Working in the New Environment Patrick Ayre University of Bedfordshire firstname.lastname@example.org http://patrickayre.co.uk
Origins • Structural and organisational changes are being delivered in the wake of Bichard and Laming • Every Child Matters: Change for Children (ECM: CfC) establishes a framework for building services around children in which previously separate services must now work together in an integrated way • However, organisational change cannot of itself bring about shifts in entrenched attitudes, beliefs, customs and vocabulary.
Government’s prospectus • ECM: CfC is a new approach to the well-being of children and young people from birth to age 19. • The Government's aim is for every child, whatever their background or their circumstances, to have the support they need to: • Be healthy • Stay safe • Enjoy and achieve • Make a positive contribution • Achieve economic well-being • This means that the organisations involved with providing services to children - from hospitals and schools, to police and voluntary groups - will be teaming up in new ways, sharing information and working together, to protect children and young people from harm and help them achieve what they want in life.
Government’s prospectus Changes include • the improvement and integration of universal services • more specialised help to promote opportunity, prevent problems and act early and effectively if and when problems arise; • the reconfiguration of services in one place, for example, children’s centres, extended schools and the bringing together of professionals in multi-disciplinary teams; • the development of a shared sense of responsibility across agencies • listening to children, young people and their families
Integrated Working Silos Inter-Agency Governance Integrated Strategy Integrated Processes Integrated Front-Line Delivery Families Community Outcomesfor children and young people Parents The big picture Implementing Integrated Working means implementing Integrated Processes and Integrated Front-Line Delivery
Integrated Working Improved Outcomes IS Index LP Silos CAF Info Sharing The vision for Integrated Working
Key elements Basic: • Integrated working • Common Assessment Framework • Information sharing and ContactPoint • Lead professional Complex: • Workforce reform and professional development • Common Core of Skills and Knowledge • Setting up multi-agency services
Lead professional from this point Lead role already required by statute or best practice, e.g. key worker Common assessmentfrom this point Statutory or specialist assessments Information sharing between practitioners - supported by the Information Sharing Index Key elements • Setting up multi-agency services • Common Assessment Framework • Common Core of Skills and Knowledge • Information sharing • Lead professional • Workforce reform and professional development • Integrated working
Multi-agency services • Multi-agency panel • Multi-agency team • Integrated services
Multi-agency services • Multi-agency panel • Multi-agency team • Integrated services
Panel characteristics • Managed by a coordinator or chair • There is a good mix of agencies • Panel members remain based in and identify with their home agencies. • Regular meetings • May have a core team of key workers and administrative support (YISP) • Practitioners are likely to focus on individual support • Usually joint assessment and information sharing
Benefits and opportunities • No recruitment or HR issues • Practitioners fully involved in home agency, including training and development • Work together regularly and experience of different working styles and remits. • Can allocate the lead professional role, give authority needed, and share information • No need for a permanent base or IT infrastructure.
Challenges • Focused on outcomes for the child or the contribution of individual agencies? • Identify with home agency not panel. • Members not be given enough time to carry out their casework and lead professional responsibilities • Planning meetings can take up a significant amount of time.
Multi-agency team characteristics • Dedicated team leader • Good mix of agencies • Members think of themselves as team members. (Recruited or seconded into the team, either full or part time) • Work with universal services and at a range of levels – individual, small-group, family and whole school • Likely to share a base • Regular team meetings: case working and admin issues
Benefits and opportunities • Good sense of team identity. • Co-working is at the heart of the team's approach, allowing sharing of skills and knowledge. • Communication is straightforward. • Joint training is easy to facilitate. • Opportunities for preventive and early intervention work in whole school and early years settings, as well as small group and individual casework.
Challenges • Recruitment and HR. • Time and resource for team building and development. • If not based together, challenges for team working and communication. • Good relationships with schools and other universal providers are vital. • Need to set aside sufficient time for meetings and other team contact time.
