UWE Bristol

Challenges for policy and practice:Stories from the Edge of CareUCLAN 2012

Presentation by

Jane Dalrymple & Barry Percy-Smith

Recent policy initiatives

Listening to CHILDREN ON

troubled families THE EDGE OF

CARE

Delivering intensive interventions Delivering intensive interventions for looked after children and those for looked after children and those on the edge of care or custodyon the edge of care or custody

Information services – Around £34 via telephone helplineAround £2 via digital services

Cos

t pe

r ch

ild /

fam

ily

Severity of assessed need

Cost

Family Intervention Services – £8-20,000 per family per year

Family Nurse Partnerships, Family Functional Therapy & KEEP – £3000 per family a year

Child looked after in children’s home – £125,000+ per year placement costs

Child looked after in foster care – £25,000 per year placement costs [plus additional services]

UNIVERSAL: Schools - £5,400 per pupil

UNIVERSAL: Children’s Centres - around £600 per user

Costs increase as children get older.

Increasing related costs such healthcare and the criminal justice system make it clear joined up working is a core part of cost effectiveness

Multi-dimensional Treatment Foster Care – £70,000 per year for total package of support

Child looked after in secure accommodation – £134,000+ per year placement costs

Parenting programme (e.g. Triple P) – £900-1,000 per family

PEIP – £1,200 - 3,000 per parent

Multi-Systemic Therapy – £3 -10,000 per intervention

It is vital that children and young people receive the right services at the right time. These figures are intended to be illustrative

High relative costs of intervention for small group of looked after children and those on the edge of care

What we did

• Spoke to 8 young people age 14-18 and 6 parents who had come into care age 11-17, been on edge of care or have/have had challenging behaviour

• Participatory life mapping

• Research informed systemic action enquiry workshop with practitioners and service leads

We tried to find out...

The common factors in young people's journeys to the edge of care;

The needs of 11-17 year olds on the edge of care, and their families;

Services young people and their families used and their experiences in terms of quality and outcomes;

How families access services, how young people access care and were there existing services which young people did not access that could have met their needs;

Gaps/ duplications/ delays/ communication problems experienced by families and agencies;

The best stage for social workers to become involved.

?? Questions emerging from????? the Journeys ???

• Why do young people end up in care when so many services are already involved?

• Why are early warning signs not recognised and in some cases responded to?

• How can a multiagency team around the family be effective with coinstrains on services such as target accountabilities and decreasing capacity?

• Why does little seem to change for families experiencing difficulties?

What does it really mean to listen to young people?Be available

Have time to talk and develop a relationship of trust

Be consistent (i.e. an ongoing relationship with one worker rather than many changes of workers and/or workers from several services who do not appear to be working together)

Take seriously what Be prepared to meet young young people and parents people and their families have said and respond accordingly in their own living situations

Family support – listen and relateAn ongoing relationship (consistency)

Practical everyday support

Access to further services where needed

A single co-ordinating worker (key worker) to be responsible for ensuring a whole family approach to intervention

Early intervention – listen and relateListening and engaging at the point where families identify a problem

Identifying a person to have a key co-ordinating role at an early stage who can develop an understanding of the needs of the family and follow through with that family to ensure that those needs are met.

Providing ongoing practical help at an early stage for families trying to cope with multiple problems – for example living in extreme poverty while also having to cope with looking after a young person with particular needs (for example a disabled young person or a young person with learning difficulties) and trying to leave a violent relationship.

I needed someone doing something earlier to help sort things out, help with my behaviour, help with realtionships with my Mum (16 year old male

Managing family relationships – listen and relateHelp families to discuss issues having an impact

on family relations

Enable parents and young people to engage with each other

Facilitate understanding about the problems and identify strategies for improving family relationships

Started arguing with my mum about stupid things, then we didn’t talk for 4 days (15 year old male)

We had one family mediation session. It was helpful but I would have liked more (P2)

Recognising the emotional and psychological needs ofyoung people and their families – listen and relate

The need for more community based approaches to person centred counselling in response to difficulties as a result of abuse or domestic violence

Ensuring that services are not so professionalised that young people and their families find it difficult to access them

Most of my life I have just had people shouting at me, not listening (YP9)

I don’t think my mum cares about me (14 year old female)

Feeling loved and valued as a social policy goal?

I had a good time with him. He took me out, spent time with him. I could chat with him and he listened and put me on the right path. I even used to call him Dad. He made me happy. He made me laugh, and feel like a special person (17 year old male)

Developing children and family services as adaptive learning systems

Why are we still asking the same questions?

Why don’t partnership agencies challenge more?

Why do we not look at life journeys?

Why don’t we value independent overviews of cases?

How do we as agencies encourage continuity over time – building up knowledge and an integrated management system to spot where interventions are needed. How do we do this?

What does listening really mean for defining policy?Listen and relate:

Connect to young peoples’s lives, realities and ideas, valuing what they have to say and negotiating responses

The worker never believed me…when I said what was happening (being beaten by mum), they don’t understand really, they weren’t listening to me…thought I was just being a silly little kid…they thought she was a lovely mum….they should have checked.(16 year old female)

Cultures of professional working – listen and relate

Really listening, recognising and being attentive to young people and parent’s situations

Encouraging young people and parents to believe in themselves and providing ongoing reassurance

Pro-actively contacting parents or young people on a regular basis (for many a weekly phone call to ask how things were going would have been sufficient)

Being available to talk things through (‘off load’) informally when necessary

Switching the focus to provision of more community-based support

Professionals and systems being more reflexive