Establish suite of measures for the locality• Identify and take demand direct from services working in
that location, e.g. housing officers, schools, children centre, community wardens, PCSO’s, G.P. etc.
• Work with managers to support new way of working and remove blockages
Doing things better or doing better things?
www.portsmouth.gov.uk
Contact Details...
Sharon GeorgeEmail – Sharon.George@portsmouthcc.gov.uk
Tel – 023 9268 8295
Do please visit Sharon and the ‘team’
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