jenny gray, helen jones and harriet ward eusarf copenhagen 2014
TRANSCRIPT
ASSESSMENT FRAMEWORK IMPLEMENTATION IN ENGLAND
Jenny Gray, Helen Jones and Harriet WardEUSARF Copenhagen 2014
STRUCTURE
+ Harriet : Looking After Children: The development of a methodology for assessing outcomes for children in care
+ Helen: The policy context+ Jenny: How the Assessment Framework
developed from this background
THE ASSESSMENT FRAMEWORK
CHILDSafeguarding
& promoting
welfare
Health
Education
Identity
Family & SocialRelationships
Social Presentation
Emotional &Behavioural Development
Selfcare Skills
CH
ILD
’S D
EV
EL
OPM
EN
TAL
NE
ED
SPA
RE
NT
ING
CA
PAC
ITY
FAMILY & ENVIRONMENTAL FACTORS
Basic Care
Emotional Warmth
Stimulation
Guidance & Boundaries
Ensuring Safety
Stability
Wider Fam
ily
Housing
Em
ployment
Income
Family’s
Social
Integration
Family H
istory
& Functioning
Com
munity
Resources
LOOKING AFTER CHILDREN: ASSESSING OUTCOMES FOR
CHILDREN IN CARE (1987-2008)Questions to answer:
– What is an outcome?
– Whose perspective?
– When to assess outcomes?
– How to assess outcomes?
CHILDREN’S DEVELOPMENTAL NEEDS
+ Health+ Education+ Identity+ Family and Social Relationships+ Emotional and Behavioural Development+ Social Presentation+ Self Care Skills
+ Different issues at different ages but all dimensions an integral part of development
FUNDAMENTAL QUESTIONS+ How far does local authority care provide children with that
care which it would be reasonable to expect a parent to provide?
+ How far does care help children achieve long-term wellbeing in adulthood
+ DID NOT ASK:
– How far is children’s development affected by parents’ capacity /reduced capacity to meet their needs?
– How far is parenting supported or compromised by wider family and environmental factors?
LEGISLATIVE AND POLICY CONTEXT
+ Children Act 1989+ Focus on outcomes for all children including
the most vulnerable+ Introduction of theories of child development
into the rationale for service provision+ Implementation of performance indicators
through which progress can be monitored
CHILDREN ACT 1989
+ State required to promote the well being of children by ensuring they received sufficient standard of care to achieve a satisfactory standard of development
+ Duty therefore on the state to ensure that this applied to children in care
+ Looking After Children provided conceptual and practical tools of monitoring progress
+ The developmental framework provided a common language across services
OUTCOMES FOCUS
+ 1998: Quality Protects was set up to support local authorities in transforming the management and delivery of children's social services.
+ Policy focus on outcomes that has become such a strong feature of child welfare, with Every Child Matters, Care Matters and the Children’s Plan continuing this trend over the past decade.
+ Outcomes framed in child development terms+ Focus on service integration+ Includes focus on outcomes for expenditure
POLICY AND PRACTICE CONTEXTThe best protection for children is high quality services - Utting report+ 1980s: many enquiries into the deaths of children at risk and even those in
care+ Many studies into outcomes for these children but few standardised
measures + 1991 : Working Group publishes report « Looking After Children Assessing
Outcomes in Child Care >> which had as its objective to link the abstract concept of ‘outcome’ to professional practice
+ 1990s: practical tools to support the developmental progress of children+ 1998-2000: developmental of the much wider Assessment Framework for
children in need or likely to suffer harm and their families
Targeted support
Integrated supportSingle practitioner
Children with additionalneeds
Keyworker/Lead Professional
Commonassessment
Statutory CIN/CP/CICassessments
Children with no Identified
additional needs(universal services)
Children in Need
MT
FC
KE
EP
FG
C
STATUTORY
INTERVENTION
SE
RV
ICE
S2013: INTEGRATION OF SERVICES: CONTINUUM
OF NEED AND INTERVENTIONS
Looked afterchildren
LESSINTENSIVE /EARLY INTERVENTION
FNP= Family Nurse Partnerships; PUP= Parents Under Pressure; FCG= Family Group Conferences; MST= Multisystemic Therapy; MST CAN = Multisystemic Therapy Child Abuse and Neglect; MTFC= Multidimensional Treatment Foster Care; KEEP= Keeping children with foster parents
S17
S47
S20/S
31
ASSESSMENTSSPECIALIST
STATUTORY
NON
AS
SE
SS
ME
NTS
STATUTORY
Where appropriate/possible aim to enable children live at home/ return
home
FNP
AT
TAC
H
Adopted Children
PU
P
MS
T /
MS
T
CA
N
CURRENT STATUTORY GUIDANCE
+ Working Together to Safeguard Children (2013) incorporates the three domains of The Framework for the Assessment of Children in Need and their Families (2000), i.e.
