NEATH PORT TALBOT LOCAL SERVICE BOARD
Monday 14th March 2011
2:00pm to 4:00pm
Port Talbot Civic Centre Committee Rooms 1 & 2
AGENDA
1.
Welcome, introductions and apologies
2.
Notes of the meeting held on 10th January 2011
3.
Matters Arising
Main agenda
4.
Draft Health, Social Care and Well-being Strategy (attached) – Karen
Jones
5.
Draft Children and Young People’s Plan (attached) – Mike Catling
6.
Priorities from the Children and Young People’s Plan, Safeguarding
Children’s Board and other Partnerships (to follow) – Julie Rzezniczek
7.
Children’s Services Review (attached) – Julie Rzezniczek
8.
Neighbourhood Management (attached) – Phillip Graham
9.
Draft LSB Compact (attached) – Phillip Graham
10.
Community Spirit (attached) – Phillip Graham
11.
LSB European Social Fund - Communities First Proposal (attached) –
Victoria Seller
12.
Any Other Business
Matters for Information
13.
Dates of Future Meetings:
Monday 9th May 2011 at 2.00pm
Monday 18th July 2011 at 2.00pm
Monday 12th September 2011 at 2.00pm
Monday 14th November 2011 at 2.00pm
Monday 23rd January 2012 at 2.00pm
Monday 26th March 2012 at 2.00pm
Venue: Committee Rooms 1/2, Port Talbot Civic Centre
Membership:
Cllr A.H.Thomas
Neath Port Talbot County Borough Council
Steven Phillips
Neath Port Talbot County Borough Council
Mrs. Margaret Thorne
Neath Port Talbot Council for Voluntary Service
Mrs. Gaynor Richards
Neath Port Talbot Council for Voluntary Service
Hilary Dover
Abertawe Bro Morgannwg University Health Board
Paul Stauber
Abertawe Bro Morgannwg University Health Board
Mrs. Annie Delahunty
Public Health Wales
Supt Joe Ruddy
South Wales Police
Ken Wall
Mid and West Wales Fire and Rescue Service
Mrs. Mary Youell
Environment Agency
Mrs. Jocelyn Llewhellin
Jobcentre Plus
David Richards
Welsh Assembly Government
Julian Smith
West Wales Chamber of Commerce
Cllr A.P.H.Davies
Town and Community Councils
Agenda item 2
NEATH PORT TALBOT LOCAL SERVICE BOARD
(Civic Centre, Port Talbot)
Members Present:
10th January, 2011
Neath Port Talbot County Borough Council:
S.Phillips (Presiding Chairman), T.Clements, P.Graham, G.Andrews, Ms.K.Devereux,
G.Marquis and Mrs. A. Manchipp
Abertawe Bro Morgannwg University Health Board:
P.Stauber and Mrs.H.Dover
Public Health Wales:
Dr.A.Delahunty
Environment Agency Wales:
Mrs.M.Youell
South Wales Police:
Superintendent J.Ruddy
Mid and West Wales Fire and Rescue Services:
K.Wall
C.V.S.
Mrs.G.Richards
West Wales Chamber of Commerce
J.Smith
OBM.NPT LOCAL SERVICE BOARD.MINS11.LSB-100111-MIN
Agenda item 2
Town and Community Councils
Councillor A.P.H. Davies
Apologies:
Councillor A.H.Thomas, Mrs.M.Thorne, Mrs.J.Llewhellin, D.Richards and Chief
Superintendent M.Mathias
1.
MINUTES OF THE MEETING HELD ON THE 1ST NOVEMBER, 2010
The Minutes of the meeting held on the 1st November, 2010, were approved
as a true record.
Matters Arising
2.
PARTNERSHIP RATIONALISATION
The Board noted that a further Report in relation to Partnership
Rationalisation would be submitted to the next meeting to be held in March
and, following a request by Members of the Board this would be circulated
well in advance of the meeting.
3.
NEIGHBOURHOOD MANAGEMENT
Members of the Board noted that a report in relation to Neighbourhood
Management would be submitted to the next meeting to be held in March,
following consideration by Members of the Authority in February. This too
would be circulated well in advance of the meeting.
4.
ECONOMIC PROFILE
Members of received a detailed report in relation to the overview of
Enterprise and Development Activity in 2010, and in particular noted the
details of the support provided to business by the Local Authority together
OBM.NPT LOCAL SERVICE BOARD.MINS11.LSB-100111-MIN
Agenda item 2
with a breakdown of the people employed within different areas e.g.
Distribution, Hotel and Restaurants and Public Administration, etc.
In addition it was noted that the Third Sector had also seen an increase in its
business support activity and in particular in relation to the Future Jobs
Fund. A further report would be submitted for information purposes.
It was agreed that the report be noted
5.
AIR QUALITY UPDATE
Members received a presentation on the progress made in relation to
improving Air Quality in Neath Port Talbot. From the results it was
pleasing to note that the number of exceedances of PM10 levels remained
well below the permitted levels for the year although the exact figure would
need verification.
The Board also received an updated report, circulated at the meeting.
In relation to the implementation of the Air Alert System the tender for
implementing and running of the system would be advertised shortly
although the tenders specification was still under evaluation.
In addition Members were pleased to note that a protocol had been
developed between Health and the Planning Section of the Local Authority
to clarify which Planning Applications health should be consulted on to
ensure that they are kept informed of developments and able to comment on
any potential effects on public health.
A Communications Protocol had been written to ensure that the communication
staff from the different agencies were aware which agency would be
responsible for issuing press statements and responding to enquiries and in what
circumstances.
A further Air Quality event would take place in September aimed at the general
public and in particular young people from schools and colleges.
It was agreed that the report on the progress made to date be noted and the
project continue as a priority for 2011/12.
OBM.NPT LOCAL SERVICE BOARD.MINS11.LSB-100111-MIN
Agenda item 2
6.
LOCAL SERVICE BOARD COMPACT
The Board received a copy of the Bridgend Compact together with a further
report in relation to Local Service Board Compact. Following discussions of
the recommendations contained in the report the formalisation of Local
Service Board Compact across Neath Port Talbot was supported as it would
commit all partners to the work of the LSB and would be evidential of the
work being undertaken. The contents of the Bridgend Compact, which was
circulated with the agenda, was supported with the exception with the
funding code of practice.
It is agreed that CVS convene a Working Group with a view to providing a
draft Compact to the meeting of Local Service Board to be held on the 14th
March, 2011.
7.
ALCOHOL UPDATE
The Local Service Board received the joint report of the Head of Change
Management and Innovation and Head of Corporate Strategy in relation to
the Alcohol and Health review, with a view to progressing the
recommendations made by the Local Authority in particular the following:“that the Local Service Board (LSB) adopt alcohol as a priority project given
that alcohol misuse is an underlying source of antisocial and economic
problems and monitors any outcome from this review accordingly”.
It was agreed that the proposals 1-4 as contained in the circulated report be
supported by the Local Service Board.
8.
ESF UPDATE
Members were advised that the Welsh Assembly Government had confirmed
the bid for European Social Funding (which covers all LSB’s in the
convergence area) which would come into effect from the 1st January, 2011
until March, 2015.
OBM.NPT LOCAL SERVICE BOARD.MINS11.LSB-100111-MIN
Agenda item 2
There were two strands of the funding bid i.e. core funding for the LSB
Development Officer post and the second for specified projects. Two
projects had therefore been submitted i.e. the Air Alert System and the
creation of shared capacity and capability to accelerate the transformation of
local services.
It was agreed that the present position in relation to the European Social
Fund bid be noted, that the projects outlined in the circulated report be
supported and that a further report be presented on the matter of secondees
to the project.
9.
COMMUNITY SPIRIT
The Local Service Board received a report in relation to the future of the
Community Spirit and noted that due to budgetary issues some partners were
unable to continue to support this scheme. The report therefore outlined
options to reduce costs and it was now necessary to receive formal responses
as to continuation of the scheme.
It was agreed that formal responses be sought from partner agencies by the
4th February and that a further report be submitted to the next meeting of the
Local Service Board in March on the future of the Community Spirit.
10.
MEDICAL REPRESENTATION ON THE NPT ADOPTION PANEL
The Board received the report in relation to Neath Port Talbot Adoption
Panel Medical Advisor and in particular noted that Dr. Barnes, the current
Medical Advisor, had informed the Panel that he was only able to undertake
one Panel per month – leaving a shortfall of medical representation.
It was agreed that this problem be explored with the Abertawe Bro
Morgannwg University NHS Trust.
OBM.NPT LOCAL SERVICE BOARD.MINS11.LSB-100111-MIN
Agenda item 2
11.
DATES OF FUTURE MEETINGS
Monday 14th March, 2011 – 2.00pm
Monday 9th May, 2011 – 2.00pm
Monday 18th July, 2011 – 2.00pm
Monday 12th September, 2011 – 2.00pm
Monday 14th November, 2011 – 2.00pm
Monday 23rd January, 2012 – 2.00pm
Monday 26th March, 2012 – 2.00pm
CHAIRMAN
OBM.NPT LOCAL SERVICE BOARD.MINS11.LSB-100111-MIN
Agenda item 4
LOCAL SERVICE BOARD
14 MARCH 2011
HEALTH SOCIAL CARE AND WELLBEING STRATEGY 2011-2014
REPORT OF THE HEAD OF CHANGE MANAGEMENT AND
INNOVATION
Purpose of Report
1. To present the outcome of the public consultation exercise conducted
on the draft Health, Social Care and Wellbeing Strategy 2011-2014.
2. To present an amended Health Social Care and Wellbeing Strategy
which takes account of the outcome of the public consultation
exercise and to seek endorsement of that Strategy.
Background
The Council and the Local Health Board have a joint statutory responsibility
to prepare and publish a Health Social Care and Wellbeing Strategy for the
local authority area.
In November 2010, a draft Strategy was prepared, outlining the priorities for
action that it was proposed the Health Social Care and Wellbeing
Partnership should concentrate upon over the next three years. A public
consultation exercise was conducted for a period of three months, ending on
January 26th 2011. The consultation took the form of a number of face to
face presentations with community groups, distribution of the Public
Summary of the draft Strategy to a wide range of community bases (for
example, doctors’ surgeries) and use of the Council’s on-line consultation
package, Limehouse.
A report, detailing the responses received, is attached to this report
(Appendix 1) for information. Set out below are the changes it is proposed
that are made to the draft Strategy as a consequence of the public
consultation exercise. These proposed amendments have already been
Agenda item 4
considered and are supported by the Health Social Care and Wellbeing
Executive Board.
Proposed Amendments to the Draft Strategy
It can be seen from the consultation responses (130 in total) that there is
broad support for the priorities that were included in the draft Strategy. None
of the areas included in the draft Strategy were identified as areas that should
be omitted from the priorities. However, a small number of proposals were
received about additional areas for inclusion. Most of those comments relate
to work already in progress. However, there are two areas that the Executive
Board felt should be added to the priorities. These are:
Inclusion of Testicular Cancer as a priority for health
education/promotion, alongside Breast Cancer which is already included as a
priority. The Executive Board of the Partnership consider that there is merit
in including this area and that there would be resources to undertake some
additional health education and improvement work;
Inclusion of Stroke as a priority for service improvement. Many of the
causes of Stroke are covered by other priorities such as, taking more
exercise, smoking cessation etc. However, respondents were specific in
pointing out the need to enhance rehabilitation services locally and
Consequently, it is considered that Stroke should be included as an area of
focus. There is already work underway in the Local Health Board in relation
to this with improvement work concentrating upon the implementation of a
new Stroke Care Pathway. There are, therefore, identified resources for
taking forward this area of work.
As well as providing comments on the draft Strategy, 45 individuals or
organisations identified that they would like to become involved in taking
forward the improvement work. The Executive Board has asked that each of
those indicating that they wish to become involved are contacted to establish
more detail of the way in which people might become involved.
Amended Priorities for 2011-2014
Following the public consultation exercise, the draft Strategy has been
updated to include the two additional priorities described above. Therefore,
Agenda item 4
the proposed priorities for the three year period commencing April 2011 are
as follows:
 Reducing obesity;
 Reducing risk taking behaviours – concentrating on alcohol
consumption, smoking and sexual health;
 Increasing uptake of vaccinations and immunisation – focusing on
childhood vaccination and influenza;
 Improving support for emotional wellbeing – concentrating on support
at times of life crises eg divorce;
 Improving health in the workplace;
 Improving dental health in children and young people;
 Increasing cancer screening/self-examination – concentrating on
breast cancer and testicular cancer;
 Transforming Services for Older People;
 Developing Community Networks;
 Improving Community Mental Health Services;
 Enhancing community support for people with Learning Disabilities;
 Improving transition and transfers of care between settings;
 Reducing inequity in services for vulnerable groups – concentrating
on people with autism, carers and homelessness and vulnerable
groups;
 Improving services for people who have suffered Stroke – focusing on
the implementation of a new care pathway.
The strategy will formally be considered by the LHB in February 2011 and
by the Council on 24th March 2011.
Monitoring and Evaluation
Lead officers have been identified from across the Health, Social Care and
Wellbeing Partnership to take forward work in each of the priority areas
listed above. The detail of work to be undertaken over the next three years
will be presented to the Executive Board for agreement. The Executive
Board will be responsible for ensuring that work progresses and that any
barriers to bringing about the improvements sought are addressed. The
Executive Board will report to the Local Service Board on at least a six
monthly basis on progress.
Agenda item 4
Alongside the project plans, a set of outcome measures is also being
developed. These measures will help track the long term trends in health and
wellbeing amongst local people using the Results Based Accountability
framework (RBA). It is hoped that this work will dovetail with a new
independent report that the Director of Public Health intends to produce on
an annual basis.
Recommended
1. The Local Service Board consider the outcome of the public
consultation exercise that ended on 26th January and endorse the
addition of Testicular Cancer and Stroke to the priorities for action
described in the draft Health Social Care and Wellbeing Strategy for
2011-2014.
2. The Local Service Board endorse the amended Strategy attached at
Appendix 2.
Background Papers
 Draft Health Social Care and Wellbeing Strategy 2011-2014
 Draft Health Social Care and Wellbeing Strategy Guidance 2010
(draft):
Agenda item 4
DRAFT HEALTH SOCIAL CARE AND
WELLBEING STRATEGY
2011 - 2014
HEALTHIER NEATH PORT TALBOT
‘Making a Real Difference’
Consultation Results
Contents:
Part 1 - Survey Questionnaire Results
3 - 18
Part 2 – Presentations and Feedback (NPT)
19
Part 3 – Written Responses
20 - 21
Part 4 - Names and contact details of volunteers
22 - 27
2
Part 1 - Survey Questionnaire Results
130 survey responses
107 – (82%) via written survey
23 – (18%) via Limehouse (on line)
1. Do you agree with the following priorities that have been
identified as key issues that need to be tackled to help
improve health and wellbeing in Neath Port Talbot
1. Reducing obesity – helping targeted groups like children to eat better food and
get involved in more physical activity.
Yes – 96%
No – 4%
2. Reducing heavy drinking – helping people cut down on drinking where it is
getting to the point where it can harm their physical or mental health.
Yes – 96%
No – 4%
3. Reducing smoking – helping targeted groups like pregnant women, people
who need surgery and younger people to give up smoking.
Yes – 96%
No – 4%
4. Providing a more consistent approach to sexual health and relationship
education in schools – encouraging young people to have safe sex, reducing the
number of teenage conceptions in the 13-15 age groups and an overall reduction
in sexually transmitted infections.
Yes – 93%
No – 7%
5. Increasing vaccinations – encouraging more people to get their children
vaccinated to make sure that they don’t get childhood illnesses that can harm their
health and making sure that older and disabled people get their annual flu
vaccinations.
Yes – 90%
No – 10%
3
6. Improving mental health – helping people who are in a lot of distress to get
support in the community sooner to stop them from becoming ill and harming
themselves.
Yes – 97%
No – 3%
7. Improving health at work – helping people to stay healthy at work so that they
do not lose work through ill health.
Yes – 90%
No – 10%
8. Transforming older people services - continuing to join-up services between
the NHS and the council to make sure people get the help they need at home as
far as possible or in modern care homes or houses where support is provided.
Yes – 97%
No – 3%
9. Developing community networks – ensuring that integrated health and social
care community network teams are established within the county borough.
Yes – 96%
No – 4%
10. Reducing inequity of access to services for vulnerable groups – ensuring
that vulnerable people such as those with autism, mental health and carers get the
services they need.
Yes – 98%
No – 2%
11. Improving services for disabled people – re-designing the way we deliver
community care services for people with mental ill-health, learning disability,
physical and sensory disability and autism.
Yes – 98%
No – 2%
12. Improving transfer from one service area to another – we will continue to
work towards getting people home from hospital quicker and with the right support.
We will also make sure that children who are disabled can get help from adult
services without having to wait when they get to 18 years of age.
Yes – 96%
No – 4%
4
13. Improving health care services for homeless people – helping people who
are homeless to see a doctor or other health worker where needed.
Yes – 93%
No – 7%
14. Dental Health of Younger Children – to understand why there are a
significantly higher percentage of delayed, missing and filled teeth in children under
the age of 5 across the county borough, which is 64.48% compared to the Welsh
average of 52.63%.
Yes – 93%
No – 7%
15. Breast Cancer Screening – to ensure health promotion campaigns on breast
cancer screening are appropriately targeted within the county borough.
Yes – 97%
No – 3%
5
2. If you have ticked “NO” for any of the above priorities,
please tell us why you feel they should not be included:
Priority 1- Reducing obesity
1. Its up to parents to monitor a child’s eating habits
2. Parents will decide what is suitable for their children. They can see whether or
not their children are fat.
3. Financial support and encouragement, as well as education, to eat well be
healthy. Support & incentives to be more active/exercise.
Priority 2 – Reducing heavy drinking
1. Not sure how you would help people drink less. Charge for treating those who
are drunk as this is self inflicted or refuse to treat them
2. We decided whether or not we smoke or drink too much. This town honours a
deceased actor who drank and smoked himself to death at an early age. In fact he
is used as an example of success in life.
3. Improved support to the indigent homeless, access to appropriate
supported/supervised accommodation being the most obvious.
4. If people don't know they are harming themselves by drinking too much they are
not going to listen to anyone.
Priority 3 – Reducing smoking
1. This day and age enough info is out there to what the dangers of smoking are
2. Should not be included
3. Should include older people
6
Priority 4 – providing a more consistent approach to sexual health and
relationship education in schools
1. Youngsters should not be encouraged to have safe sex at all
2. Even though I have ticked yes I feel that the ages identified are too late you
should be targeting younger age groups - junior schools and up so that you give
info from 9 - 10 years upwards, not making it taboo or dirty.
3. Should be encouraging youngsters not to have sex. Otherwise show them films
or pictures of male and female genital diseases
4. I agree that children 13 to 15 age group should be encouraged not to have safe
sex but to refrain from having sex until they grow up first and can then take on the
responsibility of parenthood
5. Sex education is much required for the younger persons. Having a single
parent(s) in a lot of occasions, they are given living accommodation by their local
council. This again in essence as to be paid for by the council finances. Single
parents should be helped by their parents for not educating them of their
consequences
6. Children should be taught that sexual intercourse starts when married. I cannot
agree to encouraging young people to indulge it.
7. Promotion of abstinence from sexual activity would be applicable at the ages of
13 - 15 - my understanding is the age of consent is 16.
8. Mechanics of sex education is useless unless responsibilities and consequences
are also taught
9. At face value, 'encouraging young people to have safe sex' lends itself to be
taken out of context as saying. 'It's perfectly alright for you to enjoy casual sex just
do it safely'. The strategy encourages the view that nicotine is best avoided. We
should likewise warn young people against casual sex; making them particularly
vulnerable to STD's, and unwanted pregnancies.
10. Port Talbot & Afan Women's Aid is currently running STAR project across
schools in NPT addressing healthy relationships with C & YP. Feedback so far very
positive and big lottery has funded continuation for next two years.
11. All the money already spent on sexual education has been wasted its not
working.
7
Priority 5 – Increased vaccinations
1. Vaccinations are a personal choice!
2. I don’t believe in mixing MMR into 1 injection or even flu and swine fever into 1
never mind proposals for more
3. Should not be included
4. Returning the vaccinations to the care of doctors who could place nurses in
clinics and schools to provide these vaccinations
5. Personal decision. Not compulsory to make everybody have vaccinations. At 68
