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Keeping Children Safe - An Outcomes Approach - LSCB Development Day . Rob Hutchinson, CBE 4 th & 19 th November 2010. Children’s Trusts involve…. Inter-Agency Governance: strategic direction, partnership and accountability.
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Keeping Children Safe - An Outcomes Approach - LSCB Development Day Rob Hutchinson, CBE 4th & 19th November 2010
Children’s Trusts involve… Inter-Agency Governance: strategic direction, partnership and accountability Integrated Strategy: planning, commissioning, pooled resources Integrated Processes: information sharing, common assessment Integrated People: common core, multi- disciplinary teams & co-location Children & Young People Families & Community Leadership at every level Involvement of children & young people Shared Vision Source: DfES
Population Accountabilityabout the well-being ofWHOLE POPULATIONS For Communities – Cities – Counties – States - Nations Performance Accountabilityabout the well-being ofCUSTOMER POPULATIONS For Programmes – Agencies – and Service Systems Outcome Based Accountabilityis made up of two parts:
THE LANGUAGE TRAPToo many terms. Too few definitions. Too little discipline Benchmark Outcome Result Modifiers Measurable Core Urgent Qualitative Priority Programmatic Targeted Performance Incremental Strategic Systemic Goal Indicator Measure Objective Target Measurable urgent systemic indicators Lewis Carroll Center for Language Disorders
OUTCOME or RESULT A condition of well-being for children, adults, families or communities. Population INDICATOR or BENCHMARK A measure which helps quantify the achievement of an outcome. PERFORMANCE MEASURE A measure of how well a service, agency or service system is working.Three types: Performance Definitions Children born healthy, Children succeeding in school, Safe communities, Clean Environment, Prosperous Economy Rate of low-birthweight babies, Percent 16 & 19 yr. olds with 5 A-C GCSE’s, crime rate, air quality index, unemployment rate 1. How much did we do? 2. How well did we do it? 3. Is anyone better off? = Customer Outcome
Is it a Result, Indicator or Performance Measure? 1.Safe Community 2. Crime Rate 3. Average Police response time 4. A community without graffiti 5. % of surveyed buildings without graffiti 6. People have living wage jobs and income 7. % of people with living wage jobs and income 8. % of participants in job training who get living wage jobs RESULT INDICATOR PERF. MEASURE RESULT INDICATOR RESULT INDICATOR PERF. MEASURE
POPULATIONACCOUNTABILITY For Whole Populationsin a Geographic Area
Every Child Matters – Children ActOutcomes for Children and Young People Being Healthy: enjoying good physical and mental health and living a healthy lifestyle. Staying Safe: being protected from harm and neglect and growing up able to look after themselves. Enjoying and Achieving: getting the most out of life and developing broad skills for adulthood. Making a Positive Contribution: to the community and to society and not engaging in anti-social or offending behaviour. Economic Well-being: overcoming socio-economic disadvantages to achieve their full potential in life.
Our Health, Our Care, Our Say –White PaperOutcomes for Adults 1. Health & Emotional Well-being 2. Quality of life 3. Making a positive contribution 4. Exercising choice & control 5. Freedom from discrimination & harassment 6. Economic well being 7. Personal dignity & respect (8. Effective leadership) (9. Effective commissioning) Source: A New Outcomes Framework for Performance Assessment of Adult Social Care 2006 - 07
Outcomes: The Portsmouth 8 Children and Young People should grow up - * Having an active say in any development * Healthy * Emotionally secure and confident * Having succeeded as far as they can at school * Having facilities and opportunities to play safely * Having stayed out of trouble * Living in a safe place * Having the opportunity to succeed in their dreams
Neighbourhood Country Kruidenbuurt Tilburg, Netherlands New Zealand
Healthy Eating and Exercise Project in Portsmouth • Project Driven by LSP and a local Community Board • Focused on one community • Many 1%'s ……. • Secondary School • Primary Schools • Surestart • Faith Community • Playgroups and Child Minders • Dieticians • "Trained" parents • Children’s Video • Schools Meal Service • Co-op • University • Portsmouth Football Club • Health Visitors • Public Health Consultant • PCT Chief Executive ……….etc
Performance Accountability For Services, Agencies and Service Systems
Programme Performance Measures Quality Quantity How welldid we do it? How much did we do? Effect Effort Is anyonebetter off? # %
Quadrant How well did we do it? How much did we do? How many nurses appointed since 1997? Reduction in Waiting Times Is anyone better off? Percentage of patients saying their health has improved as a result of the hospital intervention Number of fatalities within 2 months of operation
Proposed National Indicator Set How well did we do it? How much did we do? % of initial assessments carried out within 10 working days % of core assessments completed within 35 working days % of child protection plans lasting 2 years or more % of child protection cases which were reviewed within required timescale % of referrals to children’s social care going on to initial assessment % of applications for care proceedings which have been assessed as incomplete Children’s social worker vacancy rate Children’s social worker turnover rate Did it make a difference? Did it make a difference? Population: % increase of children and young people who have suffered unintentional/deliberate injuries or preventable deaths % children who report they feel safer Performance: % children becoming the subject of child protection plan for a second or subsequent time