– Children’s Developmental Needs– Parenting Capacity– Family and Environmental Factorsas does the Regulatory Framework and statutory guidance for care planning, placement and review
THE ASSESSMENT FRAMEWORK
CHILDSafeguarding
& promoting
welfare
Health
Education
Identity
Family & SocialRelationships
Social Presentation
Emotional &Behavioural Development
Selfcare Skills
CH
ILD
’S D
EV
EL
OPM
EN
TAL
NE
ED
SPA
RE
NT
ING
CA
PAC
ITY
FAMILY & ENVIRONMENTAL FACTORS
Basic Care
Emotional Warmth
Stimulation
Guidance & Boundaries
Ensuring Safety
Stability
Wider Fam
ily
Housing
Em
ployment
Income
Family’s
Social
Integration
Family H
istory
& Functioning
Com
munity
Resources
IMPLEMENTATION OF AF
+ Advantages: Child was at the centre of the process; strengths based and ecological; provided a conceptual framework for assessing children in need and their families; integrated family support and child protection on the same continuum; inter-agency/multi-disciplinary in approach; evidence based; recognised that assessment and intervention are part of an inter-related system.
+ Challenges: Huge dissemination task; training of all staff in all agencies at all levels, not just social workers; overcoming resistance to change; cultural change to focus on children’s needs; improving quality of recording and developing/using standardised records; helping all staff to understand that the skills of working with children, parents and families, analysis and making judgements and undertaking effective work with children and families were all part of implementation.
DEVELOPMENT OF INTEGRATED CHILDREN’S SYSTEM (ICS) 2003 ONWARDS
• Developed as a tool to improve practice
• Policy intention to use the Assessment Framework for all children in receipt of children’s social services
This included: Children in Need, Child Protection, Looked After Children,Children Leaving Care and Adopted Children
• Designed to maintain the focus on the child’s safety and welfare
• Intention was to record information electronically and only once,with information transferring across a children’s record andreduce recording burden on social workers as well as improve its accuracy
THE APIR PROCESS
+ Assessment
+ Planning
+ Intervention
+ Review outcomes for children
FRAMEWORK FOR INTERVENTION AND PREVENTION OF CHILD MALTREATMENT
Maltreatment (all types) Long-term outcomes
Preventionbefore
occurrence
Preventionof
recurrence
Preventionof
impairment
Universal Targeted
From: MacMillan HL, Wathen CN, Barlow J, Fergusson DM, Leventhal JM, Taussig HN. Interventions to prevent child maltreatment and associated impairment. Lancet 2009;373:250-266.
19© Child and Family Training 2013
The HfCF project includes Resources for Practitioners – a resource pack designed for work with children and young people and their parents and carers to prevent abusive and neglectful parenting and the associated impairment of children’s health and development.
The resources are aimed at all practitioners whose roles are to intervene to provide services to children and families where there are concerns that a parent may harm or neglect their child and where there is risk the child’s health or development is impaired.
Aim of the Hope for Children and Families project and resources
Underpinning Research
Alternatives for Families and Multi-systemic therapy integrates a number of different approaches
Trauma-focussed CBT The Project SafeCare approach, tackling neglect Improving parent/child interaction and attachment using
PCIT, Circle of Security and Bio-behavioural approaches A variety of approaches to modifying disruptive
behaviour, e.g. CBT and MST In practice there are always combinations of abuse and
neglect, and combinations of approaches.(Bentovim and Elliott, 2014)
DEVELOPMENT OF THE HfCF APPROACH
© Child and Family Training 2013
21© Child and Family Training 2013
Key underpinning ideas about intervention
A common practice elements approach which conceptualises practice in terms of generic components that cut across many distinct specialist treatment protocols and specific clinical procedures and processes. (Forty-seven distinct practice elements were distilled from twenty-five random controlled trials.)
A common factors framework personal and interpersonal components of intervention (e.g. alliance, client motivation, therapist/helper/practitioner factors) common to all interventions are contribute to successful treatment outcomes.
Underpinning ideas
22© Child and Family Training 2013
Forty modules have been developed across 5 key areas:
Engaging families and engendering hope
Working with parents to modify abusive and neglectful parenting
Working with children and young people who have suffered emotional and traumatic impairment
Working with children and young people who have responded with disruptive behaviour
Working with the family – to manage relationships and to link with the community
The Modules
Article Reference: Bentovim A. and Elliott I. (2014) Hope for Children and Families: Targeting Abusive Parenting and the Associated Impairment of Children. Journal of Clinical Child & Adolescent Psychology.
Website: childandfamilytraining.org.uk