Troubled Families

Mags WalshProgramme Director

9th July 2012

2

Prime Minister & Leicestershire’s Ambition for Our Troubled Families

“Last year the state spent an estimated £9 billion on just 120,000 families……that is around £75,000 per family.

David Cameron 15th Dec 2011

1. Significantly improving outcomes for families and their children

2. Reducing the current costs of public services

“Our heart tells us we can’t just stand by… Our head tells us we can’t afford to keep footing the

monumental bills for social failure. we have got to take action to turn troubled families around”

David Cameron, 15th December 2011

Louise Casey Unit Ambition

“Success is bigger than the payment by results model…I want to see real system change…this is about changing the mainstream. The Programme needs to catalyse sustainable reform of services in order to prevent future families from becoming ‘TF’ and to deliver significant cost savings to the State”

“My ‘manna from heaven’ is that a 3 year focus on the family’s needs will result in the number of agencies involved with them will reduce from, say, 17 to 2”

“This will be different because it will focus on individual families and their needs, rather than individual services”

3

Founding PrinciplesApproved by Programme Board June 2011

Place’ and ‘citizens’ before ‘organisation’ Place shared vision, objectives and services Pro-active co-design between partners in the place and between the place

& Whitehall Prevention by early and earlier intervention Better outcomes at less cost Fully understand the problem before defining a solution Ambitious & if appropriate radical local innovation Build on good practice /initiatives in place in Leicestershire i.e. Integrated

Offender Model, Children’s Centres, YOS, Systems Change, many others

Decommission & reprioritise services when required Pooled /aligned budgets around the theme/place

4

Ethnography 3 Workshops Individual

family consultation

Customer Journey

Needs Assessment

Customer Journey maps

9 families 21 adults, 13 CYP 9 familiesCraig's story

(Beacon project)Child Poverty Mental Health

Desk based research

Other Insight

SE

CO

ND

AR

Y

RE

SE

AR

CH Evidence base for family models Current/emerging policy

Melton Family Model Mapping Families LIFE - Swindon pilot

Practitioner Insight

Family Insight

Full day practitioner workshop - 135 practitioners, cross agency

PR

IMA

RY

RE

SE

AR

H

Family InsightA comprehensive approach

The detailed Insight report is now published on the Leicestershire Together Website: www.leicestershiretogether.org/partnerships/communitybudgets

Barriers to Families

6

What Must Change

Earlier Intervention

Shared vision and stronger leadership

Family-centric, not organisation-centric

approaches to working

Re-training/ attitude ofworkforce

Sharedprocesses /

systems

Informationsharing

Advocate / Key Family

Worker

Politics / resources

Better joint working

Community

From insight phase: practitioner event 7

Barriers highlighted by Aperia

The range of support and access to support is confusing, services are not joined up, are complex, and they don’t know what is available so they didn’t get the help that perhaps does exist

Services start and then stop and it is confusing – not one individual felt that their personal goals were clearly and openly aligned to the objectives of the services – hence they personally felt that nothing had changed, but services were stopped as the service felt that a goal had been achieved

People don’t listen, are too quick to judge and don’t really understand Services are reactive, based on crisis prevention and short term

interventions Services are set up to dealt with single issues i.e. offending, domestic

violence, mental health and not ‘whole family’ or ‘whole person’ approach Families often feel services work against them, not with / for them

8

Barriers highlighted by Aperia

Lack of education - many attendees regretted that they felt unprepared and ill-trained for the lives that they live. This is both at an educational attainment level and also in terms of the skills to be able to manage and run their own homes

Their past / lack of role models – some people commented that it is hardly surprising that they are currently suffering the problems that they face given their experiences / lives to date. Some referenced directly that they feel there are not enough role models for them or their children. This was a very strong view from practitioners and echoed, although less precisely, by service users

9

What we learned from the Insight Phase…

Confusing landscape of public services

Poor/overcrowded housing (incl. homelessness)

High risk behaviours (incl. substance misuse)

Poverty (incl. debt & unemployment)

Health (incl. mental health & disability)

Crime (offending and experience of)

Lack of education/ attainment Domestic violence Poor parenting

Difficulties maintaining relationships (incl. family, friends, peers, isolation & social marginalisation)

Lack of resilience (incl. capability, capacity, confidence & inability to cope)

Lack of or limited choice/control Adverse effect on aspirations/

perception of social mobility

Common issues for FCN

What Parents said they want most from Services

Stability, support, encouragement, consistency To be listened to and acknowledged People to do what they say they’re going to do and to get

back to them Freedom from prejudice/social marginalisation Services to work for and not against them Have their own needs addressed as well as their children’s

Reoccurring Themes from Evidence Base, Current Literature and National Policy on What

works:

Early intervention Building resilience Stability, continuity and

transitions Effective parenting and

supporting families Tackling educational

performance

Tackling worklessness Tackling poor health Tackling poverty Involving communities and

building social capital Building capabilities, resilience

and skills development

12

Mother has mental health problems

No parent in the family is working

Family lives in poor-quality or overcrowded housing

No parent has any qualifications

At least one parent has a long-standing limiting illness, disability or infirmity

Family cannot afford a number of food and clothing items

Family has low income (below 60% of the median)

Poor parenting

Truancy, exclusion or low educational attainment

Family in debt

Drugs or alcohol misuse

Marriage, relationship or family breakdown

Domestic violence

Child protection issues

Risk factors attributed to families with 5 or more disadvantages (from) Families At Risk: Background on families with multiple disadvantages, Social Exclusion Taskforce Research Report, 2007

Additional risk factors from families supported through family intervention (NatCen, Mar 2010).

