London Region Outcomes event
4th June 2015
Claire Lazarus, Associate and
Alan Loivette, SEND Programme Manager, Camden
Welcome
• Introductions
• Key learning that you are wanting from today
• Creativity!
Today
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Emerging practice and challenges
Camden
Discussion
Parental perspective
Havering
Next steps
Context in Camden 200
Requests received
180
Requests agreed
160
140
120
100
80
60
40
20
0
2009/10
2010/11
2011/12
2012/13
2013/14
A 5 year average suggests that Camden could expect about 105 new requests per year Context in Camden Statements by need in 2013/14 SLD SPLD HI
1% 2% 2%
PI
1%
ASD
20%
SLCN
27%
BESD
22%
PD
2%
MLD
23%
In 2013/14 children and young people described as having a primary need of either: SLCN or MLD or BESD or ASD represented 92% of all the C&YP whose requests for a statement went to panel Context in Camden Statements by pre school & school age children
in 2013/14
Pre school
39%
School
61%
We can expect an increase in numbers of requests (from statements) for pre‐school children We can expect demand for EHC plans for post 16s / 19s from young people who remain in education or training What we are doing locally… • “Local authorities should adopt a key working approach, which provides children, young people and parents/carers with a single point of contact to help ensure the holistic provision and co‐ordination of services and support –
Code of Practice 2.21”
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(EHC Plan ‐ Guidance for professionals p.6)
• In response, in Camden we have developed the role of the Assessment Coordinator – time limited to the 20 wk. assessment of need, with responsibility for:
– Supporting the family / young person with Section A
– Chairing the Team Around the Child meeting where outcomes are agreed – Supporting the family with navigating the system What we are doing locally… • “Key changes are aimed at developing much better relationships with young people and families and for co‐
production of long term outcomes based on person‐
centred planning”
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(EHC Plan ‐ Guidance for professionals p.4)
• Assessment Coordinator training focuses on development of outcomes and person centred planning and these aspects of practice feature as part of our developing workforce reform strategy How many Assessment Coordinators does Camden need?
• We expect / intend:
• One FTE AC to lead on no more than 2 EHC plans at any one time (best practice from Pathfinders)
• Have trained approx. 80 staff across E, H & C
• Assessment Coordinators to measure time taken up by the role as they are allocated to cases so we can measure effort
• Role being reviewed and any amendments to model (including allocation) to be in place for next academic year What’s working
and what’s not?
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Children’s POET
Children and Young People’s POET –
the brief
A tool able to capture:‐
– The experience of obtaining an EHCP (and in some cases a personal budget) from the perspective of the child/young person, family and practitioner
– Outcomes of having an EHCP (and in some cases a personal budget)
Outcomes parents/carers report for their children
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Local community
Relationships/friends
School/learning
Relationships/family
Fit and healthy
Home
Happy and relaxed
QOL
Support
Outcomes parents/carers report for themselves
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Take part/local community
Being valued
Feeling supported
Aspirations
Life balance
Confidence in future support
Practitioner reported outcomes
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Health
Community
Transition – school
Friendships
Transition – adults
Relationships practitioner
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Happy and relaxed
Family
School and learning
Home
Measuring success
Special educational needs and disability: supporting local and national accountability
March 2015
Measuring the success of the SEND system
Examples of data and intelligence:‐
– SEN appeals and outcomes
– EHCPs completed on time
– LA and parent survey data
– POET – Feedback from Independent Supporters
Summary of findings
• The EHC process is working well and leading to some good outcomes in some areas of children and young people’s lives
• At least 2/3rds of parents/carers said EHC Plans or Personal Budgets had resulted in things getting better or a lot better in 5/6 of the areas covered by POET
• Practitioners were very positive about some aspects of the process
Next steps
• London briefing 9th June 10.00‐12.00 @ London Councils
• Expressions of interest sought from 50+ LAs and their CCGs by 12th June • 25th June Steering Group
• Testing period mid Sept – end Dec 2015
• Analysis and third national report by end March 2016
• Individual benchmarking reports by May 2016
• Local benchmarking and action planning meetings
• Ensuring sustainability beyond March 2016…
Emerging practice/ challenges and support
Philippa Stobbs, Assistant Director
Council for Disabled Children
Outcomes and culture change in the Children
and Families Act
London Outcomes event
InControl, 4 June 2015
Philippa Stobbs, Council for Disabled Children
Outline
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What the Code says
Ways of thinking about outcomes
Challenges
Support available
The culture change, s19
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The views, wishes and feelings of the child and their
parents, or the young person
The importance of children, parents and young people
participating as fully as possible in decision-making
The information and support necessary to enable
participation
Support to achieve the best possible educational and
other outcomes
Best possible educational and other outcomes
• EHC plans must focus on education, health and care
outcomes that will enable progress
• Distinction between aspirations and outcomes
• A benefit or difference made to an individual as a result
of an intervention
• Personal and not expressed from a service perspective
and not a description of a service being provided
• What needs to be achieved by end of a phase or stage
• EHC plan should specify the arrangements for setting
shorter term targets at school, service or institutional
level.