years I'm a testimonial that it hasn’t been necessary
6. Please read "vaccinations are they really safe and effective" by neil miller.
7. Parental choice is important in forming decision making
8. So many reports of unsafe vaccines - driven by greedy operators should not be
allowed
9. I feel they are controversial seem to make more problems
10. Although this is cited in the strategy as a clear need within NPT. I wonder if this
is an information giving agenda which could be carried out via the family
information service for example rather than under AMBU priorities. I don't disagree
with the value of it in itself but wonder if some of the other issues may receive this
priority status instead.
11. Contentious - a sell - the point of the survey? Yes!
Priority 6 – Improving mental health
12. To have an improved and quicker response to the needs of people who suffer
with a phobia e.g. OCD to avoid the illness of depression
13. There are enough so called help available to create more is a waste of time
and money.
8
Priority 7 – Improving health at work
1. This should be done by the employer - not NPTC unless NPTC is the employer
2. Surely this should be the responsibility of the employer
3. There are already regulations about health and safety at work. If problems
employer can refer employee to own doctor
4. Wording unclear. Cannot fathom what this question entails
5. People must accept responsibility for their own health. Whether or not pursuing
these "priorities" saves the NHS money (difficult to calculate) should not be taken
into account. Personal freedom to make (disastrous) decisions about our way of
life is more important.
6. Unsure how this could be achieved
7. I believe whilst there is a role here, to promote the duty of employers for the
health of their employees, it may not be a priority.
8. Whilst I believe there should be safety at work, too much money is invested in
pandering to some workers "needs" i.e. state of the arm chairs, special desks etc
this expenditure is rife in the public sector.
9. Could this priority be cited within employer’s remits and shift the focus of
strategic implementation away from AMBU?
10. People should be encouraged to help themselves to stay Healthy it’s becoming
a nanny for every one
Priority 8 – Transforming older people services
1. Against privitisation of health and social care services. Private health care
generally = less well trained staff, less qualified staff, less well paid staff hence less
motivated staff. Nothing against those who work in private health as individuals, but
generally speaking, they are less well motivated, trained and qualified as 'in house'
staff. Do we want the most vulnerable and sick being looked after by such staff.
2. Should not be included
3. This is definitely an issue, there are many older people who need help and
support which is very scarce at the moment. The need to supervise the carers is
essential as some of them do not fulfill their obligations as they should
9
4. We have indicated a no to Q8 to make a point but in principle it should be yes.
However, how can you transform older people's services by withdrawing non
prescription tablets from Doctors surgeries. Recently the health board has declined
to pay for all non prescription tablets for pensioners who are currently struggling to
make ends meet. The surgeries indicate their hands are tied. A considerable
amount of pensioners rely on these tablets to help with pain relief, they have now
been told if they want them they have to pay for them.
Priority 9 – Developing Community Networks
1. Again unsure how this could be implemented
2. Teams enough already. Health Visitors, Social Workers what’s to happen to
them they do a good job leave it to them.
Priority 10 – Reducing inequity of access to services for vulnerable groups
1. Move up the listing of importance for Direct Payments
Priority 11 – Improving services for disabled people
1. They all get better treatment than able body people
2. I am a publicist and presenter on ADHD and all hidden impairment it is vital that
all voluntary organisations local and national keep it on the agenda.
Priority 12 – Improving transfer from one service area to another
1. I pay my tax and I want hospital care not home care
2. Hospitals send people home after operations ASAP as it is now. The last thing a
person wants is to be transferred to another hospital
3. Priority 12 is two priorities
Priority 13 – Improving health care services for homeless people
1. Get a job
2. The service is already in place
10
3. It is my own belief that most homeless members of the public, is caused by
disputes in the home, thus then apply to the local council for board and lodge,
causing additional burdens on the Council's finances
4. To help these people they need to be taken off the streets to help e.g. "Big
Issue" it works
5. Every Citizen has the right and choice to live however they wish 'who would
oversee this”
Priority 14 – Dental health of younger children
1. Yet again it’s up to parents to encourage good dental care
2. Where there are youngsters in need of dental treatment it is up to the parents to
address the problem
3. Dentistry. The need for much-improved and cohesive service catering for the
NPT community of all ages and at all levels. NHS treatment, as a provision, needs
to be re-established more widely and incentivised. This may be achieved, possibly,
by encouraging Eastern-European practitioners into the area with stipulations upon
the volume of NHS work that must be undertaken.
4. Why do you need to know children eat too much sweets bad diet. I don't need to
be paid to tell you that.
Priority 15 – Breast cancer screening
1. Breast cancer screening has been available for several years. Surely you
already have effective methods of ensuring those who need it are aware of how to
ask for it.
2. I’ve heard that each time a breast x ray is taken the risk of breast cancer
increases but I can't recall at the moment where I heard that.
General
Get a focus on cleaning up the air and stop people smoking . That's treating the
cause of lots but not all of the other items.
Some of the things I have ticked 'no' to are available already, and I feel that if the
others I ticked 'yes' to were addressed first, the money saved from this could then
be used to improve other services at a later date.
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3. If there any priorities you feel we have missed, please list
them below and tell us why you think they should be
included
1. Suicide / Mental Health / Dementia
- Reduce suicide - although this links to mental health.
- Mentally ill young and older people need greater care in the community and the
provision of help much sooner before they try harming themselves.
- Help for children / adults aged between 16-18 years old who cannot get access to
mental health services
- I strongly agree with any help with mental health. My son is severely depressed
and has to wait around 2 years for therapy. Absolutely disgusting!!
- No I think that all area's have been fully covered but I would like to see improved
services for those who are experience Mental Health difficulties to make their stay
in hospital a more positive one.
- Supported Housing for adult mental health disorders eg: AD HD Training &
Support Group Leaders - to all who need knowledge to have a more empathetic
attitude and understanding and families. Funding Core Support Groups - Like
ADHD and hidden disabilities.
- Post Traumatic Stress Disorder - retraining psychiatrist to recognise difference
between PTSD and other mental disorders for example schizophrenia. PCT & CBT
- Dementia - as above Alzheimers - as above As a full time carer and having the
experience we have gone through the last 3 years I hope I will be of help to deliver
some of the priorities
- As the list is not prioritising the correct order of peoples need's mental health
should be No3 smoking further down and supported housing needs are also not
provided for.
2. Stroke / Chronic Conditions
- Stroke patients have to be sent to Bridgend or Swansea, losing valuable time,
instead of having emergency facilities in Port Talbot hospital
- Not enough support during and aftercare in the community
- There are references to chronic conditions in the document, but we were
disappointed to see that these did not feature explicitly in the priorities for the
strategy. The burden that these conditions place on patients and the NHS is
already enormous and is likely to increase as our people live longer. It is therefore
essential that chronic conditions are fundamental to any approach to health and
wellbeing and that any strategic plan fully integrates services across both health
and social care.
- Reduce rates of diabetes, heart attacks and strokes. According to latest Welsh
Health Survey, NPT has some of the highest local authority rates in Wales.
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3. Drug Misuse / Domestic Violence
- Increasing heroin problem with borough in particular major health issue
- There is not enough mentioned regarding misuse of drugs and controlled
substances. When the plan seeks to develop community integrated services to
prevent people from going into hospital unnecessarily it is obvious that those
individuals who are drug abusers clearly fall into this objective. As you are aware
the unfortunate deaths from drug abuse, the number of overdoses and the amount
of demand that drug abusers place on the NHS in all its forms including mental
health, G.P.
- To stop under - aged children and adults not to use solvents
- Ambulance and A&E services must be high. The effects of drug abuse are costly
to society and are cross cutting in terms of its impact on all services that partners
provide. The very fact that drug abuse sadly affects all ages especially young
people and those who are most vulnerable as well as having an ever growing
market should be reason enough for its inclusion in the plan. The drug abuse
problem has been with us for several decades therefore I would expect a high level
strategic plan to focus on joining up local services and seeking long term solutions.
Tackling Drug Abuse would fit in well within the parameters of section 3.4
LIFESTYLE AND HEALTH IMROVEMENT
- Reducing drug dependency and improving services for substance misuse,
particularly drug detox. Reducing the increased drinking amongst children and
associated behaviour and violence
- Drug Misuse Domestic Violence Prompt Response Avoid Crisis - Avoid Hospital
Admissions
- Domestic Abuse - high incidents of domestic abuse in NPT. Affects health of
individual in many ways - hospital admissions/homelessness/heets/drug/alcohol
misuse affects ability to work/mental health etc.
5. Testicular / Prostate Cancer
- Screening for Men - Increase in testicular cancer why can’t this be included as
one of your priorities.
- Screening for prostate cancer which results in more deaths than breast cancer
- Male Testicular Cancer Screening - Should become a priority - too often
discovered late when early testing would prevent possible surgery
- No mention of male screening for prostate enlargement - poss prostate cancer equal opportunities. As a male why not test from the age of 50?
6. Transport
- Provide transport to local doctors
- Transport to Medical Centres etc at cheaper rate than taxis. The new centre in
Port Talbot is very difficult to get to from Neath and other places. Taxi fares are
very expensive. Neath to Port Talbot about £11
- Free Transport for old people to get to surgery.
- Car Park - Car park at new surgery needs to be made larger, as it is a struggle to
park at peak times
13
7. Access
- Doctors Surgery - Access to the Doctor's Surgery. Must cover 6 days out of 7
days if possible. Ideally 7 day cover.
- Dental Surgery - NHS access to all dentists and more surgeries please. With the
volume of people per community, preposterous how little dentists there are inadequate service
- Neath and Port Talbot have the highest number of people with ill health and
disabilities. And we do not have a proper hospital all services are being taken away
A & E. By A & E and people are being made to travel further for care and they are
a deprived community. The people of Port Talbot should have access to a local
casualty department and hospital not made to travel to Bridgend or Morriston.
- Full A & E 24 hours
- Day Centres - we need more. Many older or disabled people do not have access
to day centres and are very lonely. Mental Health 8. Afan lido
- The lido has to be rebuilt asap for the health and well being of all
- Provide a swimming pool in Port Talbot
9. Air Quality / Flooding
- Air quality and flooding.
- Cleaning up the air, we've been playing around with this for long enough.
10. Smoking
There is little information on around how Neath Port Talbot is going to
comprehensively reduce smoking rates. In terms of the actions outlined under
smoking there is a mention smoking cessation through Stop Smoking Wales.
However in order to have a comprehensive local tobacco control strategy there
needs to be some action areas around: 1. Promoting a smokefree culture through
a smokefree living initiative, through promotion of smokefree trust premises, and
smokefree children play areas 2. Reducing the uptake of smoking through
preventing young people from starting to smoke and reducing access to tobacco
products by young people. 3. Reducing smoking prevalence levels through
smoking cessation especially for priority groups such as smoking in pregnancy,
mental health and young people, through GP, pharmacists, and secondary care,
workplace initiatives, increasing knowledge of smoking cessation and tobacco
control. 4. Reducing exposure to secondhand smoke by promoting smoke free
environments, promotion of smoke free homes and smoke free cars. It is important
that there is engagement on tobacco control issues through GP and dental
engagement in tobacco control and pharmacy engagement through training of
pharmacists in level 3 scheme smoking cessation. This means that they are able to
deliver both smoking cessation medicines and behavioural support.
14
11. Health Screening / Advice
- Annual basic screening at Dr's for all for blood pressure / weight / cholesterol etc
(some Dr's do this other do not). Early diagnosis would prevent future big
expenditure on hospital / surgery etc.
- Well-Person Clinics at Doctors Surgery - Compulsory for surgeries. Regular,
scheduled clinic to check on people at risk eg. Borderline diabetics screened
regularly, referral and help for obese people to see obesity specialist and
counselling (they may have eating disorder). Old people screened for health
regularly. Yearly, checks for previous breast cancer patients over 60.
- dietary advice (and free wholesome food cookery classes) for anyone in the
borough. re next question below, i don't understand it.
- More work with parents on developing "parenting skills" from when babies are
born i.e. eating / exercise / teeth for kids and parents
- Maybe speakers to different organisations explaining what is (help & support)
available to certain groups – e.g. Pensioners
11. Finance / Resources
- NHS usually provide free service (not for spectacles or dentist) so charge a fee to
treat self-inflicted or deliberate injuries Efficiency - Reduce excess managers. No
golden handshakes or other bonuses. Liaise with other NHS areas before ordering
new ambulances etc to ensure you buy best value for money Re Priority 8 - Ensure
older patients ready to be discharged are move to care homes promptly. This delay
(bed blocking) has been around for years, so why are you still "continuing to join-up
services" ? Presumably NHS charges social services for "care that should be
provided by social services" This is problem for social services, not NHS
- Not all - as I've explained we just have not got the money to do everything for
everyone. What needs to be taught is people have to learn to take care of
themselves and each other we should not need nanny's if we grow up - we do
need help if we are old, young or ill.
- Have enough staff eg. Social Workers etc, to carry out the priorities mentioned,
there are long delays arranging the services to be put in place.
- Change the 0844 number to Doctors surgeries, this is costly, an 0800 number
should be provided. Most hospitals have free parking, but Neath Port Talbot still
charge, is this fair?
12. General
- Although the Older Persons Council do not feel that there are priorities that have
been missed, and applaud the Local Authority for the proposals in this document.
However we feel that some of the priorities are of vital significance to those over
the age of 50, but they do not have a measure in place to support that sector of the
community. Such priorities are: Improving mental health Not only in the realms of
dementia, but also considering an older persons general emotional wellbeing which
can have a significant impact upon many aspects of their life. Areas of their life that
15
can be affected can include their working life and issues such as social isolation,
which will subsequently influence their health, wellbeing and independence.
Reducing inequality of access to services for vulnerable groups Very often it can
be the elderly who are may receive an inequitable service. Improving health care
services for homeless people Many homeless people are older people who are
particularly vulnerable to many of the hardships suffered by the homeless
population. Providing a more consistent approach to sexual health and relationship
education in schools. Whilst acknowledging that support and a more consistent
approach for young people is an important issue. As has been emphasised by the
Family Planning Association in their Sexual Health Week this year, the age group
with the greatest increase in incidences of STIs are those over the age of 50, a
category which should not be ignored. Transforming Older People Services There
is no reference to the enormous support and vast array of services which
contribute towards maintaining and improving the quality of life for older people
thereby supporting their health, wellbeing and independence. The Older Persons
Council also wishes to express our concern that the document makes little
reference to the either the consultation of Older People, or the population in
general, when deciding upon these priorities or the measures to address them.
Whilst reference is made to the Voluntary Sector, the document mentions little
about the engagement of people to support the actions to address these priorities.
Head injuries - No help after when seeing and talking to someone like Dr Weddal
(Morriston Hospital) he has helped so many people In the Afan Valley (top) we do
not have the clinics that other areas have now. Bring us upto the starting blocks
before promising all these extra support services. Where is all this extra support
going to come from. There is no support medical after opps at home. If the support
at home is going to the medical trained yes I do support you. If you put carers in
these positions I am not. Volunteers do not and will not work.
- You state "it takes a long time for people to change their lifestyle(s)". Your priority
is to find why and do they want it changed. You state the NPT has a higher number
of people with ill health and disability. Make it your priority to find out why this is so
and let us know. What is wrong here ? 1. Near sea 2. West coast dampness 3.
Hills overlooking us 4. Industry 5. Motorway 6. Stupidity (unlikely) 7. Nearness of a
dominant country (England) 8. Desire to be cared for (Socialism) 9. Devolution only
partial (inferiority) 10. False claimants 11. Spineless GP's 12. One hopes the whole
exercise is not just a "job creation" scheme
- to increase number of doctors competent in their skills dismissal of all
psychiatrists as irrelevant to help Cancer diagnosis - re-training to increase
competence in diagnosis of breast cancer. Re-skilling surgeries in performing
operations. Re skilling these in after-care and in ethical behaviour. Dismissal of
those who kill - those whose incompetence’s results in a high lethal record over 2 24 months after treatment.
- Cervical screening
16
- Old Age Help Less welsh i.e. signs, letters, paper, More nurses, more doctors,
less pen pushers
- Toilet - Urgently needed in West Ward, on seafront re lots of OAP's use prom
- On-Line appointment booking. More Accurate Prescription keeping in health
centres as many appear to go missing leaving you going on a wild goose chase
between chemist and surgery.
- Although I support all the things listed I have more than enough ensuring our
association runs viably. I am unable to fit in as my wife is mentally needing my help
plus my own requirements (Parkinsons and diabetes). I think this answering with all
its mistakes. It is a chore to do forms like this.
- More support for families with disabled children
- Easier referral to Day Centres - this currently can take months! G.P's should be
able to make referrals. Most of the current paperwork is not necessary.
- Home Treatments available - if confined to home due to illness eg. Chiropody
- Community pharmacy is well placed to support theses priorities and improve the
health and well being of the population living in the Neath Port Talbot environs and
yet has been excluded in the list of community services that have an influence or
the potential to address some of the health inequalities that have been identified in
the consultation document
17
4. Do you support the work we are going to undertake to
deliver the priorities?
Yes – 93%
No – 7%
If no, please tell us why:
1. Pick a small number and sort these for good, then move on to the others. You
could have listed most of these items as problems 20 years ago. There are not
many success stories are there?
2. Whilst agreeing to all priorities with reference to priority 8, emphasis should be
placed to ensure if care home support is required then that should be offered near
patients normal place of residence and not requiring long journeys for families to
visit.
3. In your letter you say that you are "setting out key priorities. However, there are
no details on how you propose to implement them, or pay for them 2. Recently,
there have been suggestions that GP's should be responsible for NHS spending.
There is no mention of this anywhere in this document. I would like response to
my comments
4. In PART - some suggestions are costly and in this economic climate you would
be employing more administrative staff to oversee a costly paper exercise in part.
5. No detail - not convincing this survey has value or may be used out of context.
5. Would you like to get involved in the work we are going to
do to deliver the priorities?
Yes – 40% (45 no.)
No – 60%
Names and addresses supplied (see pages 22-27). 67 respondents stated they
DID NOT wish to be involved
45 respondents stated they DID wish to be involved (details above – 1 did not
provide contact details)
18
Part 2 – Presentations (NPT)
1. BME Forum – 3 November 2010