Child Behavioural Problems

Child Substance abuse problems

Teenage Parent(s)

NEET

Child is a carer

Limited support network

Adult with learning difficulties Communications problems

Involvement in crime/ASB

Troubled Family Risk Factors

13

Local Definition for Leics Troubled Families

Out of 23 potential risks/issues– More than 5 risks/issues = Troubled Family– Any family with an open Child Protection Plan not in the

above = Troubled Family– Add to this any family not in the above but has 2 or more

of:-• Alcohol Misuse• Drugs Misuse• Violence or abuse• Crime/ASB• Mental Health

14

Any family presenting 2-4 risks not in the TF category

= a At Risk Familye.g. at risk of becoming Troubled

15

16

NAT CEN FIP RESEARCH: Outcomes for families exiting FIP

Outcome Improvements Recorded:

Families involved in ASB A Reduction of 58% to 34%

Families involved in Crime A Reduction of 41% to 20%

Children with behavioural /truancy problems A Reduction of 53% to 28%

Risks from poor family functioning (DV, family breakdown, child protection) A Reduction of 47% to 16%

Child protection plans A Reduction of 34% to 18%

Health risks including mental, physical health and substance misuse problems A Reduction of 34%

In worklessness (ETE) A Reduction of 14% to 58% 17

Evaluation Highlighted 8 Core Features Viewed as Critical to FIP Success

1. Recruitment and retention of high quality staff who can work in an empathetic way, build trust whilst maintaining professional boundaries (the relationship with families is key)

2. Small caseloads (no more than 6 at any one time)3. Dedicated key worker who works intensively with each family in the

home & community and outside of ‘office hours’4. A whole family approach5. Consistency of key worker with family and longevity6. Having the scope to use resources creatively i.e.. personal/flexible

budget7. Using sanctions alongside support/incentives for families8. Effective multi-agency relationships/working and information sharing

18

The Design: Leicestershire’s Family Model

19

Any new model is sustainable beyond the medium term Aims to move families closer to independence from public services Model will need to be underpinned by cultural change with strong leadership

across Leicestershire Public Sector/Voluntary Sector ‘champions’ and SRO in all organisation to lead required cultural change?

Supports early/earlier intervention Builds on good, well evaluated practice Incorporates some personalised commissioning at family & locality level Workforce development a key component (multi-agency training) Robust supervision framework key Families/workers are able to access services required quickly with some priority

(with lower entry thresholds) Is able to influence commissioning for identified service gaps and policy

changes Single Family Assessment Framework Information is Shared

Family Support Model - Key Principles

20

Targeted Services

Universal Services

Specialist Services

FamilyFamily

Improved outcomesIncreased resilience, strengths &

independence

Co-located locality service:

•Permanent core team members inc. Family

Worker•P/t Co-opted team

members•Personalised family

budgets

<-Cultural

Shift -> <-Act Family->

<-Cultural Shift -> <-Act Family->

Approved Family ModelApproved Family Model

Role:

Whole family approach•Delivers direct support

•Co-ordinates other services•Outreach in home/community•Assertive intensive support

•Small caseloads

21

A. Team around the family approach with dedicated family key worker Role is outreach working in family homes and communities small caseloads and intensive approach as required by family circumstances/needs In some families may require an additional separate worker to directly support the

children Builds family capacity, resilience & recognises strengths within the family Builds self esteem, skills, relationships and aspirations

B. Co-located services in localities Local integrated core multi-agency teams Locality partnership solutions and delivery

C. Working with families for better outcomes for their families Single Family Plan (owned/developed by family with support) Honest conversations Empowering families will be key In partnership with team/key worker - with empathy but clear boundaries It will be important to work with families to agree objectives – this will require an

understanding of what their drivers / priorities are Realistic expectations on outcomes for the most long term ‘troubled’ families Access to required services key

Leicestershire’s Family Support Model

22

Needs to be everyone’s responsibility

Enablers for the Family Model

Family Feedback on the Family Model

17 Families across 2 district areas attended a number of focus groups

The findings from the original FCN insight were reinforced

• This included the importance of :

o Early years and early/earlier interventiono having a joined up whole family approach that was family led (listening to families needs,

trying to help them and not judge them) o Family designed (choice, flexibility and a language families understand) o Sustainability (to enable families to be independent of services)

o Workers who are well trained with a good awareness of the issues and challenges families face

o Quality services that meets families needs (advocacy and practical support) o Appropriate information sharing o Ensuring families do not feel any professional or social stigma when fighting for their families

needs

24

Family Feedback on the Family Model

Highlighted the importance of the following elements in a family support worker:

• the softer skills needed by staff• the ability to build a relationship, trust and mediate• not to be critical or judgemental• a consistent person• knowledge on how to get things done• authority to get things done • choice (i.e. about time in the home or community, the nature of the help)

• easily contactable or available in a crisis• sharing data amongst the team around the family• understanding the professional’s ‘language’

25

Current/Next Steps

Clarifying the National Programme Briefing & Consulting Key Stakeholders Establish Governance for the Programme Developing a Financial Budget (profile income & costs)

Impact of Government funding Impact of contributions from partners

Making appropriate links into other relevant Initiatives/Priorities i.e. Worklessness; Economic Development/Employers Engagement; Voluntary Sector Initiatives etc

Planning Implementation Delivery Model/Service, infrastructure, staffing, systems, policies,

performance framework , Information Systems, Communications Strategy etc.

26

Questions

How could Parishes contribute to the Troubled Families Programme?

What can we do to enable that support to happen?

27