Possible local additions to the NIS How well did we do it? How much did we do? % of initial assessments within 10 working days % of core assessments for children’s social care carried out within 35 working days of commencement % of child protection plans lasting 2 years or more % of child protection plans reviewed within time scales % of applications for care proceedings deemed as incomplete by the courts service % social worker vacancy rate %social worker turnover rate % complaints % surveyed families saying service was delivered in a respectful and timely manner Number of children with protection plans Did it make a difference? Did it make a difference? Numbers of children who report that they feel safer Numbers of parents who report that their parenting has improved as a result of intervention Population: % reduction in children referred for physical, emotional and sexual abuse and neglect % increase of children who have suffered unintentional/deliberate injuries or preventable deaths Performance: % of children subject to CP Plan for a second or subsequent time % of children’s plans whose recommendations have been successfully implemented % reduction of children with CP Plans % of children whose risks are reduced as a result of intervention and are removed from protection plans within 6 months
LSCB effectiveness How much did we do? How well did we do it? % of Members attending regularly % of Members presenting items % of Members stating their satisfaction with meetings % serious case reviews considered % recommendations in training plan implemented % recommendations in Reports agreed Identifiable progress achieved on business plan % agreed recommendations reviewed on a regular basis Number of meetings Numbers of agencies attending LSCB meetings Frequency of meetings Progress on business plan Financial management Numbers of member annual appraisals carried out Did it make a difference? Did it make a difference? Population: % of children who report that they feel safer % reduction in children referred for physical, emotional and sexual abuse and neglect % hospital admissions caused by unintentional or deliberate injuries Performance: % of children whose risks have been reduced and whose protection plans are ended within 6 month % reduction of children with child protection plans % protection plans which have been successfully implemented % of parents who report that services have improved the parenting of their children % children becoming the subject of Child Protection Plans for second or subsequent time
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Strengthening Families Framework How much did we do? How well did we do it? % of consultations leading to ICPCs % reduction in time subject to PP % ICPCs held in 15wdays % professionals who feel meetings are run well/timely % profs who deliver actions in timescales % parents/CYP who report feeling listened to % parents/CYP who understand/agree with the aim of the plan at the end of the meeting # of children subject to S47 # of consultations carried out using SFF # of consultations which don’t lead to CP intervention # of children subject to SFF ICPCs/RCPC # of children with PPs Did it make a difference? Did it make a difference? Population Children are safer… Performance % Children subject to SFF less likely to exp repeat PP % reduction in time subject to PP per category/need % reduction in children experiencing further episodes of harm (S47s?) % increase in # of children who stayed at home safely % children who report they feel safer % parents who report that intervention helped them to make children safer % agencies who report that intervention made children safer
Success Measures for Children’s Trusts How well did we do it? How much did we do? % Joint Commissioning Strat. which identifies both population and performance priorities % Joint Commissioning Strat/ plan implemented within defined timescales % Joint Commissioning Strat. Delivered within budget % of trust members attending meetings % of reports with agreed implementation plans % of items actioned from meeting % of priorities reviewed on regular basis % of plans consulted on/approved by children & yng people % of children, y. people & families who say services are delivered in timely and respectful manner % of staff and public who understand CT priorities Establishment of Joint Commissioning Strategy and Plan No.of attendees at Trust meetings No.of items considered No. of agencies represented No. of children and young people attending No. of events/learning opportunities undertaken No. of staff whose awareness is realised on CT priorities Did it make a difference? POPULATION: %of children, young people & families who say services made difference to 1 or more of 5 outcomes (Tell Us survey) PERFORMANCE: % of professionals who say CT priorities contributed to an improvement of 5 outcomes for children, young people & families BOTH: Depending on priorities, there’s evidence that the curve had turned on Top 2 priorities at both populations and performance level, eg teenage pregnancy & obesity for population levels eg A to Cs in school x for performance level
Safeguarding young people at risk of self harm or suicide How much did we do? How well did we do it? % mental health assessments which led to signposting to other agencies % 10 – 16 year olds and their families receiving attachment intervention % of families that are responded to as per the Rapid Response Protocol % children’s workforce trained in brief interventions % young person satisfaction with post return home services % placements receiving additional support for young people % increase in school attendance % increase in targeted CAMHS provision for young people with emerging mental health difficulties Number of young people offered services through CAHMS Number of mental health assessments carried out Number of universal services being used by young people feeling excluded Amount of attachment support for young people and their families Numbers of follow up ‘missing’ interviews Did it make a difference? Did it make a difference? Population % reduction in young people that self harm or attempt suicide % reduction in the number of attendance at A&E due to drug or alcohol misuse % young people that report feeling safe Performance % reduction in young people that repeatedly self harm % reduction in young people committing suicide % reduction of young people experiencing long term rejection % reduction in placement breakdowns % reduction in repeat missing persons % increase in children returning home in a planned way % in repeat attendances in A&E % of young people that say they have been properly consulted on their plans and the development of services people