1

In South Ayrshire

Girfec Locality Forum Pilot

Evaluation Report

2

Table of Contents PURPOSE OF REPORT .................................................................................................................................................. 3

BACKGROUND ................................................................................................................................................................ 3

EVALUATION PROCESS ............................................................................................................................................... 4

METHODOLOGY ............................................................................................................................................................ 4 DATA COLLECTION ....................................................................................................................................................... 4 SURVEY ......................................................................................................................................................................... 6 FOCUS GROUPS.............................................................................................................................................................. 6 ASSESSMENTS ............................................................................................................................................................... 6

EXECUTIVE SUMMARY ............................................................................................................................................... 7

RECOMMENDATIONS .................................................................................................................................................. 9 TIME .............................................................................................................................................................................. 9 ASSESSMENTS ............................................................................................................................................................... 9 COMMUNICATION AND LEADERSHIP.............................................................................................................................. 9 TRAINING .................................................................................................................................................................... 10

APPENDIX 1 SUMMARY OF PRE PILOT EVALUATION QUESTIONNAIRE .................................................. 11

APPENDIX 2 SUMMARY OF POST PILOT EVALUATION QUESTIONNAIRE ................................................ 16

APPENDIX 3 SUMMARY OF FOCUS GROUPS ....................................................................................................... 12

APPENDIX 4 SUMMARY OF ASSESSMENT ANALYSIS ....................................................................................... 16

3

Purpose of Report This report is an evaluation of the Girfec Locality Forums developed and piloted within the Prestwick/Troon Locality between March and June 2011. The report explores the management arrangements and processes adopted and considers with key stakeholders, how successful or otherwise the process has been.

Background Girfec Locality Forums were introduced to provide a means of streamlining and supporting a localised multi-agency approach to assessing and resourcing the needs of children and young people within South Ayrshire. This is within the context of ‘Getting it right for every child’ (GIRFEC). The South Ayrshire improvement and modernisation agenda for Children’s Services identified the need for:-

• Increased consistency and equity in how support provision is managed and delivered across South Ayrshire, including the need to improve arrangements for assessment, review and management of risk

• Development of locality-based approaches for the co-ordination and management of support provision

• Girfec being established across universal education and health and targeted children’s services as the key driver for improving partnership working and securing improved outcomes for children and young people

South Ayrshire engaged in a process of learning from the good practice of other local authorities. This informed our decision to have two Forums per locality. For the purpose of the pilot it was agreed that all requests for targeted services would require an assessment to be completed for the forum in order to determine the appropriateness and effectiveness of the process. The membership of Locality Forums consists of managers and practitioners from social work, education, health and the voluntary sector. The aim of the Locality Forums is to provide the mechanism and financial resources to support local innovative, interagency working and links with the Integrated Assessment Framework implemented in South Ayrshire in August 2007. For the purposes of the pilot, the agreed role of the Girfec Locality Forums was:-

• To consider Child’s Assessment and Plans where there is recommendation that a multi-agency approach is required

• To commission and review the Child’s Integrated Assessment and Plans where appropriate • To provide an overview of ongoing plans which no longer require to be in the child specific

forums i.e. Child Protection or LAC processes however still require multi-agency support • To consider care and education planning for children likely to become accommodated by

the local authority • To highlight gaps in service • To improve impact and outcomes • To support local service development

For more detailed information refer to the Girfec Locality Forum Pilot Good Practice Guidance – www.south-ayrshire.gov.uk/getting-it-right-for-every-child

4

Evaluation Process The evaluation process was planned and executed by a representative from Health, Education Social Work and a research assistant external to the local authority and was supported by the Girfec Implementation Officer. Anne-Marie Hasler – Children and Community Anne Pittams – NHS Ayrshire and Arran Heather Membride – NHS Ayrshire and Arran Jane Sibley – Children and Community Lesley James – Children and Community Elaine Armour – Children and Community Taryn Moir – Strathclyde University Kirsty Ramsay – Children and Community

Methodology Information has been gathered from a range of sources including members of the Locality Forums, practitioners involved in completing assessments for the Locality Forums, members of the Girfec Implementation Group and Officer Locality Group. Others not directly involved were also included.

Data Collection Quantitative data was gathered during the pilot process and is shown below:-

• 45 Child Assessment and Plans were received. 21 Early Years and 24 8yrs+. 16 were received after the 5 day cut-off and were sent to Forum Members late.

• 7 were received from Health and 38 from Education. • Forums were scheduled fortnightly. One Early Years Forum was cancelled due to no

assessments being received and two were agreed via e-mail as only one assessment had been received and it was a straight forward case. Three 8yrs+ Forums were cancelled around the time of school holidays and one was agreed via e-mail as this was appropriate for the one assessment received.

• The majority of members sent a representative during the pilot and although this had minimal impact it was noted that consistency of membership is beneficial. The only service not providing a representative was Speech and Language Therapy who only attended a third of the Forums.

• Average meeting time was 2 hours. • Additional membership was requested for two Early Years Forums. One Forum had both of

those requested attending and the other Forum did not have the member attend. • 20 out of the 21 Action Plans for Early Years received resources. 23 out of 24 Action Plans

for 8yrs+ received resources. • All revised Action Plans were returned to the Named Person/Lead Professional within 48

hours. • Budget was allocated to cover training for Seasons For Growth and also to buy in a

programme for young people who have experienced domestic violence and are showing aggressive tendencies.