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Is this an outcome? If not, what is it? And is it SMART?
1. Liam will be able to go out with friends
2. Tracy will be in school more
3. Three hours speech and language therapy a week
4. To be able to communicate with my friends at playtime
5. To enjoy school
6. Tracy has difficulty communicating with her peers
7. I will be able to travel on my own when I go to secondary school
8. I will be able to live on my own, with help, when I leave college
9. I want to be able to go to the leisure centre with my friends
10. To get an EHC plan
11. I will be able to read a book on my own if I want to
12. I will get the exams I need to go to college next year
13. Hardeep will be able to read 10 new words by half term
14. John gets 15 hours support assistant time a week
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Outcomes pyramid
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Then pyramid
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If aspirations and outcomes are so important …
Are staff confident about holding conversations about
outcomes with parents, children, young people?
What skills do staff need in order to have such
conversations with parents, children and young people?
Are outcomes included in professional thinking in preparing
advice and information for the EHC assessment and
planning process?
Are outcomes included in schools’ thinking, in advice and
information for the EHC assessment and planning process?
Is advice and information being commissioned against the
backdrop of such conversations?
Challenges
Challenges for professionals:
• Finding a common language
• Differences: having conversations, drafting an EHC plan
• Cultural baggage
• Expectations
• Data
• Equality Act and entitlement
Challenges for parents
Challenges for children and young people
Support
• Independent Support
• Information, Advice and Support Services
• Delivering Better Outcomes Together: Mott MacDonald,
NDTi and the Council for Disabled Children
• Keyworking
• Support for IASS
• SEND Advisers
• Preparing for Adulthood
• SEN leadership, NDTi
• Regional Lead Programme
"The greatest danger is not
that our aim is too high
and we miss it, but
that our aim is too low and
we hit it"
Michelangelo
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Council for Disabled Children
www.councilfordisabledchildren.org.uk
Philippa Stobbs
[email protected]
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Camden A common language?
A common approach?
Wayne Keenan, Senior Educational Psychologist, LB of Camden Progress
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Identified Assessment Coordinators
Provided training in role Produced guidance booklet
First training on outcomes was hypothetical
Language of Long term, medium term, short term
Debates on time frame
Shifted to Aspirations, Outcomes (end of phase), Short term outcomes (6‐12 months)
Aspirations are long term hopes and dreams – usually these will come from the child / young person and their family.
They are not services, activities, outputs ……
•These aspirations may not be realistic, and are generally gathered from the ‘my aspirations and goals from the future’ question in Section A of the EHCP
•Unlike outcomes, the LA does not have responsibility for the aspirations ‐ they are used to guide the setting of outcomes and are still detailed on the plan.
•Can be whatever the child/young person wants.
•Helps everyone better understand what motivates them.
Outcomes are what a child/young person (and their family) will be supported to achieve towards their aspirations over the next few years.
They are not services, activities, outputs ……
A child/young person’s needs will often impact on different aspects of their life, across their education, care and/or health.
This means that there may be common outcomes, and plans to meet those outcomes, which will need to be agreed by different agencies, in partnership with families.