NPT Tigers offered to assist to help gather this information as well as
highlighting that their work in getting more people active in the various
communities has had a positive effect – a number of participants have cut
down or given up smoking since taking up sport
SBREC also offered assistance on this issue and any relevant data for the
various communities would be provided
2. Communities First Coordinators – 9 November 2010

Will provide written response
3. Youth Council – 17 November 2010
4. Older Persons Council – 25 November 2010

Highlighted prostate screening missing as a priority
5. Social Services Health & Housing Scrutiny Committee – 12 January 2011





Overall agreement with the priorities
Highlighted prostate screening missing as a priority
Low breast cancer screening rates – could be as a result of the location of the
vans?
Shouldn’t be encouraging young people to have safe sex. Possible substitute
– Warning young people of the dangers of unprotected sex”
Query re “inequity”?
6. Supporting People Provider Forum – 14 January 2011

No feedback during presentation. Encouraged to send in responses.
7. Older Persons Council (Consultation Forum) – 20 January 2011

Query as to why “Transforming Adult Social Care” (TASC) is not included as
a priority being as TOPS is there
19
Part 3 – Written Responses
1.
Communities First NPT Sub Wards
2.
Communities First (Central Support Team)
3.
Neath Port Talbot Council for Voluntary Service
Are the following priorities for other partners and not ABMU strategic
direction?



Sexual Health –
Increasing Vaccinations
Improving health at work
Missing priorities:





4.
Cwmllynfell Community Council

5.
Supportive of key priorities
Swansea Bay Racial Equality



6.
Transport
Eating disorders
Preventative and early Intervention
Drug Misuse
Domestic Violence
More inclusion of BME communities in consultation & improving
accessibility for gypsy traveler communities to access services being
provided
More pro-active work at grass root level through channels of
communication
Tailored action plans to link strategies directly to BME communities
Grace Halfpenny (NPT) – Older Person Strategy development Officer



Not enough relevance placed upon the contributory factors that support
wellbeing e.g. transport, maximization of income, economic activity
No reference to ongoing engagement
Some specific comments on rewording
20
7.
Neath Port Talbot Older Person’s Consultation Forum




Lack of proposals for further development of collaboration with
voluntary sector
Little or no reference to consultation with older people themselves
when assessing their current and future “Health Needs”
Little reference to mental health – only refers to those “already in a lot
of distress” what about those who have not quite yet fallen into this
category?
Not acknowledgement of the Prevention and health Promotion Project
within TOPS
8.
Colin Evans (NPT) – Env Health & Housing Enforcement
9.
Association for the Welfare of Children in Hospital


10.
Community Safety Partnership (NPT)


11.
Highlighted domestic abuse as a topic that merits mention as a
significant issue in the Strategy
Issues surrounding young people require greater prominence in the
plan (few references to the CAMHS)
British Lung Foundation (Wales)

12.
No mention of attacking drug abuse
Children and YP who need hospital care have been bypassed by the
system. This group needs to be specified in all planning documents
Disappointed to see that chronic conditions did not feature explicitly
in the priorities
CRUSE Bereavement Care


