THE VALE OF GLAMORGAN COUNCIL
CABINET: 29TH JUNE, 2015
REFERENCE FROM SCRUTINY COMMITTEE (SOCIAL CARE AND HEALTH): 21ST MAY, 2015
“59 THE VALE OF GLAMORGAN AND CARDIFF INTEGRATED FAMILY SUPPORT SERVICE ANNUAL REPORT 2014/15 (DSS) –
The Director of Social Services presented the report, the purpose of which was to provide Members with the Vale of Glamorgan and Cardiff Integrated Family Support Service (IFSS) Annual Report for 2014/15 prior to its submission to the Welsh Government.
As a background summary the report highlighted that through provision of its Flying Start, Families First and IFSS programmes, the Council would have in place a coherent framework for delivering the range of preventative, protective and remedial family support initiatives set out in relevant Welsh Government strategies. By providing intensive and specialist help to families where risks were escalating, the IFSS had a key role to perform in reducing harm to children and also the volume of avoidable admissions to the Looked After Children’s service.
The IFSS programme was intended to provide more holistic support to families by breaking down boundaries between local government and health, between adult services and children’s services. It was delivered by a combination of highly skilled professionals form social care and health, acting as a single workforce.
Under the Children and Families (Wales) Measure 2010, local authorities and the NHS had a joint statutory responsibility for ensuring delivery of an IFSS in their region. In July 2011, a consortium involving the Vale of Glamorgan and Cardiff Councils and the Cardiff and Vale University Health Board made a successful bid to the Welsh Government to become one of two regions in Wales chosen to implement an IFSS under Phase II of the national programme.
In accordance with the very detailed regulations which prescribed the way in which an IFSS must operate, the three organisations established a Management Board chaired by the Director of Social Services for the Vale of Glamorgan. The Management Board was supported by an Operational Steering Group which had responsibility for overseeing implementation and development during the first year of operation. Cardiff Council was responsible for the direct management of the service.
The IFSS was based at the Alps and it had been operational since the end of February 2012. The service had five principal functions:
Undertaking intensive direct work with families through the application of time limited, family focused interventions;
Providing advice and consultancy to practitioners and agencies on engaging complex families with parental substance misuse;
Working jointly with the case managers and others to ensure that the family can gain access to the services they need;
Spot purchasing services not otherwise available; and
Providing training on evidence based interventions for the wider workforce.
The report outlined that Section 64 of the Children and Families (Wales) Measure 2010 required an annual report on the effectiveness of the IFSS to be submitted to Welsh Government. The report for 2014/15 was attached at Appendix 1 to the report and this had been approved by the IFSS Management Board.
The Annual Report summarised the following:
Key achievements and outcomes
Effective partnership working
Challenges faced by the service
Priorities for 2015/16.
The Annual Report demonstrated that the IFSS was meeting expectations in terms of numbers of referrals and the outcomes achieved. It outlined the robust systems of data collection and analysis in place to demonstrate how families were referred and prioritised for support and the impact upon key areas of wellbeing such as education, parenting, relationships, alcohol or drug cessation. This was complemented by qualitative evaluation through service user and referrer feedback. These results demonstrated that the IFSS was taking a lead role in strengthening services to support some of the most disadvantaged children, those who were in need or at risk because of parental alcohol or drug dependence.
The main priorities for the year ahead would be to increase the number of referrals with which the team worked and to train the wider workforce in the IFSS model of intervention using Motivational Interviewing, Solution Focused and other cognitive behavioural techniques. At a local level, there were plans to strengthen the maintenance phase that followed IFSS intensive intervention and to embed the system for formal review of cases. In addition, the IFSS Board would continue to plan the structure and pattern of future service delivery and identify funding for the medium to long term.
The Welsh Government’s ten year strategy for Social Services included a commitment to a career pathway and ongoing qualification requirements for Social Workers, thereby enhancing professionalism and promoting high quality services. The national career pathway was intended to retain more social workers in practice roles and it consisted of four levels:
Newly qualified social worker (years 1 and 2)
Social worker (year 3 plus)
Senior social worker practitioner (3 years post qualified)
Consultant social worker (5 years post qualified).