5

Resources agreed by the Forums Resource Early Years 8yrs+ Total Added by

Forum Additional PSA hours 7 7 14 0 Involvement of Psychological Services 7 11 18 2 Occupational Therapy 3 3 1 Referral to the Central Admissions Group 1 1 1 Referral to CAMHS 2 1 3 2 Involvement of the Care and Learning Team 7 7 Integrated Assessment requested 4 2 6 6 Referral to Speech and Language Therapy 2 1 3 1 Involvement of Queen Margaret Academy Outreach

1 1 1

Request for a Joint Support Team Meeting 1 1 2 2 Referral to STEP 1 1 0 Request to the school to take action 2 8 10 10 Request for Management to take action 1 1 1 Referral to Disability Team 1 1 0 Request for a Nursery Placement 5 5 1 Request for a multi-agency review 1 1 2 2 Request for Transport 1 1 2 0 Referral to South Ayrshire Befriending Project 3 3 1 Training cover for Seasons for Growth 1 1 1 Health Visitor input 6 6 2 Referral to Women’s Aid 1 1 0 Referral to Home Link 2 7 9 0 School Nurse input 3 3 0 Social Work involvement 1 2 3 2 Involvement of Doonfoot Outreach Support 2 1 3 3 Referral to Children 1st 3 1 4 2 Additional Nursery Nurse hours 1 1 0 Crisis Prevention Training 2 2 1

6

Survey The questionnaire survey collected both quantitative and qualitative data. A pre-pilot survey was conducted (see Appendix 1 for summary). A post pilot survey was conducted using Survey Monkey (see Appendix 2 for summary) this was set up and analysed by the external research assistant. There was a 55% response rate. The questionnaire was distributed as follows:- Forum Members Girfec Implementation Group Members Officer Locality Group Education including all Prestwick and Troon schools and nurseries (including partnership),Queen Margaret Academy, Wellington School, QIO’s, South Ayrshire Specialist Placements and ASN Services Health including health visitors, school nurses, CAMHS, Speech and Language Therapists and Occupational Therapists Children and Families including social workers, early years team and disability team Voluntary Agencies

Focus Groups Two focus groups and a Best Practice Forum for practitioners were held with representatives from Health, Education, Social Work and Voluntary Agencies to collect qualitative data. These were semi-structured sessions that collected information about the structure, process and impact of the Girfec Locality Forums (see Appendix 3 for summary). The focus groups were facilitated by the external research assistant and South Ayrshire’s resource officer.

Assessments 10 of the 45 assessments that were considered by the Locality Forums were processed through the Assessment Analysis Tool (see Appendix 4 for summary). This resulted in both quantitative and qualitative data.

7

Executive Summary The evaluation group commends the work across agencies that has been undertaken to develop and implement Girfec Locality Forums in the Prestwick/Troon Locality. The evaluation process clearly indicated high levels of commitment to inter-agency working and support for the Locality Forum process. The evaluation has drawn from the insights provided by involved practitioners, line managers and forum members. The post pilot survey indicates that the majority of positive expectations regarding process identified in the pre pilot survey were met. The survey indicated that an overwhelming 99% of the respondents understood the aims of GIRFEC and 80% felt that they had been able to use the training within their practice. 60% of respondents felt that the pilot had improved interagency working, with 79% feeling that assessments were child centred and needs led. Of those who attended the forums 72% felt that the forums were an effective use of their time, in that this would lead to improved outcomes for children and young people. This has supported us in achieving the following national outcomes: • Practitioners will put the child or young person at the centre and develop a shared

understanding within and across agencies. • They will use common tools and processes, considering the child or young person as a whole

and promote closer working where necessary with other practitioners. • Practitioners will understand their respective roles and their contribution to it and there will be

a reduction in duplication and a creation of shorter more streamlined and efficient routes to receiving services.

• There will be greater consistency in assessment of needs and risks in relation to children and their families and lead to a fair and transparent system of prioritising scarce resources.

• Managers provide leadership and strategic support to implement the changes in culture, systems and practice required within and across agencies to implement getting it right for every child.

• There are effective policies, processes, structures and tools for the delivery of good outcomes. These are integrated into practice at all levels and are sustainable beyond the efforts of individuals.

The analysis of the assessments showed that on the whole the level of assessment was proportionate and in keeping with the needs of the child. The assessments identified risks, protective factors and needs, and action plans showed evidence of multi-agency working with clearly stated roles and responsibilities. There was also evidence that information was shared with the child/young person and their parent/carer.