Attention drawn to the many bereaved people in NPT who have
family members who have completed suicide episodes
Also to those who have become isolated from their own communities
either because they have been Carers or have complex grief issues
and can no longer face the outside world.
21
Contacts details for persons who wish to remain involved in delivering the priorities
Name
Organisation
Email/ Telephone
Rhian Gadd
NPTCBC
[email protected]
Colleen O'Callaghan
Mental Health Rehabilitation Service
01639-620859
John Cardy
[email protected]
Address
Mental Health Rehabilitation Service
Lower Caewern house Heol Illtyd
Caewern Neath
SA128ur No98
Neath Police Station Knoll Park
Road, NeathSa11 3BW
Supt Joe Ruddy
South Wales Police
[email protected]
Michelle Williams
UBM University NHS
07855685454
127 Tyn y Twr, Baglan Port Talbot
07905661830
60 Brynhyfryd Road, Briton Ferry
Maria Catherine Bradley
Clive Owen
15 St Albans Terrace Taibach SA13 1
LW
Older Persons Council
Chris Velly
01639 729078
Mrs J Ivey
[email protected]
Lauriel Fraser
0783074751
22
46 Gwilym Road, Cwmllynfell SA9
2GN
13 Addison Place, Port Talbot
Contacts details for persons who wish to remain involved in delivering the priorities
Name
Organisation
Email/ Telephone
Address
01639 761726
Woodview, 8 Ferry Close, Briton
Ferry, Neath SA11 2RW
01639 689001
11B Regent Street, East Briton Ferry,
Neath SA11 2RR
William Morgan
01639 831244
4 Pen-y-Bryn, Cwmllynfell, Abertawe
T. Kristel
01792 817087
40 Lon Glynfelin, Longford, Neath
SA10 7HU
Anita Wusthoff
Ros Walsh
Staff nurse
Brian P Woolfe
CVS
01639 644692
Ynysygerwn Farm, Aberdulais, Neath
SA10 8HL
Tess Phillips
Port Talbot Stroke Club
01639 792907
"Gwyddfryn" Cwmavon, Port Talbot
SA12 9DF
Tia Bowen
NPT Youth Council
01639 632110 / 07837137405
Colin Johns
Melin Walkers
01639 632696
Barry Miles
British Red Cross
[email protected] 01639
644914
Kathleen Donoghue
CVS Mental Health Forum
01639 888732
23
12 Tonmawr Road, Pontrhydyfen,
Port Talbot. SA12 9UB
10 Addison Road, Neath SA11 2AY
159 Victoria Road, Port Talbot SA12
6QH
Contacts details for persons who wish to remain involved in delivering the priorities
Name
Organisation
Email/ Telephone
Rona Howells
Carer
01639 722513
32 Hays Crescent, Glynneath SA11
5BE
Mrs G Morris
Older Persons Council
01639 776352
5 Wilmot Street, Neath SA11 1AH
Craig Williams
NPT Social Services
[email protected] 01639 763436
D G Williams
Address
Civic Centre, Port Talbot SA13 1PJ
01639 633443
Flat 2 Millers House, Briton Ferry
Road, Neath SA11 1AA
Anne Learmonth
MDF Cymru and ex Speech and
Language Therapist
01792 830992
1, Pen y graig, Alltwen, Pontardawe
SA8 3BS
Clive Owen
OPC / CRUSE / CAB
[email protected]
15 St Albans Terrace, Taibach SA13
1LW
C F Whitefoot
Cwmafan Old Time and Modern
Sequence Dance Club
01639 770275
9 Herne Street, Briton Ferry, Neath
SA11 2PY
Mr Jones
Radio Phoenix
01792 425775
36, Siding Terrace, Skewen, Neath
SA10 6RD
[email protected]
24
Contacts details for persons who wish to remain involved in delivering the priorities
Name
Organisation
Email/ Telephone
The Chair C/o Grace Halfpenny
Neath Port Talbot Older Persons'
Council
[email protected] 01639
763418
Linda Hobbs
NPTCBC - SSHH
[email protected]
c/o Trem y Glyn RCH&DC Rear of
Park Avenue, Glynneath. SA11 5DW.
[email protected]
13, Bryn Terrace, Melincourt, Neath.
SA11 4AS.
Angela & Keith Davies
Address
NPT OPC C/o Grace Halfpenny,
Corporate Strategy Unit, NPTCBC,
Port Talbot Civic Centre.
Julie O'Shea
Port Talbot & Afan Womens Aid
[email protected]
Andy Senior
Action for Children
[email protected]
02920222127
Action for Children, St Davids Court,
68a Cowbridge Road, East Cardiff.
CF11 9DN
Jean Jenkins
Glynneath Town Council
01639 720566
Ardwyn, 19, Cefn Gelli, Cwmgwrach,
Neath. SA11 5PD
Stuart Davies
Dulais Valley Partnership
[email protected]
Old Telephone Exchange, Brynhyfryd
Terrace, Seven Sisters, Neath. SA10
9BA
25
PTAWA, PO Box 20, Port Talbot.
Contacts details for persons who wish to remain involved in delivering the priorities
Name
Organisation
Email/ Telephone
George Hussey
(Obesity Priority)
Address
[email protected]
3 Margaret Street, Velindre, SA13
1YP
Rhian Evans
Barnardo's Neath Port Talbot
[email protected] 01639
620771
19-20 London Road, Neath. SA11
1LE
Joan Jones
Parkinsons Support Group
01639 851787
3, Brynheulog Road, Cymmer, Port
Talbot. SA13 3RR
Graham Joseph Green
Wales AD/HD & Hidden Impairments
01639 646966
17 Curtis Road Neath SA11 1UW
Charles Morris
SA13 1LU number 14
Mrs Rachel Gill
[email protected]
9, Border Road, Port Talbot, SA12
7EE
British Lung Foundation Wales 6a
Prospect Place Swansea SA1 6QP
Kevin Sullivan
British Lung Foundation Wales
[email protected]
Grace Halfpenny
Older Persons Consultation Forum
[email protected]
Grace Halfpenny
Prevention & Health Promotion
Project (TOPS)
[email protected]
26
Contacts details for persons who wish to remain involved in delivering the priorities
Contacts from written responses who would like to get involved:
Marie Shufflebotham
Communities First sub ward team
[email protected]
Julie Davies
Communities First
[email protected]
Afan and PT’s Women’s Aid
Priority 4
Cruse Bereavement
Priorities 2,6, and 10
Alzheimers Society
British Red Cross
Priorities 2,6,8,9, 10, 12 and 13
Care and Repair
27
Agenda item 4
DRAFT
HEALTH SOCIAL CARE AND
WELLBEING STRATEGY
2011 - 2014
HEALTHIER NEATH PORT
TALBOT
‘Making a Real Difference’
HSCWB Strategy
1
Agenda item 4
CONTENTS PAGE
Section
1
Introduction
Pages
4
2
The Health Social Care and Wellbeing Journey to Date
6
2.1
Phase 1 – HSCWB Strategy 2005 - 2008
6
2.2
Phase 2 – HSCWB Strategy 2008 – 2011
8
* QUICK GLANCE SUMMARY
12
3
The Needs of the Population of Neath Port Talbot
13
3.1
General Population Information
13
3.2
Dimensions of Social Difference
16
3.3
Wider Determinants Impacting Health
20
3.4
Lifestyle and Health Improvement
24
3.5
Community Care Services
30
* QUICK GLANCE SUMMARY
38
Moving Forward – ‘Making a Real Difference’
40
Health Improvement Priorities
41
Service Remodelling and Integration Priorities
45
* QUICK GLANCE SUMMARY
48
5
Resource Challenges and Opportunities
49
5.1
NPT Forward Financial Plan 2009 – 2014
49
5.2
ABMU Health Board
52
6
APPENDIX 1
54
4
4.1
4.2
National and Local Strategic Influences
HSCWB Strategy
2
FOREWORD
Improving health is at the heart of the work our organisations carry out.
We have many things to be proud of in Neath Port Talbot. We have
natural assets that compare with the best – our Afan Forest hosts one of
the top ten mountain-biking destinations in the world, our Aberavon
Beach boasts the coveted Blue Flag and our parks are pleasant and
attractive destinations for both local people and visitors from elsewhere.
We also have a strong track record in delivering excellent public services
which are valued by local people and we value the strong partnerships we
have with communities, with voluntary organisations, private and
statutory sectors which are vital in ensuring we are continuously working
to improve the quality of life for local people.
Yet, despite all of the strengths we have, the health of local people is,
generally, poorer than the rest of Wales.
This is the third health social care and wellbeing strategy for Neath Port
Talbot. It reaffirms our joint commitment to improving health for
everyone whilst also reducing the gap between the most healthy and the
least healthy and improving access for those who need treatment and
support.
There have been important changes to the Partnership including the
newly formed Abertawe Bro Morgannwg University Health Board
(ABMUHB) which is committed, through the re-organisation of the NHS
in Wales, to providing stronger community focussed healthcare. Through
a one year old integrated health organisation we want to strengthen health
promotion services and do more to prevent the incidence of ill health.
This Strategy commits both the Council and the Health Board to a greater
focus on the things that will make the most difference and we are both
committed to working together in developing this strategy as the means
for achieving better access for all to healthcare and to help people live
healthier lives. The emphasis is on making the right difference for local
people. This is especially important at time of considerable public sector
spending cuts.
Cllr. A. Thomas
Leader of Neath Port Talbot
County Borough Council
HSCWB Strategy
Mr. W. Griffiths
Chair
ABMU Health Board
3
1.
INTRODUCTION
The statutory responsibility for Health Boards and Local Authorities to
produce a Health Social Care and Wellbeing (HSCWB) Strategy will
continue for the period 2011 – 2014. This is the third phase of a longterm commitment between partners including the Council, ABMU Health
Board, Public Health Wales, Neath Port Talbot CVS and other
organisations to:
 Modernise and where appropriate integrate NHS local health and
social care services for certain groups of vulnerable people
 Improve population health through encouraging healthier lifestyles
 Tackle health inequalities across the county borough/locality
 Continue to address the determinants of health
The revised draft Welsh Assembly Government (WAG) HSCWB strategy
guidance for 2010 indicates that the updated strategy should be viewed as
a flexible document and not fixed within a specific timescale. It should
help to influence necessary change and be evaluated annually to monitor
progress on proposed project outcomes. There is a continued expectation
within the guidance that the HSCWB strategy will be based on a needs
assessment, which should be evidenced within the revised strategy. At the
time of finalising this Strategy, final guidance had yet to be issued by the
Welsh Assembly Government.
The key factors influencing of this strategy are outlined in appendix 1 in
addition to the long-term strategies that were highlighted in the previous
HSCWB strategy, there are three new national strategies that are of
significant importance, namely:
 The Rural Health Plan (2009)
 Our Healthy Future (2010)
 Setting the Direction: Primary and Community Services Strategic
Delivery Programme (2010)
The strategies have been summarised in the appendix and have been
considered in the development of this document.
The HSCWB Partnership has revised this updated strategy in the light of
projected funding gaps for both the Council and the Health Board up to
and likely to continue beyond 2014. The five year forward financial
plans for both agencies have highlighted the need for significant savings
HSCWB Strategy
4
to be made, which could have an impact on the health improvement work
of the partnership and any service development work.
In anticipation of these resource challenges; the partnership has focused
its time and energy in the last 12 to 18 months on identifying key
priorities for project work that will assist capacity building and help
reduce the impact of the funding gap in the longer term. The priorities
have been achieved by reviewing the previous two HSCWB strategies
and service developments, and focusing on key areas that are achievable,
sustainable and likely to make the biggest difference to population health
and services for vulnerable people.
Longer term, the health and wellbeing priorities will become more firmly
embedded in the Community Planning process with the aim of removing
the need for a separate Health, Social Care and Wellbeing Strategy for the
county borough. The revised planning model will be developed and
determined in time for the first four yearly review of the existing
Community Plan.
HSCWB Strategy
5
Agenda item 4
2
THE HEALTH SOCIAL CARE AND WELLBEING JOURNEY
TO DATE
2.1
PHASE 1 - HSCWB STRATEGY 2005 - 2008
In the first phase of the HSCWB journey the long-term vision of the strategy
and partnership was agreed and remains relevant into the third round. The
vision is;
‘To make a real difference to the way people experience services; to
the quality of people’s lives and the environment in which people
live.’
The first Health Needs Assessment (HNA) for Neath Port Talbot was
produced in 2003 and showed that population health was poor in comparison
with the national Welsh average. There were higher levels of heart disease,
respiratory disease, a growing trend in diabetes and more people recorded as
having a long-term limiting illness or disability. The level of obesity, which
is a contributory factor in heart disease, diabetes and other chronic diseases,
was the second highest in Wales. There was an ageing population with the
highest rate of unpaid carers in England and Wales.
The HNA for Neath Port Talbot enabled the partnership to agree to focus its
resources on developing interagency knowledge and specific themed
initiatives that could help redress NPT’s poor health profile in the longerterm. Thematic strategic planning groups were established to consider
lifestyle behaviours and wider health determinants that would have
protective and improving impacts on population health. Themes that were
chosen from the findings of the first HNA were; increasing physical activity
levels, improving nutrition, tobacco control, infection control, quality of life
for older people and improving emotional health and wellbeing.
A number of health improvement initiatives connected to these strategic
planning groups had varying degrees of success. Progress was largely
dependant on access to short-term grant funding from the Welsh Assembly
Government, the Big Lottery and other sources. Funding bid criteria was
often prescriptive and related to nationally targeted health improvement
initiatives. These funding streams have been diminishing in the last few
years and continue to present challenges to service sustainability, which will
be picked up in the next phase of the strategy journey.
HSCWB Strategy
6
The front-line service development and delivery arm of the first strategy
focused largely on the delivery of integrated services between NHS primary
and community health care services; council social care services and the
third sector. Integrated working was strengthened in the first phase of the
strategy journey. Key achievements included:
 The reduction of waiting times for health and social care services
 The development of community integrated services to prevent people
from going into hospital unnecessarily and individually tailored
assistance to help people return home from hospital earlier
 The integration of community equipment services across agencies and
regional boundaries
 The development and establishment of self-help and recovery services
in the community for people with poor mental health
 Enhanced services through GP practices for people with certain
chronic conditions to enable earlier diagnosis and improve long-term
condition management within the community
 Improved access to information and support for carers
 Improved interagency procedures to prevent the spread of infection
This vision has remained the same throughout, is evident in the second
strategy, and will continue into the third phase. ‘Making a real difference’
will be a central theme in the strategy for 2011 - 2014. There will be a
repositioning of expertise and resources which are currently focused mainly
in strategic planning, into strategy implementation and service change.
Historically, the three-year planning cycle suggested by the Welsh Assembly
Government guidance has left little scope for strategy implementation,
(which could have had a more significant impact on service change). It is
the intention of this partnership to redress the imbalance between strategy
development and strategy implementation in the third round.
HSCWB Strategy
7
Agenda item 4
2.2
PHASE 2 – HSCWB STRATEGY 2008 - 2011
The second phase of the HSCWB journey attempted to build on the first
phase at a time when there was a dramatic change in the international and
national economic climate. Demand for services continued to rise as
financial resources for public sector services have been shrinking. During
this phase, the NHS in Wales experienced the biggest reorganisation in its
sixty year history. Local Health Boards were reduced from twenty two to
seven Health Boards across Wales with the widening of geographic
boundaries and the abolition of the internal-market mechanisms.
The ABMU Health Board in its revised form covers Neath Port Talbot,
Bridgend and Swansea local authority areas. Each local authority area is
respected as a ‘locality’ in its own right with its particular needs, priorities
and circumstances. However, a number of core services across the ABMU
Health Board region have been centralised as part of the reorganisation
process and there is still work to do to ensure that the right balance between
maximising the opportunities for working across wider boundaries whilst
recognising the services and changes that can best be delivered at a very
local level. There are strong professional relationships across the
organisations, which engender the confidence that these changes will be
worked through with the needs of citizens firmly at the centre of
consideration.
The second phase of the HSCWB strategy led to a growing recognition of
the relationship between population health and wider determinants as the
HSCWB partnership matured and broadened its scope and membership.
Key areas of health improvement and health inequalities work that have
been progressed in the second strategy phase have included the relationship
between:
 Health, spatial planning and community infrastructure
 Health, homelessness and vulnerable groups
 Health and the workplace
 Health and increasing levels of risk-taking recreational activity such
as binge, hazardous and harmful drinking of alcohol
The partnership focused on the delivery of three projects in 2009/10 which
brought together, and applied the learning from the previous thematic
groups and linked the previous work into the wider health determinants
agenda. The three projects were:
HSCWB Strategy
8
 The Healthy Sustainable Communities Project
 Strengthening the Scrutiny of HSCWB Strategy Implementation
 The Healthier Business Campaign
Healthy Sustainable Communities
The Healthy Sustainable Communities Project brought together the
disciplines of public health and spatial planning to ensure that health
improvement was co-designed into the Local Development Plan. The work
was initiated with a high level conference, which took place in June 2009
with representations from the Deputy Chief Medical Officer of WAG, the
local Director of Public Health, the Environment Director from the Council
and academics from a leading UK consultancy specialising in cross-cutting
policy development for health, sustainability and planning.
The conference led to the establishment of an LDP health project board. The
purpose of the group was to further develop and consolidate the working
links between public health and council planning. The group is currently
working with a public health specialist from Wales Health Impact
Assessment Unit in Cardiff to test out the use of health impact assessment in
a renewal area within the county borough to assess the health risks and
potential health gains of particular planning applications and interventions.
The project will continue into the third phase of the Health Social Care and
Wellbeing Strategy for 2011 – 2014.
Strengthening Scrutiny
The scrutiny project involved the Council’s Social Care Health and Housing
Scrutiny Committee leading a task and finish project to test out the
effectiveness of alternative methods of scrutiny to provide challenge for
partnership strategy development and implementation.
Growing levels of alcohol consumption specifically binge; hazardous and
harmful drinking continues to be a concern for the HSCWB and other
partnerships. The responsibility for addressing alcohol misuse currently
rests with the Community Safety Partnership and much of the focus has been
on anti-social behaviour and domestic violence. The impact on individual
health and chronic disease levels has received less attention. Public health
research has shown that alcohol is the third highest risk factor negatively
impacting on health out of twenty six risk factors with only smoking and
high blood pressure being worse.
HSCWB Strategy
9
The growing trend of alcohol misuse and increasing rate of alcohol related
admissions to hospital was considered to be a hidden threat to the local
health improvement agenda in the longer-term. Therefore, a scrutiny project
considering the impact of alcohol on the health of adult males was
progressed utilising the WAG Scrutiny Development Fund.
Witnesses were invited from the Local Public Health Team, ABMU Health
Board; specifically the accident and emergency section within the hospital
and the Community Drug and Alcohol Team within the community, West
Glamorgan Council on Alcohol and Drug Abuse, heads of service and
specialist practitioners within the council who work in related social care
and health protection sections, South Wales Police and a large local
commercial employer who had successfully implemented an alcohol and
drug policy within the workplace.
The main outcome of the review was a formal acknowledgement within the
council that alcohol is a more cross-cutting issue than can be addressed
solely through the work of the Community Safety Partnership. This has led
to alcohol being adopted as a key priority cross-cutting theme of the Local
Service Board. The inquiry helped to clarify that there is an urgent need to
raise the profile of alcohol and its relationship to chronic disease at a
national and local level, and to lobby for this to be further reflected in
national policy and resource allocation.
Healthier Business Campaign
The third health improvement project for 2009/10 was a campaign to engage
local businesses in health improvement initiatives. The project was
launched by Health Challenge Neath Port Talbot (HCNPT), a planning
forum of the HSCWB Partnership, in September 2009. The purpose was to
encourage private sector businesses to sign-up to HCNPT. This would help
local businesses to identify health improvement needs within the workforce,
raise awareness of health improvement initiatives available through HCNPT,
and support employees to lead healthier lifestyles by introducing initiatives
such as stresspac, smoking cessation sessions, corporate gym membership,
healthier eating classes, which may lead to increased productivity and
reduced sickness levels at work. The HCNPT website was developed to
include web pages of health information tailored specifically to meet the
needs of the business community. The Business Campaign project will
carry over into the next round of the HSCWB strategy.
HSCWB Strategy
10
HSCWB Linkages to Other Partnership Plans
Working links with other strategies and partnerships have been established
in this second phase, with health and wellbeing now centrally placed within
the revised Neath Port Talbot Community Plan and the evolving Local
Development Plan (LDP).
Relationships between the HSCWB Partnership, Children and Young
Peoples (CYP) Partnership and Community Safety Partnership (CSP) are
closer with agreement for cross-cutting themes to be led by a particular
partnership rather than each partnership duplicating. Key examples include
an obesity implementation project, which is proposed to be led by the CYP
Partnership in the next phase, rather than two separate nutrition and physical
activity planning groups sitting within the HSCWB Partnership. Another
example is the alcohol misuse project which will sit at LSB level. The third
example is the development of health impact assessment, which will sit
within the Local Development Planning arrangements.
Integrated Community Services for Vulnerable Groups
The NHS community care and social care service integration element of the
partnership, underwent a radical change of approach in the second round of
the strategy implementation. There was a shift from strategic planning for
specific vulnerable groups to a programme and project management model
to transform whole service areas. The service transformation agenda is
becoming increasingly urgent in the current economic climate. The
Transforming Older People Services (TOPS) programme has received
increased focus in the last eighteen months and will continue to be one of the
highest priority projects for the next strategy round.
There are similarities between the priorities identified for the TOPS
programme and ABMU Health Board’s Primary and Community Services
Strategic Delivery Programme, as they are both serving the needs of the
same population group. There is recognition at partnership level of the
need to urgently align these two programmes as far as possible. This work
will continue to be progressed in the next HSCWB strategy phase for 2011 –
2014.
HSCWB Strategy
11
Agenda item 4
QUICK GLANCE SUMMARY OF SECTIONS 1+2 - THE JOURNEY
SO FAR
 There remains a statutory requirement for Health Boards and Councils to
produce a HSCWB strategy for 2011 to 2014.
 Updated WAG HSCWB strategy guidance has stated that this revised
strategy should be a working document that will lead to action to ensure
that people living in Neath Port Talbot can improve their health and that
those people who are disabled or ill can receive a range of community
services that are more joined-up.
 The vision of the strategy remains the same as the previous two strategies
with an emphasis on ‘making a real difference.’
 There have been the biggest reforms in the history of the NHS, which will
have a significant impact on the way we develop and deliver local services.
 The pressures placed on NHS community and primary health care; social
care within the council and other community services are increasing whilst
public sector service resources are shrinking.
 The partnership has used much of the short-term grant funding available to
develop initiatives to promote healthier lifestyle choices, and to integrate
services between NHS community health care and social care services.
 Five-year Financial Plans (FFPs) for the Council and Health Board indicate
the need to make significant financial savings over the next four years and
beyond, which will have an impact on health improvement initiatives and
service development. The need for the partnership to focus on key priority
areas that should help to build capacity is therefore vitally important.
 The Health Improvement element of the strategy developed three projects
in phase two of the HSCWB strategy implementation. These included a
public health and planning project; a scrutiny improvement project and a
health improvement project with local businesses in an attempt to improve
general population health.
 Short-term grant funding streams have been reducing in recent years and
will cease at the end of March 2011, which will have an impact on the
above work.
 The partnership has refocused its work from strategic planning to strategy
implementation and service transformation for the next phase to ensure that
health improvement initiatives and statutory NHS community health care
