Working with the whole family HSCB Annual Conference 2011

1. Working with the whole familyHSCB Annual Conference 2011

2. Working with the whole familyHSCB Annual Conference 20119.00 Arrival and coffee9.30 Welcome and the Hertfordshire picture Phil Picton, HSCB Independent Chair9.50 Keynote speaker - Naomi Eisenstadt CB10.30 A Hertfordshire perspective Sue Williams and Earl Dutton11.00 Coffee11.20 Workshops (2 x 40 minute sessions)13.00 Lunch13.45 Theatre group presentations and discussion groups16.15 Plenary led by Phil Picton 16.30 Close

3. Welcome and the Hertfordshire picturePhil PictonHSCB Independent Chair

4. Why are we here? “… moving from a system that has become over-bureaucratised and focused on compliance to one that values and develops professional expertise” Munro 2011

5. Recurrent problems • children being invisible to professionals because the focus is on the parents, • inadequate assessment of the dangers of parental problems of • substance misuse, • domestic violence, • and mental illness, • fixed judgments not being challenged and revised • (Munro 1st Report)

6. Domestic violence 34% Mental health problems 27% Drug misuse 22% Alcohol misuse 22% Child of teenage pregnancy 10% More than one child abused 19% Brandon et al, Dept of Education, 2010 Numbers from SCRs

7. “… half of the children are not known to children’s social care,” Brandon et al, Dept of Education, 2010

9. Working with the whole family to address deep disadvantage Naomi Eisenstadt Senior Research Fellow, University of Oxford Departments of Education and Social Policy

10. Why haven’t we cracked the problems of exclusion Even with the recession, most people in Britain are healthier, wealthier, and wiser (?) than thirty years ago Successive successful policies have left behind individuals and families with increasingly complex, inter-related and persistent problems Public health messages and policies that work for the many, still miss some; need to address a highly segmented market; a more nuanced approach to targeting Inequality gaps widen as policy success for the many leaves a few even further behind

11. Social exclusion across the life courseSETF study, July 2009 4 studies: families with children, young people, working age adults without children, older people For this talk: data from: Families with children: Paul Oroyemi, Giacomo Damioli, Matt Barnes, Tim Crosier Key questions, what are the forms of multiple disadvantage what lessons for social policy

12. What do we mean? • "Social exclusion is a complex and multi-dimensionalprocess. It involves the lack or denial of resources, rights, goods and services, and the inability to participate in the normal relationships and activities available to the majority of people in a society, whether in economic, social, cultural or political arenas. It affects both the quality of life of individuals and the equity and cohesion of society as a whole" • Bristol Social Exclusion Matrix (Levitas et al, 2007)

13. What we know about disadvantage and transfer of disadvantage Inequalities interact with each other: poor mental or physical health in childhood leads to poor educational outcomes, leads to poor employment prospects, leads to poor health in adulthood Clear gradient, disadvantage not only in the bottom quintile, but very bottom 2-3% characterised by complex and inter related problems Children fall in and out of risk during childhood; stuff happens Disadvantage has negative impact across generations

14. Interrelationship: health and education inequality St Paul’s: without it, correlation increases to 80%

15. Prevalence of multiple disadvantage (2006) 45% have multiple disadvantages 55% have 0 or 1 disadvantage % of families Number of disadvantages (total possible 18 for this study)

16. 9 clusters of multiply-disadvantaged families

17. The association between different forms of disadvantage

18. Children from families facing multiple disadvantages are at greater risk of a range of negative outcomes Source: Families and Children Survey (2004 and 2005, 8 disadvantages measured for this study)

20. Challenges to delivery of a think family approach What changes do we need in the workforce to improve collaboration between adults and children’s services How do we deal with the sometimes genuine tensions between child and adult best interests? How do we make ‘joining up’ work at the front line without impossibly complex lines accountability? In times of fiscal constraint, more to be gained by collaboration, but also stronger resistance to share budgets. This stuff is hard....