8

Areas for Development Concerns raised have been noted under the themes below and will be addressed through the document’s recommendations. Time Implications

• The amount of time required to complete child assessment and plans • Duplication of work due to entering information in different plans • Lack of Administrative support • Time required by Forum Members to carry out the task effectively

Assessment

• Confusion around the use of Initial and Integrated Assessments. Initial Assessments require information from all agencies involved with child/young person and should not be completed in isolation. It has been noted that there are required fields missing from the Initial Assessment e.g. Historical Information, Ethnic Group, Previous Schools etc. These are included in the Integrated Assessment

• The views of the child were not always clear within the assessment and require to be sought and recorded throughout the assessment and plan

• Parents require to be included throughout the assessment process and be updated after a forum has returned an Action Plan

• The requirement for assessments to be completed for services such as Speech and Language Therapy, Occupational Therapy and Psychological Services

Communication and Leadership

• The forums require consistent Administrative Support • The forum members require to be able to make decisions on agreeing resources • The capacity and sustainability of Locality Forums and Services must be supported by

Middle and Strategic Management • Centralised services have to be able to support Localities • Details of a devolved budget require to be agreed and published by strategic management • Troon/Prestwick locality has a lower level of need than the localities of Ayr and

Maybole/Girvan. Management needs to consider this when planning further roll out Training

• Management require to ensure that the appropriate staff attend Girfec Training prior to rollout

• There is an identified need for training on Planned Outcomes and Action Planning It is the shared feeling of the evaluation group, that Girfec Locality Forum’s are fit for purpose and after agreed changes have been implemented they should be rolled out across South Ayrshire. Plans should then be developed to evaluate outcomes for children and families. The evaluation group recommends that the Girfec Implementation Group agree the recommendations of this report and pass to the Officer Locality Group for approval. These changes should be implemented and Training continue to be delivered with rollout commencing from January 2012.

9

Recommendations

Time The main concern raised throughout the Evaluation Process was in regards to the time of the process. Various measures proposed include:

• Streamlining the assessment paperwork by having one assessment and plan that replaces existing plans A group is currently tasked with incorporating the CSP and IEP into the GIRFEC paperwork. The OLG have agreed that a modified child health plan will be acceptable to the locality forum.

• Strategic management streamlining existing Forums such as the YORG, PRAG, CMG, CAG etc and communicating this effectively to practitioners

• Implementing a local IT Solution Sharepoint is being developed and requires to be implemented before further rollout. iACT is being developed nationally and South Ayrshire are involved in the user group.

• Strategic and middle management to ensure an appropriate allocation of time to allow practitioners to effectively engage in the assessment process including administrative support and for Forum Members to be given the time to take on this role effectively

Assessments 1. To eradicate the confusion around the use of the Initial and Integrated Assessments there

should be one form that is completed by the Named Person or by an assessment team led by a Lead Professional.

2. Repetition in regards to different assessments should be removed by streamlining i.e. Girfec,

Co-ordinated Support Plan, Individual Education Plan, Child Health Record and paperwork being used by social work such as Child Protection, LAC etc.

3. Assessments should only be required to go through the Forum’s for more complex cases that

require a multi-agency response. For Speech and Language Therapy, Occupational Therapy and Educational Psychology direct referral should continue where this is the only service required.

Communication and Leadership 1. Consistent Administrative Support for each locality forum requires to be identified prior to

further roll out. 2. The evaluation shows a clear commitment to agencies working together and sharing

information however information has to be sought from all agencies involved with the child/young person and included in the assessment. This must be promoted by line management with back up reference to the information sharing protocol.

3. The capacity and sustainability of Locality Forums and Services has to be supported by Middle

and Strategic Management. Consideration must be given to the higher levels of need present in the non-pilot localities.

10

4. A plan is required to detail how centralised services are able to effectively support a locality model of working. Examples include pre-3 nursery placements, intensive support, care and learning, home link, psychological services, peripatetic services etc.

5. Clear information regarding a devolved budget to the Locality Forums is required. 6. The members of the forum need to be of a level where they are able to make decisions

regarding the allocation of resources and services. Training 1. There is a clear requirement for training on Planned Outcomes and Action Planning.

An outcomes document is currently under development by the Girfec Implementation Group and a Workshop will be developed based on this. Dates for the Workshop are included in the Inter-agency Training Calendar.

2. Management require to ensure that appropriate staff attend Girfec Training prior to further

rollout. Line managers need to be involved in assessing the level of readiness and appropriateness of involvement of their staff.

3. The evaluation identified the need to emphasise the following in training

• Gaining the views of the child/young person and including these throughout the assessment. The use of the interactive my world triangle should be added to existing training courses to support this.

• The importance of the role of the named person/lead professional in notifying the parents/carers of the decisions of the forum and continuing to include them as part of the action plan.

• Gaining information from all agencies involved with the child/young person and including it in the assessment and plan.

11

In South Ayrshire

Girfec Locality Forum Evaluation Report

Appendix 1

Summary of Pre Pilot Evaluation Questionnaire

12

GIRFEC LOCALITY FORUM – PRE PILOT EVALUATION

Q1 What positive outcomes do you expect will come out of the GIRFEC Locality Forums? Education:

• Targeted support from a range of professionals working with a range of services to meet the needs of children and young people.

• Hopefully a more holistic service for young people. • Contact name for advice on issues. • Realistic overview of complex additional support needs. • Realistic overview of current resources. • Clearer systems. • More equal access to resources. • Hopefully access to greater and shared range of resources to support young people. Also, the

opportunity to reduce the time taken to access resources. • Further suggestions of strategies to support young people and their families. • Better communication between all sectors. • Supporting the child/family across all areas instead of independently. • Improved, open, honest information sharing amongst all agencies. • Improved, more streamlined support for young people and families. • Better integrated working practices. • Child’s single plan. • A clearer picture of how children can be protected and other services can be accessed for help

and support. • Wider consultative group.

Health:

• Children having an agreed multiagency support plan based on an assessment of needs which has been reviewed, discussed by partners maintaining child outcome as a focus.