and social care services can remain sustainable in the longer-term.
HSCWB Strategy
12
3.
THE NEEDS OF THE POPULATION OF
NEATH PORT TALBOT
A full health needs assessment (HNA) was carried out in 2003/4 in readiness
for the development of the first Health Social Care and Wellbeing Strategy.
The HNA process considered a vast amount of information and data
available nationally and locally on the general health and wellbeing of the
population as well as broader determinants that can help or hinder health
such as; the economy, the environment, access to training and employment,
income levels, housing, sanitation, community cohesion and lifestyle. It also
included a range of information on community services for vulnerable
people.
The revised WAG HSCWB guidance suggested that the HNA’s for 2006/7
and 2009/10 could be updated rather than using a different methodology as
the initial process was considered robust and any changes in trends needed
to be tracked consistently. This section of the strategy will highlight any
significant changes to the previous HNAs and update any key information
on health determinants that are relevant to the priorities that the partnership
has identified for the revised HSCWB strategy for 2011 - 2014.
3.1
GENERAL POPULATION INFORMATION
Population Density and Deprivation
Neath Port Talbot has the 8th highest population density of 22 local
authorities across Wales and is made up of urban and rural communities.
There are 17 areas in the county borough within the top 10% of the most
deprived communities in Wales. Neath Port Talbot has 11 designated
Communities First areas. This is higher than Swansea who have 10
Communities First areas or Bridgend who have 8 Communities First areas.
Research shows that people living within deprived communities have poorer
health and experience significant health inequalities.
The population of the county borough is estimated to be 137,645 (mid-year
estimates for 2008). The Welsh Assembly Government population growth
projection mid-year estimate for 2008 has recently been questioned by a
number of Local Authorities across Wales as over-optimistic. Analysis has
shown both international and inward migration was very high in Neath Port
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13
Talbot in the early period of data collection and then significantly tailed off
toward the end period possibly due to the current economic climate. The
revised 2009 mid year estimates indicate the first population decline in
Neath Port Talbot since 2000/2001.
The Office for National Statistics has indicated the population of older
people in Neath Port Talbot is estimated to increase by 17% from 2006-2031
with the largest increase projected in the 75 year+ age group who are
estimated to increase by 76%. A more conservative estimate for 75 year+
age group from Abertawe Bro Morgannwg University suggests a 69%
increase. Either way, both estimates anticipate a significant increase in the
older age population by 2031.
Life Expectancy and Disease Prevalence
Life expectancy has increased in Neath Port Talbot since the first HNA.
Male life expectancy has increased from 74.1 years to 76.3 and for females
there has been an increase from 78.9 years to 80.4. Male life expectancy is
moving towards the Welsh average which is 76.9. However there is still an
inequality for females compared to the Welsh average, which is 81.4.
Despite people living longer in Neath Port Talbot than they did seven years
ago, the evidence-base continues to suggest that people experience poorer
health than is average for both Wales and neighbouring local authority areas.
The average percentage of people reported as having a long-term limiting
illness in Neath Port Talbot is 29%. The Welsh average is 23% with
Swansea being on a par with the national average and Bridgend being 25%.
The major causes of premature death and long-term limiting illness within
Neath Port Talbot relating to chronic conditions are highlighted in the
summary below. The chronic conditions highlighted below do not represent
an exhaustive list. Rather it is intended to give a brief overview of the
current and ongoing health inequalities to ensure that the partnership does
not lose sight of the need to continue to consider health promotion, health
improvement, self-care and early intervention in longer-term service
planning and delivery.
Diseases of the circulatory system such as heart disease and stroke are one of
the biggest causes of premature death in Wales. Neath Port Talbot currently
has the second highest incidence of stroke/Transient Ischaemic Attack
(TIA)in Wales and the fifth highest death rate from heart disease. The
HSCWB Strategy
14
incidence of Coronary Heart Disease at 4.62% continues to be above the
national average.
There continues to be high levels of respiratory disease within the county
borough. The incidence of asthma is the highest in Wales at 7.73%. Neath
Port Talbot is recorded as having the highest numbers of smokers in Wales
at 26%. There is also a history of employment in large manufacturing
industries.
The rates of cancer in Neath Port Talbot are similar to the Welsh average on
the whole with smoking related cancers being higher than average. Cancer
continues to be a significant cause of death if not diagnosed and treated
early. Information on screening coverage for breast cancer shows that Neath
Port Talbot has the third lowest coverage rate out of 22 local authorities in
Wales. This is a health inequity that requires some dedicated health
promotion work in the next strategy round.
Trends for diabetes are continuing to rise nationally with Neath Port Talbot
having the second highest incidence of diabetes in Wales. One of the factors
contributing to the increasing levels of diabetes is the level of obesity and
being overweight. Neath Port Talbot has the third highest incidence with
61% of the population reporting being obese or overweight. Obesity and
overweight is also a contributory factor to a number of other chronic
conditions such as Coronary Heart Disease (CHD)..
The mental health component score, which is a survey to measure the mental
health and emotional wellbeing of the population, indicated that Neath Port
Talbot is similar to the rest of Wales. However, suicide rates in younger
males are much higher than the national average. The Wales average for
males was 22.5 in 100,000 of the population. Neath Port Talbot was
reported as 32.6 per 100,000.
Older people are the most vulnerable to chronic ill health and disability as
indicated in the previous two HNAs and strategies. The current information
available on the mental health of older people (50 years plus) shows that up
to 16% of older people experience clinical depression. Dementia is another
area where there will be a need for focused attention. There are 1,700 cases
of older people with dementia in Neath Port Talbot and this is predicted to
increase to 3,000 by 2031.
HSCWB Strategy
15
3.2
DIMENSIONS OF SOCIAL DIFFERENCE WITHIN
THE POPULATION
Ethnicity
The primary source of information concerning ethnicity, religion and faith
group populations is largely dependent on census information and self
reporting. It is crucial information for planning health care and other public
services as there is a greater prevalence of some chronic conditions by ethnic
group such as hypertension, stroke and diabetes as indicated in the first HNA
and strategy.
The ethnicity of the whole population within Neath Port Talbot remains
broadly similar to the first HNA with 98.9% of people reporting themselves
as being white and 97.5% describing themselves as White/British. The
percentage of people from other ethnic groups is listed in the table below:
Ethnic Group
White/Irish
Other White
Mixed
White/Black Caribbean
White/Black African
White/Asian
Other mixed
Asian/Asian British
Asian British/Indian
Asian British/Pakistani
Asian British/Bangladeshi
Asian/Asian British Other
Black/Black British
Black/Black British Caribbean
Black/Black British African
Black/Black British Other Black
Chinese or Other Ethnic Group/Chinese
Chinese or Other Ethnic Group/Other Ethic
Group
HSCWB Strategy
Percentage
0.05%
0.84%
0.39%
0.02%
0.03%
0.11%
0.08%
0.40%
0.17%
0.07%
0.11%
0.02%
0.10%
0.06%
0.03%
0.01%
0.17%
0.11%
16
There are two authorised gypsy traveller caravan sites in Neath Port Talbot
with 56 pitches. The sites can accommodate 112 caravans. There are
currently 97 authorised caravans based on these sites. The estimated number
of people living within the gypsy traveller community is 236. Neath Port
Talbot has the 4th highest number of gypsy traveller caravans in Wales and
have a higher number of gypsy travellers than most other local authorities in
Wales. The gypsy traveller community are a group which are considered
vulnerable in terms of access to primary and secondary health care services.
The group are cited in the Homeless and Vulnerable Groups Health Action
Plan (HaVGHAP), which requires Health Boards to ensure that the health
care needs of these and other specifically defined homeless groups are
addressed. Health Boards have been directed to work closely with Councils
and other partners to develop and implement the HaVGHAP.
Religion, Faith and Beliefs
The religion, faith and beliefs of the population need to be considered in
planning as many of the informal networks associated with these groups are
an important part of service delivery and ongoing longer-term support in the
community. These groups are often but not exclusively linked to ethnicity
and are an important means of public services engaging with people who are
more challenging to reach. Links with informal community support
networks are likely to become increasingly important at a time when there is
a reduction in resources available for public services.
The percentage of people indicating a religion, faith or belief include 72%
describing themselves as Christian, 19% indicating that they have no
religion, 8% not completing the question and remaining percentage
indicating Buddhist (0.1%), Hindu (0.8%), Jewish (0.03%), Muslim
(0.23%), Sikh (0.09%), other (0.22%).
Disability
Disability specific population groups are difficult to track for planning
purposes as registration with the local authority is voluntary and a significant
number of people do not perceive themselves as disabled. The learning
disability register provides more robust information as people are identified
and tracked from a younger age due to early contact in childhood with the
NHS and social services.
Deaf people who use British Sign Language and deafened people who lip
read are quite averse to being referred to as disabled. The Deaf community
HSCWB Strategy
17
in Wales has campaigned over the last decade to be recognised as a group
with language and communication needs rather than being considered as a
disability population group. Therefore many choose not to register as
disabled.
People with chronic conditions were not recognised as a disability group
within the initial Disability Discrimination Act (DDA) 1995 definition. An
amendment to the original DDA in 2006 has ensured that people with
chronic conditions are now considered within the disability definition.
Information on Autism Spectrum Disorder (ASD) is patchy, particularly in
adults. These groups are not often considered within the current registration
process and have not been tracked historically in any meaningful way.
Work at national and local level is currently being progressed to redress this
imbalance.
The Welsh Assembly Government still collate disability population group
information from local authority registers via a snap-shot return for the 31
March each year.
People who do register with the local authority are generally seeking
community care support services because of deteriorating functioning. Not
all of these people register and many disabled people do not approach
support services. Therefore the registers are not representative of the whole
disability population group within the wider population. The information
below is from census information relating to long-term-limiting illness and
Disability Discrimination Act (DDA) definitions rather than local registers;
although learning disability registers have been included as they provide
more robust information.
The general numbers of people who are disabled according to the DDA
definition across Wales is 19.1% of the population with 14.3% being
categorised as work-limited disabled. Neath Port Talbot has the second
highest ratio per population of the 22 local authorities of DDA disabled at
26.22%.
Breakdown by age shows an increasing number of DDA defined disabled
people in the older working age group, which is similar to the picture of
chronic disease prevalence. Well over half the DDA defined working age
disabled population in Neath Port Talbot are between the ages of 60 – 64
HSCWB Strategy
18
years. Out of the disabled working age population, 57.48% were in this age
band. This is another indicator that that disability and chronic disease is
more prevalent as people get older.
The numbers of adults registered as having a learning disability in Neath
Port Talbot is 513, of these 314 live and are supported in the family home.
Over 50% of carers are parents over 60 years of age with two thirds of this
group of carers being over the age of 70 years. Approximately 130 families
use respite to enable carers to have a break and this number is expected to
increase.
Research has shown that people with learning disabilities have an increased
risk of early death compared to the general population. The main causes of
death are respiratory disease linked to pneumonia, swallowing and feeding
problems and gastro-oesophageal reflux disorder. Direct GP enhanced
service health checks have been available to people with learning disabilities
for several years to monitor health and wellbeing. However, uptake and data
collection is inconsistent.
A recent mapping exercise for the development of a national Autistic
Spectrum Disorder (ASD) strategy identified the following information:
Age Group
0 – 8 years
9 – 11 years
12 – 14 years
15 – 19 years
20 – 39 years
40 – 50 years
50 +
ASD Numbers
92
94
109
57
21
2
0
Further work will need to be completed to revise the way that information is
collected and utilised for planning services for disabled people at a national
and local level. The partnership will consider how this can be taken forward
in the next phase of the strategy.
HSCWB Strategy
19
Agenda item 4
National Identity and Language
National identity and language is another area of social difference that has to
be considered within the strategy. There are 20.4% of Welsh speakers over
the age of three years living in the county borough, with 25.5% stating that
they can understand spoken Welsh. Welsh literacy is recorded as lower with
17.4% indicating that that they could read and write in Welsh.
3.3
WIDER DETERMINANTS IMPACTING HEALTH
There are many determinants of health that have positive or negative impacts
on the health and wellbeing of the population as indicated in the previous
two strategies. It is not within the remit of this strategy to identify and
attempt to address every single determinant. The determinants highlighted
below are the ones that are of particular interest to the HSCWB Partnership
for the strategy round 2011 – 2014, as they have the potential to significantly
impact the health of the population if not addressed as a priority over the
next three years.
Economy
Employment and income levels are two of the most significant protective
health factors in determining the health of a population. The changing
economic climate must be considered as having a potential impact on the
health of the population in the lifetime of this revised strategy for 2011 2014. The information given in this section may already be out of date
given the rapidly changing economic environment and should be considered
within this context.
The Gross Value Added (GVA), measures the contribution to the economy
of each individual producer, industry or sector in the United Kingdom. The
GVA per head in Neath Port Talbot is lower than average at £13,542 as
compared to Wales at £14,853. Neath Port Talbot has a higher gross
disposable household income per head at £13,024 than the average for Wales
of £12,574. The average house price in Neath Port Talbot is lower than
average at £90,846 compared to £120,601 for Wales.
The average earnings for Neath Port Talbot are £479.30 full-time equivalent
per week. This is higher than the average for Wales, which is £444.90.
There is a lower economic activity rate at 71% than the Welsh average of
75.4%. The unemployment rate is 7.1%, which is lower than the Welsh
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20
average of 7.7%, and there are lower percentages of people claiming job
seekers allowance at 4.3% compared to Wales at 4.4%.
Earnings and disposable income appear to be favourably placed compared to
the Welsh average. Neath Port Talbot has a history of employment in large
manufacturing industries. These job opportunities have been reducing in
recent years with an increase in lower paid and part-time jobs in the service
sector. The current statistics above therefore tend to mask low economic
activity rates.
The poorer health profile of the county borough places Neath Port Talbot in
a position of having the second highest rate of DDA defined disabled people
with a work-limiting disability. This may be masking the overall rate of
people who are unemployed within the county borough as people have to be
deemed fit for work to be counted within the statistics for unemployment or
to be able to claim job seekers allowance.
The previous strategy strongly indicated the need to develop a greater
entrepreneurial culture to increase levels of self-employment and support
smaller businesses to become more viable. There is need to invest in
making a closer connection between learning and work, with appropriate
skills training and qualifications that match the emerging changes in the
economy. The numbers of working age people with no qualifications is
16.2%.
There needs to be targeted health improvement support in more deprived
communities where there are higher rates of unemployment. The
Communities First initiative in Neath Port Talbot has already started to
establish health improvement initiatives in many of these areas. However,
this work needs to be more closely aligned to the evolving ABMU Health
Board Community Networks initiative.
Environment and Housing
The environment is another health determinant that can have an impact on
health. A Local Service Board (LSB) air quality project was established in
2009 to implement the European Union revised standards that have been
included in the WAG Air Quality Strategy for 2007. The main issue for
population health is the PM10s (fine particles) that are omitted through
traffic and industry. PM10s are a concern for health because they can be
digested into the lungs. Research shows that long-term exposure to air
HSCWB Strategy
21
pollution can reduce life expectancy by 7 – 8 months. It can exacerbate
existing conditions like asthma; angina and cancer. Since the year 2000, in
Neath Port Talbot, 5 out of 10 PM10 monitoring reports have exceeded the
national standard. However, reports for the last three years have shown a
significant improvement with PM10s being well within the national standard
with a continuing downward trend of omissions.
The environment includes the places where local people actually reside.
Housing is a further significant determinant of health within the population.
The overall proportion of social housing in Neath Port Talbot is higher than
the Welsh average. The vast majority of council dwellings are noncompliant with the Welsh Housing Quality Standard (WHQS). Universal
failings relate to bathrooms, kitchens and energy efficiency. Current repair
conditions within Neath Port Talbot council housing stock are generally
adequate; however 20.2% require major repairs. The local council tenant
‘yes’ vote for transfer of housing stock to a registered not-for-profit social
landlord, should help to attract investment to tackle these health inequalities
in the next strategy phase.
The age profile for private sector stock is older than the average for Wales
and there are poorer conditions prevalent than the social rented sector. The
pre 1919 stock, along with terraced houses, converted flats and the private
rented sector have high rates of unfitness, which is similar to the position for
Wales as a whole. These dwellings appear to fail standards for similar
reasons to those found across the rest of Wales, with disrepair and
inadequate food preparation facilities being the primary cause of failure.
Three renewal areas (RAs) have been declared for Neath Port Talbot. A
survey relating to the development of the third RA showed some significant
key findings from a health perspective. For example, trips and falls on
uneven surfaces were recorded at 44%; more than half the homes had a
significant fire risk; half of the homes needed repair or renewal of roofs to
prevent water ingress; 18% of houses had significant levels of damp or
mould; 39% of residents felt unsafe to walk around their community after
dark; 44% of residents felt that their health restricted their ability to get
around their community and 79% of residents had no connection with the
local community, voluntary or faith groups.
All of the above factors have been shown through research to have a clear
link and impact to poor health and wellbeing. Learning from the first two
HSCWB Strategy
22
more established renewal areas shows that the renewal approach is making a
visible difference to the physical housing stock and the environment within
Neath Port Talbot.
The HSCWB partnership has started to consider the possibility of
improving general population health through this renewal area mechanism
by utilising health impact assessment in spatial planning and linking health
improvement initiatives into targeted communities to improve the overall
environment and population health. The Local Development Plan Health
Project Board has linked in with public health practitioners and the Welsh
Health Impact Assessment Unit in Cardiff University to take this work
forward into the next HSCWB strategy phase.
Supporting People (SP) is a range of specialist housing with support for
specifically identified vulnerable groups of people which include older
people, learning disability, mental health, domestic abuse, substance misuse,
care leavers, and homelessness. There are currently over 1,200 units of local
SP funded provision which has provided 1,900 vulnerable people with
support during 2008/9. The projected and prioritised units of support
provision required for the next strategy round is 223 units, which would
meet the needs of 3,000 vulnerable people known to have a housing related
support need as of 2009.
There are significant challenges in identifying baseline numbers of people
who are homeless or potentially homeless. The numbers of people
approaching Housing Options for advice and assistance with a real or
perceived housing related problem for 2009/10 in Neath Port Talbot was
1,289. The numbers of people registered as homeless across the Neath Port
Talbot and Bridgend local authority areas was 157 with the majority of these
registrations being within the 16 to 24 year age group.
A recent pilot study in Neath Port Talbot to support homeless people
identified approximately 9 rough sleepers. These people are identified as
vulnerable under the Health Board HaVGHAP requirement as are
immigrants and asylum seekers. The total number of immigrants registering
with a GP and applying for a national insurance number was 215 with the
largest percentage being within the 25 – 44 year age group. There are no
asylum seekers known within Neath Port Talbot County Borough at the time
of this updated HNA. Neath Port Talbot is not currently one of the dispersal
areas for asylum seekers.
HSCWB Strategy
23
3.4
LIFESTYLE AND HEALTH IMROVEMENT
Smoking
The prevalence of smoking in Neath Port Talbot is 26%, which is higher
than the Welsh national average of 24%. Death rates through smoking are
higher in Neath Port Talbot than the Welsh average. The death rates in male
smokers are 358 per 100,000 compared to Wales which is 340 per 100,000
and for females it is 173 per 100,000 compared to Wales 155 per 100,000.
Despite the higher smoking prevalence, higher death rates and significantly
higher rates of respiratory disease in Neath Port; the percentage of people
accessing Stop Smoking Wales is much lower in Neath Port Talbot (2.5%)
than in neighbouring local authorities/localities. The access for Swansea is
5.2% and for Bridgend it is 3.7%. This health inequality is being addressed
with the full roll out of an enhanced pharmacy scheme to help people stop
smoking. The scheme was piloted in Swansea in 2006; introduced to
Bridgend in 2007 and started in Neath Port Talbot in 2008.
A number of support services to help specific targeted groups of people stop
smoking have been developed and are being implemented. A maternity
referral pathway project to support pregnant smokers and their families to
stop smoking is in place and midwives and staff have received training to
implement the pathway.
Stop Smoking Wales and Health Boards continue to work together to
increase the numbers of people accessing a referral support pathway for
people who are identified as requiring elective surgery. The purpose is to
track and help people give up smoking prior to surgery.
There continues to be little research on effective smoking cessation
interventions for young people. However, Stop Smoking Wales supports
young people aged 12 – 17 to give up smoking. Helping to reduce risk-tohealth behaviours continues to be a priority for the HSCWB partnership and
this work will carry over into this next strategy phase.
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Agenda item 4
Obesity and Overweight
Neath Port Talbot has the third highest percentage of people reporting
themselves as obese or overweight at 61%. This is higher than the national
averages of 57% and that of neighbouring local authorities/localities.
Swansea is lower than the national average at 56% and Bridgend is higher at
59%.
Contributory factors to obesity and overweight are poor diet and low levels
of physical activity. Overall only 27% of the adult population of Neath Port
Talbot report undertaking the nationally recommended levels of 30 minutes
of moderate intensity physical activity on 5 or more days a week (5 x 30). In
addition to low physical activity levels; only 34% indicated eating the
recommended 5 portions of fruit and vegetables a day. The national Welsh
average is 36%.
The gender differentials show a continuing health inequality between males
and females in terms of physical activity. When broken down by gender;
35% of males reported engaging in the nationally recommended levels of
physical activity. The Welsh average is 37% for males. The rate for females