21. Key policy choices Shift the curve: public health prevention approaches will decrease the absolute number of citizens experiencing exclusion, but will always miss the most excluded Working with the most excluded: complex, expensive, often fails. Very little public support (they don’t vote) Real choices: do nothing, do good by stealth, convince the public worth doing

22. New Government, new ideas Demonstrable commitment to the ‘neediest’ Tension in ideas of ‘Big Society’ co production and use of evidence based programmes, strong emphasis on manualised pre-determined interventions Graham Allen Review Frank Field Review Tickell Review Meanwhile, high risk if increase in poverty: prices of essentials increasing, wages flat, and more part time working Public sector cuts most inordinately impact on women and therefore children

23. Good news/bad news Strong commitment to early years and educational attainment Maintenance of universal 15 hours free for 3 and 4 year olds Increases in paid parental leave and increased flexibility between mothers and fathers Very concerned about university access and social mobility Likelihood of rising unemployment Tax credit changes Changes to housing benefits Increased conditionality on disability benefits Overall benefit cap (particularly hard on large families) Hence, protection of some services but strong likelihood of increased demand and reduced funding. Tough times ahead.

24. A Hertfordshire perspective: Working together to safeguard children in HCC Sue Williams Operations Director, Safeguarding

25. Strengthen the links and create a continuum of care between universal, targeted and specialist children’s services by shifting resources and/or appropriate workload from specialist services (children’s social workers) into universal (eg children’s centres) targeted early intervention teams (eg TYS) and develop robust sustainable links with adults teams (learning, disabilities, mental health and substance misuse teams). Vision

26. Munro review of child protection Meeting the Needs/TAS FIP and Scaffold Setting up Early and Targeted Intervention portfolio inc TYS, EITS and others Cross services protocol Local child protection fora Step up/down inter agency procedures Joint child protection investigation team/Protector Actions 2010/11

27. Graded care profile and CAF - using same tools, developing shared language Links with children’s centres/hospitals/HVs Exploring and creating effective and sustained links adults substance misuse, learning disabilities, mental health, DV and children’s targeted and specialist teams What’s next?

28. HSCB Annual ConferenceWorking with the whole family Earl Dutton, Assistant Director Health and Community Services

29. Working in a holistic way • The essential key remains joint working • We must stop passing individuals between us • Talking to your opposite number in other parts of HCC • Partnerships are more important than ever • Make more person centred pragmatic decisions

30. Working in a holistic way (2) • Cross boundary protocols already in place • Shared offices and systems • Brilliant examples of working together • Can always do more

31. Working in a holistic way (3) • Many synergies across all agencies • We can always learn from each other • Remain open minded and think ‘outside the box’ • HCS are very committed to this way of working

32. Working with the whole familyHSCB Annual Conference 20119.00 Arrival and coffee9.30 Welcome and the Hertfordshire picture Phil Picton, HSCB Independent Chair9.50 Keynote speaker - Naomi Eisenstadt CB10.30 A Hertfordshire perspective Sue Williams and Earl Dutton11.00 Coffee11.20 Workshops (2 x 40 minute sessions)13.00 Lunch13.45 Theatre group presentations and discussion groups16.15 Plenary led by Phil Picton 16.30 Close

33. 11:20 workshops (2 x 40 minute sessions)Workshop 1: working with parents who misuse substances Oak RoomWorkshop 2: effective interactions Birch Workshop 3: family group conferenceHazelWorkshop 4: parental mental healthBeechWorkshop 5: Think Family in practice PineWorkshop 6: parental learning disabilities WillowWorkshop 7: the effects of domestic abuse on families Yew

34. Working with the whole familyHSCB Annual Conference 2011REACT ACTING FOR BUSINESS

35. How can we make best use of expertise in the system, especially when parents needs fall below the threshold? How can we keep a focus on the child while supporting the parents? How do we improve risk assessment and intervention for families with multiple difficulties? Questions….