“Outcomes should be written in a way that helps children and young people towards the achievement of their aspirations (Section A). The plan should be clear how SMART outcomes link to their longer term aspirations.” (Council for Disabled Children, The SEND Reforms – A Guide to EHC Plans)
Outcomes may be to • Maintain a child or young person’s situation (eg to continue to live at home), or to
• Change their situation (eg to improve their language skills)
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Previously, outcomes in Camden were broken into long, medium and short term outcomes – this has changed
Long term = aspirations
Medium term = Outcomes on the EHCP: now seen as until the end of the next key stage – broadly:
• Early years
• Primary: KS1 / KS2
• Secondary: KS3 / KS4
• Further education including up to 25 where appropriate
Short term: There will also be 3‐12 month short term outcomes – these will now be completely separate from the EHCP, and will be set by the educational setting within 2 months of the planning meeting
Long Term ‐ Aspirations
Education and
and Relationships
and Wellbeing
Preparing for Adulthood programme: www.preparingforadulthood.org.uk
Aspirations we want for all children and young people with SEND are that they are:
1.
As healthy as they can be
2.
Kept safe from harm
3.
Able to communicate confidently, make choices, form friendships and relationships and be part of their community
4.
Able to play, learn, socialise, work and achieve their potential
5.
Resilient and able to cope with any difficulties they may face
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Prepared for living as independent an adult life as possible
Developed through extensive consultation with parents, young people and education, health and care colleagues.
Developing person centred outcomes
Person centred planning is used to enable people requiring support (particularly those with SEND) to increase their self‐determination, resilience and independence.
A person centred outcome…
• Will show what the C/YP will be doing at the end of the next key stage
• Will be clearly linked to the long term aspirations
• May be ambitious – there is a difference between ambitious and unrealistic and this may be a dilemma that needs to be managed • May have obstacles in the way of achieving it
• Needs to be SMART (short / medium)
Developing SMART outcomes
Specific
Exacty what is it that you want to achieve?
Is it clear and understandable by all?
Measurable How will anyone know whether a outcome has been achieved?
What evidence could be used to show that it has been achieved?
Achievable
Is this something that the child/young person could achieve over time, if they were given the right support and resources?
Realistic?
or
Are they likely to achieve the outcome within the timeframe, given the support and resources that they are likely to have?
Relevant?
Appropriate to the child’s needs and circumstances
Time bound When do you hope that the outcome will be achieved by?
How often should progress be reviewed to check if progress is on target?
Outcomes ‐ examples
Long term aspiration
- David will eat a range of foods and textures
including something from each food group on a
daily basis to meet his nutritional requirements
‐ David will have a balance diet
Medium term (end of education phase)
David will eat a range of different foods, particularly
those not dry and crunchy, at home and in other
environments
Short term outcome = 3-12 months
David will lick a new vegetable and a new fruit in
clinic / home
Questions to test if something is an outcome If you got your outcome…what would it…..
Give you?
Do for you?
Make possible for you?
Where, when and with whom do you want it?
You can repeat these questions if you need to until you get to the outcome. This helps us find the true outcome rather than the solution that we may have embedded in the outcome
What would that:Give you?
•Time with a
speech and
language therapist
Do for you?
•Help me be more
easily understood
by my friends
Make possible for you?
•Friendship
•Social activities
•Feel confident
around other people
6 sessions of speech and
language therapy
So what is the real outcome?….
I will be understood by my friends when I play with them – for example at the after school club everyday.