• Increased understanding of partner’s roles and responsibilities. • Increased awareness of partner organisations resources/skills. • Increased access to services/resources. • Ability to identify unmet need and reasons for partners being unable to meet the need i.e.

resources, lack of services. • Better outcomes for all children. • More timely responses to meeting children’s needs. • Identification of gaps in resources. • Improved collaboration with other agencies. • Reduced, when no duplication of services. • More appropriate referrals to pertinent agencies. • Closer collaborative practice leading to more positive outcomes for children and young people. • More holistic approach where needs are identified and prioritized.

Voluntary Sector: • Greater clarification at request for service stage. • Greater communication • Locality focus becoming clearly familiar with services/resources etc. • More awareness and understanding of other roles etc. • Allocation of resources based on children’s needs (better assessment of needs required). • Less duplication of resources, leading to clearer role, remit and outcomes expected of each

service provider. • Better sharing of information. • Multi-agency perspective on Action Planning based on assessment of needs.

13

Others: • Hopefully it will encourage better information sharing between agencies. The agency referring

to forum will enquire first with other agencies before referring on. • Better allocation of resources. • Monitoring of cases with voluntary input from services. • Getting the right service early on.

Forum Members: • More holistic approach to assessment and planning. • Better communication and understanding of what services would be available and more

appropriate to meet the needs of children/young people and their families. • Also being asked to identify needs earlier to prevent ongoing distress, child care concerns. • Equity in distribution of resources. • Fewer inappropriate referrals to Social Work Department. • One referral/assessment therefore no duplication of services and families having to give

information more than once. • Better information sharing. • More joined up services around a child. • Less room for omissions in care/protection and reduction of risk.

Q2 Do you foresee any challenges in meeting the aims of the forums?

Education: • Lack of relevant information to forum because of limited knowledge of person submitting initial

assessment plan. • Sustainability of process. • Number of referrals. • Resources and their allocations. • Utilising appropriate support at short notice. • Information available to ensure that most appropriate decisions are made for support. • Workload and time management. • Budget implications and ability to sustain model. • Effective communication of need based solely on current paperwork. • Demotion of effective systems e.g. JST and EYF. • Need to look at current practice within the school. • Training for guidance/support staff. • The forums seem to be replicating meetings in which high level professionals sit at meeting to

discuss the needs of a child. I feel that in addressing child’s needs they need to come from the child’s perspective i.e. every child has a significant person in school/at home who they can discuss their feelings/needs with. That person then identifies the specialist and or programme that will help the child. The child then sees the link between their needs and the support given. The child would then look for further help/support to address their problems/needs.

• Development time to streamline establishment’s procedures/paperwork. • Re-allocation/distribution of resource/support. • Assumptions over what others are able to do. • Need the list. • CAMHS – statement of involvement and sharing. • Prior knowledge of agencies already involved. • Clarity of roles. • Who monitors impact of plan? • Involving people who really know the child. Direct access to people who are involved with child. • There could be too many “agency” interventions that could lead to too many adults involved

with the child. • Delay in accessing some supports which at the moment are easy to access e.g. Speech and

Language Therapy, Educational Psychologists. • Establishing effective channels of communication that will enhance the process and not delay it. • Parental requests out with school that bypass whole system. • Forum’s previous knowledge of child and their knowledge of how long it will take for child to

14

access a resource/agency they are putting forward as a proposal. • Lack of awareness of other agency input.

Health

• Looking forward to hearing the impact of this joint working, planning and action model has on children/families in the Locality.

• Allocation of service provision. • Quality of assessments submitted. • As it is quite broad in the types of referrals that will go through the forum, it may be a challenge

to get through the amount of referrals. • Time constraints on forum members should be considered that after a certain time frame the

chair etc. is changed and other service members rotated. • Wonder about the paperwork, whether the forums will know whether what they are

recommending is actually do-able and whether for more straightforward cases this is just a hurdle that doesn’t need to be there.

Voluntary Sector:

• Information of what is available. • Attendance/representation on forum. • Key to this will be the screening stage and the resource booklet. • Insufficient assessment information and resistance to completing paperwork may result in

children and young people being denied access to required support. • By-passing of locality forum system by encouraging self-referral to voluntary sector providers –

this will continue the resource-led rather than needs-led culture.

Others: • It is difficult to assess what availability the services have who have been referred. • I also foresee that the forum would potentially have difficulty in the initial meeting due to

requests for further information. • Members of the forum must be able to ‘authorise’ the allocation of the services being identified. • I think it will be hard to identify best resources without the named person/lead professional

present.

Forum Members: • Potential volume of referrals. • Data management challenges! • Hoping that the process won’t lengthen the wait for services and that gaps in services identified

may not be put in place due to lack of funding. • Not having enough information on application form.

15

Q3 How successful do you feel the locality forums will be in improving outcomes for children and young people?

Comments: Education: • Providing forum is supported in terms of manpower and budget. • Over a 6 month period I would rate a 3. Over a 5 year period I would rate an

8 – but far too many other factors are involved to make realistic estimates. • I am hopeful that they will improve our current resources. • Not sure yet hopefully we will identify what needs to be changed. • Lots of communication transfer and knowing what professionals involved. • Have greater awareness. Need more confidence in the fact that this will be

able to make the difference. • Will become more successful as everyone gets used to the process. • It would be helpful to evaluate how things have been done up until now as

well as identifying what we think will be which is what this forum asks. So far this does not evaluate the process.