The consultant social worker role within the IFSS was demonstrating that specialist and evidence based social work interventions (as part of planned, systematic multi-agency involvement in the lives of families) could have considerable impact and deliver better outcomes.
The Director of Social Services explained to Members that the dilemma facing the service was that it was relatively expensive, it only dealt with a small number of families and it was highly resourced. An important question may be whether this was the best use of resources and that a review of the service needed to be undertaken to assess whether it delivered value for money and the best outcomes for families. He also explained that the main priority of the IFSS was in relation to tackling substance misuse but he questioned whether the service should broaden its focus.
The Chairman, in questioning the allocation of resources, stated that on average each case would cost the service around £28,000. In response, the Director of Social Services advised that the Council had to provide the service and that there was benefit of working in scale with its partners but discussion on the way forward for the service would need to take place. He alluded to the highly prescriptive nature of the service that had to be provided in a specific and regulated way. There was a need to look at all the evidence in order to show if there were opportunities to undertake this work in a more cost effective manner and it seemed unfair to exclude this service from exercises around budgetary reductions.
In response to a Committee Member’s query regarding the number of cases in which no spaces were available, the Director of Social Services advised that this was the biggest concern identified by the Council. It would not mean that help was not provided to the families and the service would attempt to back fill cases when capacity was available. He stated that a question that he would like to ask was whether there was a need for such an intensive service in order to affect change. He considered that there was a need to test the methods used and to assess whether support needed to be undertaken this way and to identify if there were other ways of working.
Further to this point, the Director of Social Services advised that the programme used within the IFSS service was time limited and that support provided could not go beyond a specified point. In his opinion, the service should be far more flexible and he questioned as to why the service needed to be so prescribed if families were co-operating. He went on to state that the programme was entirely prescriptive and that results could be achieved in various ways and he questioned whether there was a need to always have the same level of professional input in all instances. He stated that he would have liked to have seen more flexibility built into the system.
A Committee Member then raised two questions regarding whether Welsh Government intended to review how the service operated and whether more qualitative data could be used in order to determine success. In response, the Director of Social Services agreed that it would be more useful if better qualitative data was available, such as getting behind the reasons for families cutting themselves off from mainstream services. In terms of outcomes, he was worried that a service like this may create dependency and that the service should be able to step back and provide continuous support but he recognised that this then created a danger of clogging up the system. He reiterated his previous point regarding the highly prescriptive nature of the service that did not allow the Council to make any adjustments to the programme. In terms of whether Welsh Government was aware of the Council’s concerns, he would need to consult with the Head of Children and Young People Services, but he would raise these points at the next Executive Board meeting of the Association of Directors.
When asked if the number of cases which were refused was creating greater need, the Director of Social Services indicated that the IFSS provided a top tier service and that the situation at present was being managed quite well. He alluded to the stability in terms of the number of Looked After Children which showed that services such as the IFSS did have a role, although in his opinion, he would like the service to be more regularly available and operate in a more flexible manner.
Having considered the report, it was
(1) T H A T the content of the Integrated Family Support Service Annual Report for 2014/15 be noted.
(2) T H A T the work being undertaken to provide intensive support to families, especially those where children were adversely affected by parental alcohol or drug dependence, be endorsed.
(3) T H A T the report be referred to Cabinet for consideration.
Reasons for recommendations
(1&2) To ensure that the Council’s statutory functions in relation to providing an Integrated Family Support Service were fully met in accordance with Welsh Government guidance.
(3) To draw Cabinet’s attention to the Committee’s assertions around the highly prescribed nature of the support work provided by the Integrated Family Support Service and the need to assess the cost effectiveness and impact of the service.”
Attached as Appendix - Report to Scrutiny Committee (Social Care and Health): 21st May, 2015