Issues ‐ Breadth of outcomes Issue
Making a narrative of input and outcomes
Linking Process to Outcomes: Chairing the meeting
• Visually display broad areas being suggested for long term outcomes
– E.g. flip chart, interactive whiteboard
• Keep the focus on outcomes
• Work backwards: Start with aspirations and identify end of key stage outcomes needed to reach this
• You don’t have to do the short term outcomes – this will be done later in a separate meeting similar to provision mapping / IEP
• Don’t get bogged down in the wording in the meeting – this can be tweaked later if you can’t get it right
• If using an interpreter, plan how this will work
• Meet beforehand with interpreter and parent / carer / YP
• Allow more time
Camden Examples
Boy X – 12 years old
Aspirations and Goals for the Future
Outcomes (End of key stage 4)
I will be able to purchase items in a local shop for a meal
I would like to live in my own place near my parents I will know what housing options are available to me and have expressed a preference
I will be able to travel independently around Camden in order to get to school, meet friends and go home Short term outcomes (1 year – set at a later meeting): • I will be able to add and subtract using coins up to 100 pence
• I will be able to make a decision and give a reason for my preference in a supported activity
• I will be able to walk to school independently
Actions: LSA to meet at school gate, supported activities for making choices
Camden Examples
Boy Y – 5 years old
Aspirations and Goals for the Future
Outcomes (by end of key stage 2)
I will have at least 3 friends I play with at home and school
I would like to make and keep long lasting friendships I will know how I communicate and will be able to and be part of my communicate with other people either verbally or non‐
community
verbally
I will be able to play independently in the playground
Short term outcomes (1 year): • I have a friend I feel happy to invite to my house
• I will be using 30 Makaton signs at school and at home when communicating with a range of adults and peers
• I will be able to take part in simple structured games in the playground with one other peer, when supported by an adult
Actions: SLT to share Makaton signs with school staff, TA to support learning of simple games at playtime, School staff to make Communication Passport
Activity
• Two example EHC plans
– Read through the plan you are given in groups of 3
– Discuss what you think should be appropriate aspirations and outcomes
– Have a go at writing them into the Camden EHCP format
• Aspirations and Goals for the Future
• End of Key Stage Outcomes linked into aspirations
• The main difficulty we have when developing outcomes is our tendency to embed the solution into the outcome i.e. writing outcome as provision • Writing outcomes as ongoing actions: developing , reach potential, • Writing outcomes as unmeasurable abstracts: use the ‘Hey look at me…’
Outcomes examples: issues 1
Aspirations
Outcomes (at the end of key stage)
To be in paid employment in an area of her vocational interest (In Autumn 2014, Jessica’s long‐term aspiration is to open a bakery in New York with her best friend) To develop decoding skills in reading so that she can read for practical purposes and for pleasure. For example, so that she can read and understand examination questions; read and follow a list of instructions such as a recipe; read and enjoy a work of fiction of her choice independently. To develop functional writing and touchtyping skills so that she can write for practical purposes and for pleasure. For example, that she can record her ideas and share her knowledge in learning activities and examinations; so that she can complete application forms for college; so that she can write shopping lists. To develop functional numeracy skills so that she can plan and manage a simple budget. To complete work experience in her area of interest so that she can use her literacy, numeracy and communication skills in a working environment Aspirations
Outcomes (at end of key stage)
To develop age appropriate life skills so that she can manage money, bills, and self‐care independently.
To use practical memory strategies in different situations. At the beginning of a task, she will say which memory strategy to use and why. To buy the ingredients for a recipe within a budget and check for the correct change independently To develop her physical stamina to maintain energy to complete practical tasks Aspirations
Outcomes(at end of key stage)
Independent living: Millie will be able to get herself ready for school on time, independently. Millie will have skills to help her work and live independently so that she is Millie will be able to travel able to do things on her own. independently to and from school. Aspirations
Outcomes (at end of key stage)
Learning: Millie will be consistently using key strategies to support her receptive and expressive language skills Millie will have achieved her academic potential. Millie will be able to read chapter books for her own enjoyment. She will be able to show her understanding of what she has read by answering questions about the text. Millie will be able to identify when she has not understood spoken or written information, and will be able to use identified strategies or ask for support around this when she needs it. Millie will be able to touch type at a speed that enables her to record her ideas efficiently, between a range of 10‐
20 words a minute Table top discussion
• What are you finding challenging?
• What have you found to be successful?
• Feedback and examples of good practice
A parental perspective
Orphelia Field and Sufia Chowdhury
OUTCOMES
Dr Miles Thomas
London Borough of
Havering
and University of East
London
INTRODUCTION
Welcome and aims
The Code
The Havering experience
The Challenges
The Solutions
THE CODE
We must have regard to;
1. the views, wishes and feelings of the child or young person,
and their parents;
2. the importance of the child or young person, and their
parents, participating as fully as possible in decisions; and
being provided with the information and support necessary to
enable participation in those decisions
3. the need to support the child or young person and their
parents, in order to facilitate the development of the child or
young person and to help them achieve the best possible
educational and other outcomes, preparing them effectively
for adulthood
This offers a radical requirement to shift focus/practices and in
doing so presents significant operational challenges!
THE HAVERING EXPERIENCE
Stable LA with good relationships with parents and schools
SMART practices
Low statutory assessment rate
Resource efficient
Will and structures to support effective inclusion
Embedded person centred and Solution Focused culture and
practices
Our experience reflects the National experience
THE CHALLENGES
Organisational/systemic change (scope and pace)
Children and adults with disabilities team (education and social
care… health?)