Health: • Looking forward to hearing the impact of this joint working, planning and

action model has on children/families in the Locality. • Greater understanding of available resources. • I was impressed by the level of positivity in the room. Everyone seems to be

approaching the forums with a ‘can do’ attitude. Voluntary Sector:

• The forums will make an excellent contribution to better identifying resources/measures to improve outcomes, but sufficient resources must be in place (with enough capacity) to actually improve outcomes for children and young people.

Others: • When the forum gets to the stage of considering referral to reporter (where

this is known) it would be useful to have a reporter present to speed up the process and assist drafting grounds.

Forum Members: • I have very optimistic view of what the forums can achieve. However, there

will clearly be issues that arise through implementation of a new system. • The example use at locality briefing could have been more representative of

the types of info the forums will receive. I think it gave professionals the wrong impression of what they will be expected to submit. Accessibility will be major factor in the utility of the forum – has to be seen as not onerous.

16

In South Ayrshire

Girfec Locality Forum Evaluation Report

Appendix 2

Summary of Post Pilot Evaluation Questionnaire

17

Evaluation for Girfec Locality Forums Online Survey Feedback The pilot in Troon/Prestwick has been in operation since early March. Various professionals have taken part in the Locality Forum and span schools, CAMHS, social work, voluntary sector, school nurse, health visitor, speech therapist, educational psychologists and Central ASN staff. All involved parties were contacted via an emailed survey to gain feedback regarding the success of the Girfec Locality Forums. Recipient Summary- Full list can be seen in appendix 1. Sent: 170 Responded (Partial/Complete): 94 (35 / 59) Unresponded: 76 Response Rate: 55% The full blank survey can be seen in appendix 2 and all comments can be seen in appendix 3. Question 1: Do you understand the aims of Girfec? 93 people answered this question.

Figure 1

Figure 1 shows that 98.9% of respondents understood the aims of Girfec. Further clarification of Girfec was offered and knowledge was credited to the training received and implementing the model within the context of day to day work. Question 2: Do you understand what Girfec Locality Forums are? 87 people answered this question.

18

Figure 2

Figure 2 shows that 92.6% of all respondents understood what the Girfec Locality Forum was. Further explanation of the use of the forums was given however some suggested that additional training and clarification of details was still necessary. Question 3: Did you submit a Child’s Initial Assessment and Plan to a Girfec Locality Forum? 81 people answered this question.

Yes 40.7% (33)

No 59.3% (48) Reasons for not having completed an initial assessment followed the following themes:

• Not part of remit as not a practitioner. • Not working within the area of the pilot. • Other colleagues had taken the initiative. • As yet no referrals had been received.

Many indicated that while they had not yet submitted an assessment they had taken a part in the process. Question 4: Did you submit a Child’s Integrated Assessment and Plan to a Girfec Locality Forum? 78 people answered this question. Yes 15.4% (12) No 85.9% (67)

Reasons for not having completed an integrated assessment followed similar themes to question 3 and again many indicated that they had contributed to the process.

19

Question 5: Do you feel the quality of assessments has improved? 78 people answered this question.

Figure 3

As can be seen in figure 3, 44.9% of respondents felt that the quality of assessment had improved while 43.6% were unsure and 11.5% felt that there had not been a better quality of assessment. Question 6: Do you feel increased confidence in completing a Child’s Assessment and Plan? 71 people answered this question.

Figure 4

As can be seen in figure 4 the majority felt increased confidence in completing a Child’s Assessment and Plan with 52.1%. 32.4% were unsure and 15.5% did not feel a sense of increased confidence completing a Child’s Assessment and Plan.

20

Question 7: Are the Child Assessment and plans child centred and needs led? 62 people answered this question.

Figure 5

As can be seen in figure 5 the majority felt that the Child Assessment and Plans were child centred and needs led with 79.0%. 17.7% were unsure and 3.2% felt that assessments were not child and needs led. Question 8: Do you feel the packages of support are better matched to the needs of the children and young people you are working with? 62 people answered this question.

Figure 6

As can be seen in figure 6 the majority felt packages of support are better matched to the needs of children and young people with 51.6% giving a positive response. 33.9% were unsure and 14.5% did not feel the packages of support were better.

21

Question 9: How successful have you found the forums in improving outcomes for children and young people? 44 people answered this question. Respondents were asked to rate how successful they had found the forums in improving outcomes for children and young people on a scale of 1-10 with 1 being poor and 10 being excellent. Table 1 shows all rated answers. Table 1: Answer Options (On a scale of 1-10 with 1 being poor and 10 being excellent) 1 2 3 4 5 6 7 8 9 10

No. of occasions rating selected 0 1 2 2 14 3 7 12 2 1

As can be seen in the graph below figure 7 the mode is 5 with the second most popular answer being 8. The average score was 6.3.

Figure 7

2

Question 10: Have the Girfec Locality Forums been beneficial to your practice? 56 people answered this question.