in Neath Port Talbot was 20% compared to the Welsh average of 24%.
Females continue to be harder to engage in physical activity and sport in
adulthood.
There has been active and creative project work intervention between
Communities First and the Physical Activity and Sports (PASS) Services in
an attempt to address some of these inequalities. A doorstep FIT initiative
led to 10 newly trained and up skilled fitness instructors and 16 new classes
providing a total attendance of over 5333 people. Thirteen of these classes
have been sustained. Doorstep FIT takes the service to the community
rather than expecting the community to come to the service.
A number of cluster bids (awarded by the Local Authority Partnership
Agreement (LAPA) Steering Group), again lead by PASS and Communities
First saw 18 new small scale projects ranging from nature trails, dodge ball
leagues and dance classes, many of which are being sustained by those
targeted communities. The last two strategy rounds have seen walking clubs
being developed and sustained, particularly in the valleys communities.
HSCWB Strategy
25
The widening of physical activity initiatives outside of the traditional sports
menu has helped to engage a wider range of the population including women
and older people. A recently completed local evaluation of walking and
dance projects has illustrated that walking groups have been particularly
successful.
The WAG funded ONC community food and nutrition training has led to the
skilling–up of communities first project workers, which has increased the
delivery of food related projects across the county borough.
A Life Coaching project was piloted in a GP practice in Neath Port Talbot
out of short-term funding and was formally evaluated. Initial feedback has
shown that the 6 month pilot was successful in helping people change
lifestyle behaviours at least in the short-term. Future development of this
service is under review.
It is the view of the Neath Port Talbot HSCWB partnership, that health
improvement should be embedded into all partnership agency policy and
service delivery. Especially for vulnerable groups and those identified as
being in population groups with significant health inequalities. Capacity
building to bring about this fundamental change in policy and service
delivery will continue to be progressed into the next strategy phase.
Sexual Health
Sexual health is an area that has not received a lot of focused project
attention by either the HSCWB partnership or the CYP partnership in the
previous two strategy rounds. Neath Port Talbot has a higher conception
rate for 15 – 17 year olds at 45.1 per 1000. The Welsh average is 44.9 per
1000. More concerning are the rates for 13 – 15 year olds. The Neath Port
Talbot conception rate for this age group is 10.2 per 1000 with the Welsh
average being 8.5 per 1000. There has been a marked increase in Neath Port
Talbot in conception rates in 13 – 15 year olds from 8.4 per 1000 in 2004 to
10.2 in 2007.
The rates for sexually transmitted infections (STIs) are currently difficult to
track on a local basis. STI data does not provide information on the
incidence of STI in Health Board locality resident population groups. The
prevalence of HIV/AIDS in Wales has continued to increase with 148 new
cases being reported in Wales in 2008. In addition, there has been an 18%
increase in people being diagnosed with uncomplicated Chlamydia in 2007HSCWB Strategy
26
2008. Young people continue to be the largest group to be diagnosed and
treated for sexually transmitted disease.
There are wide variations in the quality and impact of sexual health
education in schools across Wales. WAG has renewed its commitment to
improve sexual health and narrow sexual health inequalities across Wales
with a public consultation document on Sexual Health and Wellbeing for
Wales 2009 - 2014. Work is currently being progressed to develop an
integrated sexual health model across the ABMU Health Board area. The
HSCWB and CYP partnership need to work closely in the next strategy
round to ensure that these inequalities are addressed at a local level.
Substance Misuse
Substance misuse; specifically drug and alcohol misuse continue to pose
challenges to wider population health and have the potential to add to
service delivery pressures. Hospital admission rates in Neath Port Talbot,
due to drug and alcohol misuse are higher than the national average.
Services for drug users have improved across the Neath Port Talbot and
Bridgend localities of ABMU Health Board in recent years. Since the
reorganisation of the NHS, there is now one single point of service access in
each of the localities including Swansea.
Services for drug users appear to be well established across the ABMU
Health Board area. However, the HSCWB partnership continues to have a
significant concern about the lack of profile and resources nationally and
locally in relation to the increasing levels of binge, hazardous and harmful
alcohol consumption and the impact this lifestyle behaviour has on longterm health, with particular reference to chronic disease levels and mental ill
health. A recent partnership project to raise the profile of alcohol and health
has already been summarised in the first section of this strategy.
The key headline statistics for Neath Port Talbot in regard to alcohol misuse
includes; 48% of adults indicating drinking alcohol above the recommended
national guidelines which is higher than the Welsh average of 45%. Neath
Port Talbot has significantly worse hospital admission rates due to alcohol
for males with 2,292 per 10,000 compared to the Welsh national average of
1,940 per 100,000. The hospital admission rates due to alcohol for females
are also higher than the Welsh average at 1,201 per 100,000 compared to the
Welsh average of 1,122 per 100,000. The trend in both alcohol–related and
alcohol attributable hospital admission rates is upwards.
HSCWB Strategy
27
The growing levels of alcohol consumption in children and young people are
of significant concern. Wales had the highest percentage of all 40 countries
surveyed in 13 year olds having been drunk more than twice. In children
aged less than 16 years, more girls were admitted to hospital than boys with
295 admissions. The admissions for boys were 215.
Despite the hospital admission rates - deaths from alcohol for Neath Port
Talbot are on a par with the Welsh average for males and lower than the
national average for females. Both Swansea and Bridgend have higher rates
than Neath Port Talbot of people drinking above the Welsh national average
at 49%. Swansea and Bridgend local authority/locality areas have higher
rates of death from alcohol compared to Neath Port Talbot but lower rates of
hospital admissions than Neath Port Talbot.
The emerging picture is one of there being significant health-related issues
with alcohol across the ABMU Health Board area. It would make sense to
integrate strategic thinking, learning and service development at the regional
level, rather than three local authority areas/localities trying to address these
issues separately and with limited resources.
A World Health Organisation (WHO) review of 32 alcohol strategies and
interventions found that in terms of; degree of effectiveness, breath of
research support, extent to which these have been tested cross-culturally and
relative expense of implementation, the most effective alcohol policies
include:
 Alcohol control measure (price and availability)
 Drink-driving laws
 Brief interventions for risky and harmful drinkers
This work will also complement the priorities of the Safer Neath Port
Talbot Partnership, in particular partnership initiatives to tackle
domestic violence.
Communicable Disease and Immunisation
Research shows that unimmunised or partially immunised children are more
likely to live in areas of high deprivation. Inequalities in immunisation
uptake have been persistent and result in lower coverage in children and
young people from disadvantaged families and communities.
HSCWB Strategy
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Neath Port Talbot has the following level of uptake for 2009/10 in
comparison to the rest of Welsh local authority areas:
 The second lowest annual uptake rates for 5 in 1 vaccine by 1 year of
age
 The fourth lowest annual uptake of one dose of MMR by 2 years of
age
 The lowest annual uptake of meningitis C by 1 year of age
 The fifth lowest annual uptake of two doses of MMR by 5 years of
age
 The fourth lowest annual uptake of 1 in 4 booster by 5 years of age
Immunisation uptake rates appear to improve in Neath Port Talbot as
children get older and are often higher than the Welsh average in teenagers:
 Uptake of MMR1 by 16 year olds is higher than the Welsh average by
over 2%
 Uptake of MMR2 by 16 year olds is higher than the Welsh average by
over 3%
 Uptake of 3 in 1 teenage booster is significantly higher than the Welsh
average by nearly 7%
 Uptake of HVP vaccinations in girls reaching their 14th birthday is
higher than the Welsh average
Initial progress has been made in immunisation rates in Neath Port Talbot,
specifically in older children and young people. The partnership recognises
that there is a need to continue to be proactive in improving immunisation
rates locally, particularly in younger children. This has been agreed as a
priority for the partnership into this next strategy round.
Long Term Conditions
The ABMU Health Board and the Council will work in partnership to
improve services for people with or at risk of developing long term
conditions (for example asthma and diabetes). This will include promoting
wellness rather than treating illness and supporting self care, independence
and social inclusion. To achieve this we will work together to increase
access to services for the promotion of health, social and emotional
wellbeing as well as the strengthening of partnerships with the third sector,
where appropriate, to contribute towards providing better services.
HSCWB Strategy
29
3.5
COMMUNITY CARE SERVICES
It is not the intention of this strategy to give an overview of every single
service area across and within the partnership. The service areas or specific
projects identified here are highlighted because they are or could be
influential in improving health and tackling health inequalities.
General Practice (GPs)
The poorer health profile for Neath Port Talbot highlights the importance of
people being able to access services within General Practice (GP) as this is
often the main pathway into other support services. There are 80 GPs
working from 23 main surgeries with an additional 4 branch/satellite
surgeries in Neath Port Talbot. The number of registered patients is
137,808, which is higher than the population for Neath Port Talbot; however
there are county boundary differences with some GP practises.
The average size list for surgeries in Neath Port Talbot is 5,992. The
average list size per GP is 1,753. The average list size in Neath Port Talbot
for GPs is higher than the Welsh average. Practice bases are mainly
concentrated around the main population centres of Neath and Port Talbot
town centres and Pontardawe. Residents living in approximately two-thirds
of the electoral divisions do not have local access to a GP main surgery. In
approximately one quarter of those electoral divisions there is access to a
branch or satellite surgery with a limited range of general medical services
and multi-disciplinary team working. The Health Board is directly
responsible for the management of 2 GP Practices within Neath Port Talbot.
Access to services has already been highlighted as a challenge in this
strategy as reorganisation of the NHS has led to further centralisation of
services. The partnership are mindful of the fact that significant health
inequalities already exist in the Neath Port Talbot locality compared to the
Welsh national average and when compared to the neighbouring localities of
Swansea and Bridgend, particularly in relation to chronic disease and worklimiting illness. ABMU Health Board has recognised that service design has
not been as tailored to the needs of local communities as it could have been,
specifically in more rural areas such as the valleys communities. ABMU
Health Board is proactively working to address some of these inequalities.
A Primary Care Resource Centre (PCRC) in Port Talbot opened in October
2009 and is the first of its kind in Wales. It provides a wide range of
HSCWB Strategy
30
primary care services, community nursing and therapies, social care and
third sector provision. A number of these services are and can be further
mobilised into specific communities with further interagency integration of
some services. An ABMU Health Board Primary and Community Services
Strategic Delivery Programme which is planning the development of
Community Networks, Community Resource Teams and a Communications
Hub will link into the NPT wide TOPS review of services in the home
project, to help address some of the service access inequalities in this next
strategy phase.
The Neath Port Talbot GP out of hour’s service has been provided by
Primecare since October 2004. A recent survey carried out by Cardiff
University – Department of Primary Care and Public Health has indicated
high patient satisfaction levels with the service.
General Dental Services
Decayed missing and filled teeth (DMFT) is a WAG funded survey to
measure the prevalence of dental health in children and young people.
Neath Port Talbot has a significantly higher percentage of DMFTs in five
year olds at 64.48% compared to the Welsh average of 52.63%.
The DS2 programme involves getting more teeth into contact with fluoride
supplements to reduce dental decay. There is inconsistency in involvement
in the DS2 programme as some schools decline involvement.
An ABMU Health Board-wide oral health equity audit to assess fairness of
service access has recently been completed and the HSCWB and CYP
partnership will need to work closely together in the next round of strategy
implementation to proactively tackle these significant health inequalities.
A new dental suit opened in September 2010 based in Port Talbot Primary
Care Resource Centre. The suite encompasses a variety of dental services
such as the provision of the community dental service, vocational dental
trainees and potentially the hospital dental services. A specific contract has
been developed and implemented with a dentist who visits care homes.
Pharmaceutical Services
All pharmacies provide core services but many do not have the capacity to
offer a wider range of services. The development of a Directed Enhanced
Services initiative will provide equity of a wider range of services across the
HSCWB Strategy
31
county borough. The core services pharmacists provide are; supply and
disposal of medicines, signposting to other health care services and
promotion of healthier lifestyles. Some also provide emergency hormonal
conception, smoking cessation support, needle exchange and supervised
methadone and buprenorphine, access to palliative care medicines and
advice to care homes and domiciliary care providers on medicines
management.
The new contract requires pharmacists to provide a minimum of 40 hours
service a week. Boots pharmacy in Neath and Port Talbot town centres are
open on a Saturday and Sunday. The gap in the provision of pharmacy
services after 6.30pm continues with people directed to Swansea or
Bridgend for late opening where appropriate. Community pharmacy has
been tested out and has improved access in a number of rural communities.
This work will continue through the next strategy phase.
Optometry Services
Ophthalmic services are provided to the population of Neath Port Talbot by
independent optometrists. There are 18 ophthalmic premises across the area
providing sight tests for the population and there are 9 optometrists who
provide a domiciliary service.
An all Wales Diabetic Retinopathy Screening Service has been developed
and implemented at centres across Neath Port Talbot and a direct Cataract
Referral scheme was first established in 2003. The referral scheme has
streamlined the referral pathway by allowing optometrists to refer patients
directly to ABMU Health Board rather than patients having to go back to
their GP in order to be referred to secondary care. Optometrists can continue
to refer patients directly and conduct post operative assessments in primary
rather than secondary care.
Nursing and Therapy Community Services
A range of services available at community level include; district nursing,
health visiting, school health nursing, occupational therapy, physiotherapy,
speech and language therapy, podiatry and dietetics. It is not possible at
present to provide a comparison of services offered in Neath Port Talbot
with elsewhere in Wales, with the exception of Community Nursing where
ABMU HB is undertaking a benchmarking exercise. This information has
not been made available at the point of the HNA exercise as it is an ongoing
HSCWB Strategy
32
project. It would be helpful to have access to the information in time for the
final draft of this strategy.
Community Integrated Intermediate Care Service
The Community Integrated Intermediate Care Service (CIIS) is the result of
a merger of the Neath Port Talbot Early Response Service and Reablement
Service and can be accessed through an intermediate care referral centre.
The CIIS team comprises of; a service manager, a clinical lead, medical
consultant, social workers, nurses, health visitors, physiotherapists,
occupational therapists, therapy technical instructors, health and social care
support workers, coordinators, contact officer and business support officers.
The service is currently supported by a consultant for older people and
attached medical team, an older persons day unit at Neath Port Talbot
Hospital, nursing and therapy staff from Cimla Community Hospital and
care officers and care assistants in Caewern Residential Reablement Unit.
The service offers an early health and social care assessment and where
required, will deliver short term intervention (currently up to 6 weeks) to
people in their own home with the purpose of;
 Preventing – a progressive deterioration in a person’s physical
condition and unnecessary hospital admission.
 Assisting – earlier discharge from hospital and helping people relearn
or develop skills to live independently at home.
 Reducing – the number of people having to go into a residential or
nursing home or becoming dependent on long-term care packages at
home where these are not required and helping them to consider
alternative solutions.
 Providing – a wide-ranging assessment with appropriate professionals
and support staff in the Older Persons Day Unit within Neath Port
Talbot Hospital.
 Improving – communication between primary, secondary and social
care and removing the barriers that have existed between different
agencies and professionals.
HSCWB Strategy
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The CIIS service is one of the services that will be reviewed as part of the
Improving Integrated Services at Home project that is highlighted in the
older people services section below.
Unscheduled Care
This refers to care which is unplanned such as emergency admissions to
hospital and attendance at Accident and Emergency and the Local Accident
Centres. The objectives of ABMU Health Board are to ensure timely and
quality patient care in accident and emergency departments. It is also
important that citizens and patients receive effective information and can
access the most appropriate unscheduled care when they need it. As part of
means of achieving this, the Health Board will work in partnership with the
local authority, primary care and other key partners to develop community
services such as CIIS to prevent unnecessary admissions to hospital
wherever appropriate. This will enable people to receive care as close to
home as possible.
Mental Health
Mental Health Services are being remodelled and modernised with an
emphasis on improving the joint planning and service development
pathways between primary care, secondary care, social care and the third
sector. Prevention of long-term mental ill-health; mental health promotion
and early intervention services are considered to be a significant part of these
developments to take pressure away from core long-term care services.
Current projects relating specifically to mental health which are of specific
interest in this next strategy round are:
 The repatriation programme to develop a range of local low secure
and cost effective alternatives to current high-cost out-of-county
placements.
 Tackling delayed transfers of care from secondary care back into the
community.
 Implementing a local delivery plan to improve all mental health
service developments in the ABMU Health Board area.
 Ensuring that an eating disorder service is developed across the
ABMU Health Board area in conjunction with the third sector.
 Continuing work to manage risks associated with self-harming
behaviours and suicide through the Improving Futures delivery
mechanism.
HSCWB Strategy
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 Further development of preventative and early intervention services to
improve emotional wellbeing.
 Ensuring that Annual Operating Framework (AOF) and National
Service Framework (NSF) targets are met.
Mental Health service remodelling will continue to be a key priority for the
next strategy round with likelihood of further integration and cross-boundary
working.
Older People Social Care Services
Older People Social Care Services are going through a significant period of
remodelling. The Transforming Older People Services (TOPS) programme
has received significant partnership focus and will continue to do so in this
next strategy round. It will be linked into the primary care and integrated
intermediate care developments outlined above. The current TOPS projects
that are ongoing and will continue into the next phase of this strategy
journey are:
 Replacing seven of the eight long term council care homes, with four
new homes that will be delivered by an external partner commissioned
to design, build, finance and operate the replacement services.
 Reviewing and integrating where appropriate, services provided in the
home. Starting with the development of a new integrated,
intermediate care service.
 Implementing the Primary Care and Community Services Framework,
including the development of three sub-locality networks;
 Improving the efficiency of the Council’s own Home Care Service.
 Remodelling the assessment, care management and commissioning
functions of social care and the assessment arrangements of other
agencies.
 Redesigning day service provision.
 Moving forward with extra care housing developments.
 Widening prevention and self-care services.
 Developing services to meet the needs of older people with dementia;
 Remodelling other health, social care and community services where
the evidence suggests that this is necessary..
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Continuing Care
Ensuring a collaborative approach to continuing care between the Local
Authority, the Health Board and the Independent Care sector, Third Sector
and patients and carers. Through a collaborative approach we will strive to
deliver continuing care as close to the individual’s home as possible, or in
the majority of cases, on the patient’s own home, supported by robust care
planning and coordination. Wherever possible, we will look to bring people
whose care is currently provided out of the County Borough back to care
which is delivered within Neath Port Talbot based on robust assessment of
need and innovative care planning.
Learning Disability
The inequity in health for this population group has already been highlighted
earlier in this strategy. The service remodelling issues are not dissimilar to
other population groups already highlighted. The main areas of work within
services that has started and will continue into the next strategy round are:
 The repatriation of people with complex needs placed in out-of-county
service provision back into their originating communities.
 Ensuring that people with complex needs have fair and equal access to
continuing health care provision.
 The development of affordable housing and supported
accommodation options, particularly for people who are living with
carers who are getting older.
 Further development of the Coastal project which arranges or provides
vocational guidance, employment, skills training and adult learning to
adults with a range of disabilities or significant social disadvantage.
Physical and Sensory Disabilities
There are a range of services for people with physical and sensory
disabilities with dedicated teams within the county borough. Current and
ongoing developments include;
 The increase of access for Direct Payments, which allows service
users to receive payment to arrange their own care and support
packages following assessment of need. Neath Port Talbot has the 6th
highest uptake of Direct Payments with 166 disabled adults and
children accessing the scheme.
HSCWB Strategy
36
 The coastal initiative which is available to people with physical and
sensory disabilities as well as people with learning disabilities. The
project provides opportunities to learn; train and work rather than
people having to attend traditional models of day care.
 The development of a Neurological Alliance across the ABMU Health
Board region which is now constituted. This is a critical development
when consideration is given to the high levels of stroke/TIA and
epilepsy within the county borough/locality.
Carers
Neath Port Talbot has the highest number of unpaid carers in England and
Wales. The total number of carers identified in the 2001 census for Neath
Port Talbot was 18, 923 with 600 of this total being children and young
people under the age of 18 years. The carer population group includes
17.45% reporting themselves as experiencing poor health.
Since the last strategy a number of initiatives have been progressed. These
have included; the development and launch of a carers handbook; a greater
number of carers assessments have been offered; an action plan has been
developed to address the needs of young carers; a range of carers events
have been organised and have included health improvement advice, and the
option of Direct Payments has been opened up to carers with some evidence
of increasing uptake.
There is still a lack of awareness across agencies and professional groups on
the needs of and issues faced by carers. New measures are being proposed
at a national level with a view to increasing legislation to place a new
requirement on the NHS and local authorities across Wales to prepare,
publish and implement a joint strategy in relation to carers.
HSCWB Strategy
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Agenda item 4
QUICK GLANCE SUMMARY OF SECTION 3a – NEEDS ASSESSMENT