Integrated service characteristics • Range of services which share a common location and a common philosophy, vision and agreed principles • Visible 'service hub' for the community, with a perception by users of cohesive and comprehensive services • Management structure which facilitates integrated working • Commitment by partner providers to fund and facilitate integrated services
Integrated service characteristics • Usually delivered from a school or early years setting • Staff work in a coordinated way, likely to include joint training and joint working, perhaps in smaller multi-agency teams • Service level agreements set out the relationship between home agencies and the multi-agency service • The manager may be a member of the school or early years setting (for example a headteacher) or they may be recruited externally.
Integrated service characteristics Services may include: • high-quality, all-year-round, inclusive education, care and personal development opportunities for children and young people • multi-agency teams to provide specialist advice and guidance on aspects of health, social welfare and employment • outreach services to support local families with additional needs • a family support programme to involve and engage parents • a framework of training for adults providing a range of informal and accredited courses • a framework of training strategies for practitioners.
Benefits and opportunities • Opportunity to address full range of issues in a non-stigmatising universal setting. • Knock-on benefits for educational standards. • Greater co-working and cross-fertilisation of skills between agencies. • Opportunities for joint training. • Shared base enhances communication • Members are still linked in to what is going on in their home agency. • Members likely to have access to training and personal development in their home agency.
Challenges • Requires fresh thinking around the concept and purpose of the school or early years setting • Engaging partners and the whole school community in 'collaborative leadership'. • Sense of joint purpose so members identify with new service not home agency. • Pay and conditions for staff doing joint work at different levels of pay
Challenges to effective inter-agency working • Relationship problems • Resource problems
Relationship problems • Closed professional systems and closed minds • Power struggles and polarisation • Exaggeration of hierarchy • Status insecurity • Sectors inadequately integrated
Relationship problems • Acclimatisation and collusion • Stereotyping, lack of trust, lack of knowledge • Role confusion • Lost in translation • Different professional cultures, values and vocabulary (Who is the client? What are we trying to achieve? What constitutes ‘good practice’?) • Different priorities and thresholds
Resource and practical problems • Challenges structural as well as case-based • At best, rearranging the deckchairs on the Titanic, at worst, developing an unsustainable system?
Resource problems • Few new resources? • Lack of motivation and practical commitment at individual and service level • Geographical location and accessibility
Resource problems • High staff turnover paralysis (Beckett) • Stress and overload firefighting style, reactive practice (Beckett) • Climate of blame, mistrust & fear distort resource allocation (Ayre, 2001)
Overcoming the problems: Strategic • Common assessments • Collocation of staff, • Multi-disciplinary teams • Integrated training, pre- an post-qualification
Overcoming the problems: Personal • Ask the ‘naïve’ question • Understand and value other perspectives • Share knowledge about your own agency, its priorities and values • Practice in an inclusive, interagency manner (Not “me and them”, but “us”)
What works: Heavy end • Successful programmes draw on ecological model of causes of neglect and abuse • Abuse results from • Stresses caused by poverty and disadvantage • Poor social resources to manage those stresses • Personal difficulties with parenting
What works: Heavy end • Programmes combine • Educational elements • Social and emotional support • Help to cope with stress • Success depend crucially on ability to identify those factors which place people at increased risk
What works: Secondary prevention Outcomes more dependent on organisational climate than methodology: • Low conflict • Co-operation • Role clarity • Personalisation of programmes (Glisson and Hemmelgarn, 1998)
What works: Secondary prevention “Effective children’s services require non-routinised, individualised service decisions that are tailored to each child”. They require: • flexibility and discretion, • the ability to internalise and apply, not just to follow, guidance. • They cannot flourish without a positive work climate.
What works: Secondary prevention Home visiting is effective when: • The visitors are qualified or well-trained • The visiting is multi-dimensional, intensive and long-term • Visits start before the child is born
What works: Secondary prevention Effective parenting programmes: • Are conducted on a group rather than individual basis • Are primarily behavioural rather than based on relationship building • Use modelling as a way of teaching new skills • Are seldom sufficient in themselves