Figure 8

Figure 8 shows that 44.6% felt that the Girfec Locality Forums had been beneficial to their practise. 37.5% were unsure and 17.9% said that the forums had not been beneficial to their practice. Question 11: What do you see as the positive impact of Girfec on your practice? 54 People answered this question. Answers could be categorised within the following themes:

• Improved multiagency working and information sharing • Greater understanding of resources available • Integrated approach to assessment • Updating information on a more regular basis • Shared process leading to better/more information • Child centred with approach more joined up working • Better targeting and use of resources

Some felt that it was too soon to see a positive impact (3) and some felt there was no positive impact (3.) Question 12: What positive outcomes have you experienced coming out of the Girfec Locality Forums? 48 People answered this question. Answers could be categorised within the following themes:

• Identification of resources that would not have been thought of. • Creative problem solving • Early intervention • Opinions from other agencies • Holistic perspective • Improved communication • Decreased duplicity

3

Some respondents (11) felt that it was too early to say or they did not have enough experience of the Forums to comment. Question 13: What challenges did you experience in carrying out Child’s Assessment and Plans? 53 People answered this question. Answers could be categorised within the following themes:

• Time consuming • Repetitive paperwork (alongside other systems) • Difficulty collating information

Question 14: Have you experienced any other challenges in regards to the Girfec Locality Forums? 45 People answered this question. Answers could be categorised within the following themes:

• Time demand of being a member of the forum with existing workload • Child-centred assessment ignores systemic issues • Duplication with health visitor face assessments • Time consuming paperwork particularly for access to services such as Speech and

Language Therapy 5 had not experienced challenges regarding Girfec Locality Forums. Question 15: Are you a member of a Girfec Locality Forum?

Answer Options Response Percent

Response Count

Yes 31.7% 20

No 65.1% 41

Unsure 3.2% 2 Question 16: What has worked well in the forum? 17 People answered this question. Answers could be categorised within the following themes:

• Agencies gaining a better understanding of each other’s roles and resources available • Quality of chair • Knowledge of other resources than identified on the assessment. • Co operation and positive collaborative working

Two felt that it was too early to say how well the forum worked. Question 17: How has it impacted on your workload? 16 People answered this question. Answers could be categorised within the following themes:

• Impacted greatly due to additional time demands • The forum is considered valuable but requires considerable time commitment. Time to read

assessments, attend meeting and carry out actions and reviews • Concerns raised about additional demands on time when all fora in place

4

Question 18: How could it work better? 16 People answered this question. Answers could be categorised within the following themes:

• Less should go through the forum (higher threshold than at present) • Simplify paperwork for requests for another service • Assessments including information from all agencies involved with the child • Less regular meetings • Creation of a minute of each meeting with decisions taken and implication for services. This

should help with service accountability and record keeping Question 19: Do you feel this is an effective use of your time to improve outcomes for children and young people? 18 People answered this question.

Respondents were asked to rate how effective was the use of time to improve the outcomes for children and young people on a scale of 1-10 with 1 being poor and 10 being excellent. Full answers can be seen in table 2 below.

Table 2: Answer Options (On a scale of 1-10 with 1 being poor and 10 being excellent) 1 2 3 4 5 6 7 8 9 10

No. of occasions rating selected 0 1 1 1 2 0 2 8 2 1

As can be seen in the graph below figure 9 the mode is 8. The average score was 6.94.

Figure 9 On a scale of 1-10 (with 1 being poor and 10 being excellent)

Question 20: Have the Girfec Locality Forums made a positive contribution to improved services for children and young people? 45 People answered this question. Respondents were asked to rate if the Locality Forums made a positive contribution to improved services for children and young people on a scale of 1-10 with 1 being poor and 10 being excellent. Full answers can be seen in table 3 below.

5

Table 3: Answer Options (On a scale of 1-10 with 1 being poor and 10 being excellent) 1 2 3 4 5 6 7 8 9 10

No. of occasions rating selected 0 2 2 4 11 4 6 11 3 2

As can be seen in the graph below figure 10 the mode is jointly 5 and 8. The average score was 6.27

Figure 10

Question 21: Have the Girfec Locality Forums made a positive contribution to improved services for children and young people? 51 people answered this question.

Figure 11

6

Figure 11 shows that 47.1% felt that the Girfec Locality Forums had made a positive contribution to improve services for children and young people. 49.0% were unsure and 3.9% said they had not made a positive contribution to improve services for children and young people. Additional comments followed these themes:

• Too early to say • Too much focus on Paperwork

Question 22: Were you aware of any difficulties in having an Action Plan carried out? 56 respondents answered this question.

Figure 12

Figure 12 shows that 39.3% had been aware of difficulties having an action plan carried out. 30.4% were unsure and 30.4% said they had not made a positive contribution to improve services for children and young people. Question 23: Does Gifrec link well to child protection, LAAC, Curriculum for Excellence, ASL and Hall4? 56 respondents answered this question.

7

Figure 13

Figure 13 shows that 73.2% of replies felt that Gifrec had linked well to child protection, LAAC, Curriculum for Excellence, ASL and Hall4. 25% were unsure and 2.00% said Girfec did not link in well. Question 24: Do you feel the Girfec Locality Forums have improved inter-agency working? 58 people replied to this question.

Figure 14

Figure 14 shows that 60.3% of replies felt that Gifrec had improved inter-agency working. 27.6% were unsure and 12.10% said Girfec had not improved inter-agency working.

8

Question 25: Did you attend Girfec Training? 60 respondents answered this question

Figure 15

Figure 15 shows that 86.7% of replies attended training while 13.3% did not. Question 26: Have you been able to use any aspects of the training course you attended to help you in your practice?