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Neath Port Talbot (NPT) is a mix of urban and rural communities with 17 areas identified as
significantly deprived.
There are 11 designated Communities First areas which attract European funding for support
because of deprivation.
The population of NPT is predominantly described as White/British. However there are
smaller clusters of other ethnic population groups that require improved service access
including the gypsy traveller community.
There continues to be much higher levels of chronic disease and long-term limiting-illness
within the county borough compared to the Welsh national average and neighbouring local
authorities/localities.
NPT has an ageing population.
Key chronic disease inequity ‘hotspots’ for NPT compared to Wales are:
o
o
o
o
o
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Highest incidence of asthma
Second highest incidence of stroke/TIA
Second highest incidence of diabetes
Third highest incidence of obesity and overweight
High rates of suicide in young males
Disability population groups continue to be difficult to track for planning purposes as people
are not clear of definitions and registers are rarely an accurate reflection of the range of
population groups or needs.
Autism Spectrum Disorder is a new category to be tracked for planning purposes.
However, the current registration system does not serve any of the disability population
groups very well in terms of planning. There needs to be an overhaul of the whole system as
all these groups are likely to place pressures on resources by increasing demand for services.
Welsh language users are a population whose communication needs must be considered in
strategy development and service provision.
The wider determinants that have a significant impact on health which the partnership will
need to continue to focus on in this strategy round are:
o The economy – particularly employment, income levels and work-limiting disability
o The environment – particularly air quality, spatial environments and where people live
particularly housing and homelessness