Resources and capacity
Urgent v Important
Inconsistency, ambiguity and paradoxes (social model v deficit
model)
Evidence based intervention/Practice based intervention
Ethical practice in line with the principles of the Code (social
justice)
THE SOLUTIONS
The processes we use should be evidenced based and ethically
aligned to the code
Person Centred Reviews (Sanderson et al 2006)
Integrated formulation (Johnstone and Dallos 2013)
Solution Oriented approaches (DeShazer 1991)
These can support the co-construction of meaningful outcomes
based on the aspirations of children and their families/carers
The key is the ways in which we map them to the EHC process
BACKGROUND TO PCRS IN HAVERING
Expectation in DCSF guidance that some form of person
centred planning is appropriate for ‘everybody with a
learning disability’
Pupil’s identified as vulnerable and/or those with complex
needs (Key transitions)
In 2009 we identified Year 9 as a priority group
In 2010 we successfully piloted the approach to support
the transfer of vulnerable pupils from Year 6-7 (White
2015)
In the Summer Term 2012 the approach was piloted in
Early Years settings and successfully evaluated
The process is embedded in practice in our schools and we
are developing the use of PCRs in the EHCP process
PERSON CENTRED APPROACHES
Model based in humanistic and positive psychology
Children and parents at the centre
Reviews focus on interests, strengths needs and preferences
One page profile produced prior to the review meeting
Facilitated review is dynamic and participatory (paper on
walls)
Focus questions include
• What people like and admire about…
• What is important to…
• Best ways to help…
THE IMPORTANCE OF THE
FACILITATOR
Keeps the meeting focused (co-construction of CYP centred
outcomes based on aspirations and integrated formulation)
Introductions and explanation of the process and roles
Impartial (child advocate?)
Acts as a scribe for the action planning (outcomes/resources)
Identifies action chasers
All EPs in Havering and many SENCos/Early years workers are
experienced in this now
It requires a set of skills and, perhaps most importantly, a set of
beliefs
PUPIL VIEW OF PCRS (WHITE 2015)
PARENT VIEW OF PCRS (WHITE 2015)
SOLUTION ORIENTED APPROACHES
Steve DeShazer and Insoo Kim Berg
Work with the person not the problem
People are experts in their own lives
Preferred Future (Aspirations)
Exceptions and reframing (from deficit to outcome state)
The Miracle Question (describing the preferred future in detail i.e.
moving from aspirations to outcomes)
Scaling (Outcomes)
Identifying resources (in the broadest sense) and co-constructing
(SMART) person centred outcomes
SUMMARY
PCRs provide an evidenced based process that is in line with principles
and aims of the code, particularly in terms of the central position of
CYP and their parents/carers (Aspirations)
Integrated formulation allows shared understandings in line with
principles and aims of the code (sophisticated understanding agreed
between families and professionals regarding the nature of Needs)
Solution focused approaches provide an evidenced based set of
techniques in line with principles and aims of the code by which
meaningful Outcomes can be co-constructed from Aspirations
The Outcomes constructed/agreed then need to be pursued in an
evidenced based manner (separate issue)
To do this requires commitment and resources which need to be in line
with the principles set out at the start of this presentation…
KEY REFERENCES
De Shazer (1991) Putting Difference to Work New York; Norton
Fox, M. (2011) Practice based evidence – overcoming insecure
attachments Educational Psychology in Practice vol. 27 No. 4
Johnstone, L. and Dallos, R. (2013) Formulation in Psychology
and psychotherapy: Making sense of people’s problems
Routledge
Sanderson, H. Thompson, J. and Kilbane, J. (2006) The
Emergence of Person Centred Planning as Evidence Based
Practice Journal of Integrated care Vol 14, Issue 2
White (2015) Person centred reviews and transition; an
exploration of the views of students and their parents/carers
Doctoral Thesis University of East London accepted for
publication Educational Psychology in Practice
Next Steps
Upcoming dates
• Engagement of children and young people –
22nd June
• Residential –7th and 8th July (Leeds)
• Market development event – 24th Sept
• Residential – 3rd and 4th November (Milton Keynes)
• Local offer and meaningful Joint Strategic Needs Assessments – 10th Nov
Thank you
• [email protected]
• 07880 787190
• [email protected]
• 020 7974 6232