Answer Options Response Percent

Response Count

Yes 79.6% 39 No 8.2% 4 Unsure 14.3% 7

answered question 49 Question 27: If yes can you tell us what you have been able to use? 38 People answered this question. Answers could be categorised within the following themes:

• Completing assessments effectively (what can be summarized and what is essential) • Support others to complete assessments • Use resilience matrix and My World Triangle • A clear understanding of all that is required • Guidance notes and exemplars

Question 28: If you have not had occasion to use the training outcomes in practice can you tell us how you hope to do so in the future? 5 people answered this question. Answers could be categorised within the following themes:

• Being more aware of intended outcomes

9

Question 29: If you know how the training has had an impact on better outcomes for children, young people and their families/carers, can you tell us what that was? 12 people answered this question. Answers could be categorised within the following themes:

• Increasing people's focus on the actual desired outcome, rather than the action, and considering why they wanted services, and whether that service was the right one

• Ability to complete assessments using the same paperwork to consolidate information collected and identify supports for individuals

• Assessments submitted allowed all agencies to get the full picture of the young person’s needs and come up with an appropriate action plan

• Clarity and focus on a holistic, child centred picture which identifies needs and desired outcomes

Question 30: How confident are you that there is a clear leadership strategy directing the implementation of Girfec Locality Forums? 52 People answered this question. Respondents were asked to rate how clear leadership strategy directing the implementation of Girfec Locality Forums on a scale of 1-10 with 1 being poor and 10 being excellent. Full answers can be seen in table 4 below. Table 4: Answer Options (On a scale of 1-10 with 1 being poor and 10 being excellent) 1 2 3 4 5 6 7 8 9 10

No. of occasions rating selected 0 2 1 5 12 9 7 8 7 1

As can be seen in the graph below figure 9 the mode is 5. The average score was 6.29

Figure 16 On a scale of 1-10 (with 1 being poor and 10 being excellent)

10

Question 31: Have you felt involved in the implementation of the Girfec Locality Forums? 54 respondents answered this question

Figure 17

Figure 17 shows that 51.9% felt involved in the implementation of Girfec while 33.3% did not and 14.8% were unsure. Question 32: What improvements would you like to see before further roll out of Girfec Locality Forums? 42 people made suggestions for improvements which could be categorised into the following themes:

• Clear strategy for who is responsible in each establishment • Compulsory training prior to roll out • Streamlining of paperwork across the authority to improve communication and reduce time

taken to complete assessments. Having one universal assessment. • System needs to be able to relate to capacity of services before making decisions • Use of Girfec forums for more complex cases and looking more closely at which referrals

should go to the forum. Direct request to single agencies. Girfec assessment is a lot of paperwork to fill out for this type of referral

• Admin support is crucial both to support the forums and the assessment process • Devolved budget to forums • Adequate time to be allocated to allow assessments to be completed as part of workload • More thought going into how we ensure all professionals involved with a child/young

person have been contacted prior to an assessment /plan being put forward to the forum • Minute taking of decisions and clear executive leadership • Time taken to complete assessments reduces through experience

11

Question 33: Any additional comments? 24 people made additional comments. Those feelings not outlined above can be seen below:

• While pro-GIRFEC but it does raise challenges that are difficult to reconcile given the capacity of services, choosing what is the most effective use of scarce time and how we retain our systemic work that impacts on individuals but also groups and large numbers of children. Eg a child's behaviour issues in school might be due to lack of proper differentiation in the school - this might be a wide issue affecting a number of children in the school thus would be best tackled at a school level, not the individual child

• Confusion around the role of the lead professional • I have found the forum to be extremely helpful and would love to see them continue,

perhaps there could be further discussions over the summer and autumn on a face to face basis with those involved to determine the ongoing contribution of each service to the forums, and how small services will be able to continue to be a part of this important forum

• I feel the Philosophy driving this is sound but the practical implementation requires further consultation. Practitioners require to be given adequate time to take part in consultation

• In theory this will be a worthwhile implementation but time and training needs to be invested. Peer support would also be useful

• It is the way forward be it time & resource demanding but the child is at the core. Girfec and locality forums positively support young people in South Ayrshire

• Issue with being given responsibility for action where that action is out with the remit or experience of the person being tasked with the decision

• One aspect I feel has been very positive is the joined up approach able to be given to the cases that we have heard to bring resources into the authority which will not only impact on this locality but across the authority

• A promising start has been made. I have really enjoyed the work I have undertaken in this and feel that for the first time ever, agencies are talking to each other in a more open and honest way

• So far, locality forum has held me back from getting the right support for pupils quickly. Hopefully will get better

• All services need to consider existing practices in service provision. The needs of children and young people should drive provision and there should be cognisance of those needs in self-evaluation and improvement planning within services

12

In South Ayrshire

Girfec Locality Forum Evaluation Report

Appendix 3

Summary of Focus Groups

13

GIRFEC Locality Forum Evaluation Focus Group thematic Analysis Q1. What key outcomes have we achieved?

a) Have we improved the quality of assessments submitted to the various planning/resource allocation forums?

b) Have we increased professional confidence in those assessments? c) The positive impact on my practice has been.

