Thresholds:a pathway to services

or the road to rationing?

Sue Woolmore23 June 2010

Cultural context

• Heightened political and public interest in child protection• Complexity of child protection lost in popular commentary – ‘tabloid template’• Professional accountability expressed in policy, procedure and measurable targets

• Professionals pay a high personal price for their ‘vocation’

Changing landscape

• Public spending cuts – public consultation• Significantly diminishing resources and

uncertainty• DCSF re-branding as Department for

Education• Dissolution of National Safeguarding

Delivery Unit• Resignation of Sir Roger Singleton, Chief Adviser on safety of children• Future of Children’s Trusts unclear

Parallel processes?

“co-operative efforts are often the first to suffer when services and individuals are under pressure”

Lord Laming: The Protection of Children in England: A Progress Report

March 2009 Para 4.3

What kind of pressure?end 2007 to end 2009:• increase of 24% in initial contacts• 16.5% increase in number of referrals• Section 47 enquiries increased by 21.3%(16 local authorities reported more than 100%

increase)• 23.4% increase in initial assessments• 20% increase in initial case conferences• 32.9% increase in CPPs• increase of 17.2% in children new to careADCS Safeguarding Pressures Project March 2010

Loughborough University and LGA

Laming recommendation• CYPS should carry out initial assessment

for any referral from another professional:– would create 300% increase in initial

assessments– would cost £250 million– 6,300 extra social workers would be required

Who’s business?

“Safeguarding is everyone’s business”

Ideology or necessity?

Thresholds?

• Where do thresholds fit with this debate?

• Are our thresholds focussed on meeting needs or protecting scarce resources?

• What place do thresholds have in Rotherham?

Level 3

Multi-agency assessment and response;Child in Need meeting Child in Need action plan;review process

Level 4

Multi-agency assessment and response; initial/core assessment led by CYPS Social Care

Level 5

Multi-agency assessment and response; core assessment, in accordance with child protectionprocedures, led by Social Care

Level 2

Multi-agency assessment and responseCAF meeting Level 1

Single- agency liaison and response

Level 0

Children / families in universal services

Consultation

Learning from SCRs

“the preoccupation with thresholds was one of a number of interacting risk factors and many children’s cases were on the boundaries of services and levels of intervention”

Analysis of Serious Case Reviews 2005 – 07 Brandon et al

Rotherham landscape

“Prevention and early intervention is one of the ‘big things’ in the new Rotherham Children and Young People’s Plan and underpins everything we do for children, young people and families.”

“Our challenge then is to work together to improve the co-ordination of services and be ready to support families as soon as possible when they ask for help.”

Joyce Thacker, Strategic Director CYPS

Prevention and Early Intervention Strategy

“Our challenge is to work together …”• Safe and Well Practice Guidance• Prevention and Early Intervention

Strategy• Pre CAF checklist• Rotherham ECM continuum

Can I be honest …?

it’s all about you

Characteristics of effective integrated working

• Founded and sustained by very strong personal relationships between staff in co-located or locality teams

• Deep commitment of staff; most have chosen to work in multi-agency setting

• No major dependence on IT, due to reliance on personal relationships

• High level of professional and personal support for staff

• Strong leadership and management (vital)

DCSF 2007 Effective Integrated Working: Findings of Concepts of Operations Study

Back to early intervention …

• backbone of recent national policy• easily accepted across agencies and

professions• familiar to both statutory and voluntary

sectors• makes sense to the community• fundamental to Rotherham’s vision• key role for universal services• the CAF

The elephant in the room …

• Where do Rotherham families find support when they need it?

• If it comes from services, who’s providing the support?

• Do Rotherham families get what they ask for, or simply what’s available?

• Do thresholds open or close doors to services?

Role of the CAF“even now debate rages about its effectiveness

and doubts continue about the extent it has been embraced by different agencies”

What’s the matter with CAF? Community Care April 2010

Research in 2007* concluded that children’s workforce has philosophy that CAF can be used to “exclude children from their systems (i.e. by referring them to Children’s Services)“

* Making a case for common assessment framework responses to concerns about children. Thorpe et al Social Work and Social Sciences Review

Resourcing the CAF

• Few of the potential beneficiaries have been offered a CAF

• But, “larger numbers would result more in the identification than the meeting of needs”

• ‘CAF is, in reality, another service ‘rationed’ according to resources available and according to agencies’ priorities’

The Common Assessment Framework: does the reality match the rhetoric? Child and Family Social WorkGilligan and Manby 2008

What’s the point in referring?

Following referral to Children’s Services:“only a small proportion of these families

actually received an additional resource or service as a result of the referral”

“almost half of the cases currently being referred to Children’s Services might potentially be diverted via a common assessment”

Thorpe et al 2007

Rotherham’s threshold story

• Sound policies and procedures• Developing locality model• Passing the baton?• Do batons get dropped?• Is ‘working together’ a relay or three legged?

Blame game …

• it’s so easy, so tempting …• we witness and carry so much pain on behalf

of our community• we all want to make a difference• we’re usually measured by what we don’t do• and we measure ourselves by what we can’t

do• making thresholds work for meeting

children’s needs - working together

Thresholds and batonsCase study• facilitated group discussion• protected space for strengthening local

relationships• opportunity to share ideas and solutions• translate rhetoric and vision into reality for

Rotherham’s children• build resilience, confidence and cohesion of Rotherham’s most precious resource