Community Budget Programme Board

December 12th 2011

By 2014/15 we will aim to have:-

1. a shared view of all the Families with Complex Needs in Leicestershire as well as the families at risk of becoming complex

2. streamlined needs-based, focussed and cost effective services, that address the needs of these families, improving their lives and reducing their costs to the public purse

3. integrated public and voluntary sector family focussed services designed around a single Leicestershire Family Model

4. service delivery based on a re-balanced provision focussed more on targeted services than universal

5. a place based structure responsible for commissioning family focussed services from a single, shared budget

Families with Complex Needs

Ethnography 3 Workshops Individual

family consultation

Customer Journey

Needs Assessment

Customer Journey maps

9 families 21 adults, 13 CYP 9 familiesCraig's story

(Beacon project)Child Poverty Mental Health

Desk based research

Other Insight

SE

CO

ND

AR

Y

RE

SE

AR

CH Evidence base for family models Current/emerging policy

Melton Family Model Mapping Families LIFE - Swindon pilot

Practitioner Insight

Family Insight

Full day practitioner workshop - 135 practitioners, cross agency

PR

IMA

RY

RE

SE

AR

H

Family Insight- a comprehensive approach

The detailed Insight report is now published on the Leicestershire Together Website

www.leicestershiretogether.org/partnerships/communitybudgets

Common issues for FCN• Poor/overcrowded housing (incl.

homelessness)• High risk behaviours (incl.

substance misuse)• Poverty (incl. debt &

unemployment)• Health (incl. mental health &

disability)• Crime (offending and/or

experience of)• Lack of education/ attainment• Domestic violence• Poor parenting

• Difficulties maintaining relationships (incl. family, friends, peers, isolation & social marginalisation)

• Lack of resilience (incl. capability, capacity, confidence & inability to cope)

• Feelings of having limited choices/control over lives

• Adverse effect on aspirations/ perception of social mobility

In already fragile families, incidents can happen that have multiple implications

Additional intergenerational risks children of FCN face..

• Childhood spent in care• Becoming carers at an early

age• Chaotic family lifestyles and

lack of continuity • Mental health issues• Increased risks of substance

misuse• Increased risk of poor

health• Abuse/exposure to

exploitation & violence

• Girls/women with poor self esteem and low confidence can often become victims of domestic violence

• Unresolved anger can lead to violence

Children of FCN often become future FCN..Setting up Intergenerational cycles..

Types of Changes

Communication between agencies

Attitudes

Information sharing

Communities

Mgmt needs to listen and act

Advocate / Lead organisation

Senior Managers back

to the floor

Widen scope of FIP

Better working together

Stop being precious, be

more flexible, changes in

funding

Earlier intervention

POLITICS

More resources / money

Shared vision, shared targets

Family, not organisation-centred ways of working

Needs assessments

Re-skill / believe in people –

professional respect

Personal responsibilit

y

LongTerm

strategy

Action, not talk

Single IT system

Leadership

Earlier interventio

n

Shared vision and stronger

leadership

Family-centric, not organisation-centric

approaches to working and funding

Advocate / FIP

Politics / resources

Re-training /

attitude of workforce

Information sharing

Better joint working

Shared processes /

systems

Community

Family Support Model - Key Principles

Any new model is sustainable beyond the medium term Aims to move families closer to independence from public services Model will need to be underpinned by cultural change with strong leadership

across Leicestershire Public Sector/Voluntary Sector ‘champions’ and SRO in all organisation to lead required cultural change?

Supports early/earlier intervention Builds on good, well evaluated practice Incorporates some personalised commissioning at family & locality level Workforce development a key component (multi-agency training) Families/workers are able to access services required quickly with some priority

(with lower entry thresholds) Is able to influence commissioning for identified service gaps and policy

changes Single Family Assessment Framework

Team around the family with dedicated family support worker may require 1 for adults, 1 for children in some families Role is outreach working in family homes and communities with small caseloads

and intensive approach as required by family circumstances/needs Co-located services in localities (demand determined)

Local integrated multi-agency teams Mix of permanent & co-opted staff delivering core needs/services Necessary administrative support

Locality partnership solutions and delivery Mix of local & County commissioning

Sensitive to local needs assessment, local intelligence and opportunities Builds family capacity, capabilities & aspirations

Recognises strengths within the family Builds self esteem, skills, relationships and aspirations

Has flexibility built in so families are able to move in and out of support for a period of time

Family Support Model - High Level Operating Model

Dedicated family support worker will Support the family and co-ordinate relevant and required services Provide practical support around basic issues & life skills Be a positive role model Spend time working with family members within the home &

community Be an advocate for the family Recognise the importance of the communities role in supporting

families & identify opportunities for integration Have access to locality ‘families’ budget Consider Personalised Budgets for some families

Case loads of 5 for most complex to enable sufficient time to work with the family - up to 12 for least complex

Role of Family Support Worker

Child Protection

PoliceProbation

YOSMental Health

Youth services

Domestic Violence

GP

JCP

SM Treatment

Brief interventions (SM/Health)

Benefits

Counselling

ETE

Education support

Youth/children workers

Housing SupportHealth

Visitor?

Administrator

Family Model Draft 1: FCN Team around the family with lead family support worker

‘Place’ information hub solution Access to a single view of family and history

Decisions made with a view of all known information about a familyThis needs to be dynamic and growing as information and

involvement growsPresumption is to share information

o principle that we ‘dare to share’ on a basis of ‘what specifically don’t we need to share’?

o questions over the depth/degree

Requires a well trained workforce re: information sharing Requires cultural change

Family Support ModelCore Support Elements

Disabilities

Domestic Violence

Benefits

Employment

Educational /behavioural

supportSubstance

Misuse

Mental Health

Positive activities

Practical Support

Esteem

Housing

Family Worker

Co-ordinates

Family Worker co-ordinates CORE family support themes i.e.