The following themes were identified from the discussion: It is good having one child, one plan. Quality training has been provided. More confidence in integrated working. Assessments contain:

more detailed information and better quality information good chronologies the child’s views one action plan for the child which includes everyone involved covers a more holistic picture

Assessments are: having a positive impact on increased information sharing between agencies time consuming require consideration regarding the level of information sharing required delaying access to intensive support, care and learning and educational psychologists

Challenges faced are: communicating effectively across agencies concerns over quality and reliability of information in the assessment the need for more training the need for more clarification on the named person/lead professional

Q2. How well do we meet the needs of our stakeholders?

a) Are child assessment and plans child centred and needs led? b) Do you feel the packages of support are better matched to the needs of the

children/young people you are working with?

The following themes were identified from the discussion: Assessment and plans are child centred which is good as sometimes the parent’s issues can takeover and the child is lost however it sometimes assumes that the problem is with the child. They definitely identify needs and are needs led which highlights limited resources. There is a need for reviews of the assessment and plans. Capacity issues in relation to ASN services and voluntary services. Challenges in centralised resources being allocated by locality. Seeking clarification of how budgets are allocated. A lack of available resources. Nursery placements should not be considered at the forum. Concerns regarding capacity and sustainability on roll out. A need for consideration of the membership of the forum. Q3. How good is our delivery of services for children and young people?

- Have the GIRFEC locality forums made a positive contribution to improved service for children?

The following themes were identified from the discussion: Very good packages have been put in place. Use of resources has increased dramatically in the pilot area.

14

Concern regarding capacity and sustainability of services on roll out. Resource/management/HR issues. Clarification on the use and responsibility of the budget. Too early to tell. Q4. How good is our management?

a) Girfec links well to other policies such as child protection, LAC, Curriculum for Excellence, Hall 4, More Choices More Chances

The following theme was identified from the discussion: Links well and will continue to be strengthened. Links well with health policies.

b) Were you aware of any difficulties in having an action plan carried out?

The following themes were identified from the discussion: Importance of including parents in the assessment process and ensuring they are kept fully informed and give full consent. Outcomes can be better than the original request due to multi-agency discussion. Challenges with the contingency plans. Unclear regarding the role of the Named Person/Lead Professional in having the action plan carried out. Q5. How good is our leadership?

a) I am confident that there is a clear leadership strategy directing the implementation of GIRFEC

The following themes were identified from the discussion: Yes – knew who to contact. Clear strategy but needs developed. Theory is good. Forums have been heavily education based. Training provided. Delays and cumbersome process in accessing speech and language, nursery placements and educational psychologists.

b) I have felt involved in the implementation of GIRFEC

The following theme was identified from the discussion: Yes – to continue. Looking forward to Locality Forums coming to Girvan. Q6. What is our capacity for improvement?

a) What improvements would you like to see before roll out of GIRFEC locality forums?

The following themes were identified from the discussion: Address capacity and sustainability issues before roll out. Streamlining paperwork with staged intervention. More training. Forums to move to considering only the more complex needs. Streamline forums. If not enough information in the assessment they should be sent back for more to be added.

15

b) Any final comments?

The following themes were identified from the discussion: More complex needs need to be the focus of the forums to be more efficient. The need for more exemplars of case studies. Health want nursery admission forum to remain instead of using the locality forum. The pilot forum to share good practice with other forums. Time needs to be made available to complete assessments. Increase knowledge of eligibility criteria for services is needed. Clarification and streamlining of the roles of different forums is required. Challenges of centralised resources in localities and managing capacity needs addressed. Review of outcomes required. Concerns around the capacity for agencies to make available the right people to attend forums when they rollout.

16

In South Ayrshire

Girfec Locality Forum Evaluation Report

Appendix 4

Summary of Assessment Analysis

17

Thematic Analysis of a sample of submitted assessments 10 out of 45 assessments were analysed using the assessment analysis tool, covering submissions from all agencies and both age groups. Thematic strengths and areas for development were identified for the assessment, chronology and action plan. Assessment Positives Clear who was involved with the child. Level of assessment was proportionate and in keeping with the needs of the child. Assessments identified risks, protection factors and needs. There was evidence that information was shared with the child/young person and their parent/carer. There was an absence of repetition throughout assessments. Areas for development Assessments need to make it clear when a child/family is from an ethnic minority. Analysis should only include needs and risks. Assessments need signed. Assessments need a review date. Information should be sought from all involved with the young person and be included in the assessment Purpose of the plan should state why the child is being assessment, not be a recommendation There was confusion about when an initial or an integrated assessment was appropriate There was a need to recognise the importance of recording the views of young people, for example through the interactive my world triangle and ensuring these views, and those of the parent/carer are obvious in the analysis and action plan. Chronology Positives Where information was recorded it was proportionate, in keeping with the needs of the child and succinctly recorded. The chronologies focused in events relating to the child and identified patterns of risk. Areas for development Information should be sought from all involved and be included n the chronology. There is a need to ensure there are not gaps in the chronology. Action plan Positives Action plans showed evidence of multi-agency working with clearly stated roles and responsibilities. Most action plans were prioritised, for example ensuring a child’s safety as the top priority. Areas for development Specific time scales need put in. Person responsible needs named alongside agency. Action plans should contain responsibilities for parents/carers and young people where appropriate.

18

Planned outcomes need improved – often actions were stated as outcomes. Actions need to be related to the desired outcome. Contingency plans are required. There is a need for an appropriate level of detail in the actions section.