Lifestyle continues to have a significant impact on health with NPT still having very high
levels of risk-to-health behaviours within the population such as:
Higher levels of smoking than the national average
Lower levels of physical activity and poor diet
A marked increase in teenaged conceptions particularly in the 13 – 15 year age group
Increasing levels of drug and alcohol misuse with significantly worse hospital
admissions for alcohol misuse in the county compared to the Welsh average and
neighbouring local authorities/localities
o Lower than average uptake of immunisation in children under 5.
o
o
o
o
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QUICK GLANCE SUMMARY OF SECTION 3b – COMMUNITY SERVICES
The community services that have an influence or the potential to address some of the
health inequalities that were identified in the previous section include:









General Practice (GPs) – list sizes are higher in Neath Port Talbot (NPT) than the
Welsh average with many services concentrated around the main population centres
of Neath and Port Talbot town centres and Pontardawe. There are services available
in branch surgeries and satellite centres but they do not provide the same range of
services. A new Primary Care Resource Centre in Port Talbot contains a wide range
of primary, community, social and third sector care services from one building with
a range of community outreach services. It is the first of its kind in Wales.
Dental Services - there is a significant inequity in the number of children aged 5
with decayed missing and filled teeth in NPT compared to the national average.
ABMU Health Board is closely auditing dental services across the three localities. A
new dental suite opened in the Primary Care Resource Centre in September 2010
and provides a range of community services that will help to address this inequity.
Ophthalmic (eye care) services - are provided by independent optometrists across
the county borough/locality and an established diabetic retinopathy screening
service and cataract referral service has helped to speed up access to more
specialised services when these are needed.
A Community Integrated Intermediate Care Service (CIIS) - is a merger between the
Early Response Service previously provided by social services and the Reablement
Service, which was a joint service between ABMU Health Board and Social
Services. This service provides a wide range of assessment and support from
consultants, therapists, nurses, social workers and support staff to reduce the
numbers of people going into hospital and residential care and to help people remain
independent at home.
Mental Health Services – are focusing on remodelling services so that people can
receive support with their emotional wellbeing earlier through a range of self-help
and community services to reduce self-harming behaviours. Services for people with
higher level need will be developed so that people can move back into the area if
they have had to move away because services were not suitable locally.
Older People Social Care Services – are being completely remodelled with a
specific emphasis on modernising residential care service; integrating more complex
community care services between ABMU Health Board and Social Care; improving
the efficiency of the home care service; remodelling day services; widening extra
care housing and reviewing social work services.
Learning Disability – will be focusing on developing services to bring people back
to the county borough; improving the process of arranging to meet continuing health
care needs; continuing to develop affordable supported accommodation and further
extending learning and employment opportunities for disabled people through the
coastal project.
Physical and Sensory Disability – there continues to be an increase in the numbers
of people accessing Direct Payments to arrange their own care services and a
Neurological Alliance has been established.
Carers – a number of initiatives have been established for carers of all ages.
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4.
MOVING FORWARD – ‘MAKING A REAL DIFFERENCE’
The Health Social Care and Wellbeing Partnership has grown and matured
over the last six to seven years. A significant amount of interagency
learning has been consolidated with an improved understanding of the roles
and responsibilities of each agency. The partnership is now in a much
stronger position to be able to focus down into some key priority areas of
project work for this next strategy round. There is a more consistent
evidence-based picture of the challenges and opportunities emerging from
three Health Needs Assessments; locally developed strategies and a range of
initiatives that have been piloted.
A significant amount of priority setting work has been progressed in the last
12 to 18 months based on the previous learning of the partnership. A move
towards programme and project managing these key priority areas with
clearer lines of accountability will be the focus of this next strategy round
for 2011 – 2014. The partnership believes that the proactive management of
these key priority projects will help to fully implement and monitor the
progress of the strategy and the partnership – ‘making a real difference to
the way people experience services; to the quality of people’s lives and the
environment in which people live,’ which has been the vision of the
HSCWB partnership from its inception.
The partnership will move away from the current HSCWB strategy model,
which was based on a Health Social Care and Wellbeing Partnership Board;
two separate planning groups known as Health Challenge Neath Port Talbot
(HCNPT) and Joint Executive Group (JEG) and a number of other subgroups usually based on lifestyle or specific population groups underneath.
There were eleven of these sub-groups in all, not having any decision
making powers or dedicated resources.
In the proposed revised partnership model the HSCWB Partnership Board,
HCNPT and JEG will be replaced by a Health and Wellbeing Programme
Executive Board. This board will consist of four key interagency Executive
Directors who have decision-making powers. Underneath the Executive
Board will be a number of Projects led by senior officers from across the
Partnership who are able to redirect resources. The projects will be based
around the priorities identified over the last 12 to 18 months by the
Partnership. Capacity building and specific service expertise will be
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40
provided by project managers with specific experience in the priority project
area.
The priority projects identified for Health Improvement are indicated below.
Each project manager will be responsible for developing a project plan to
take the project work forward. Progress will be reported into and formally
monitored by the Health and Wellbeing Programme Executive Board.
Scrutiny and challenge will be provided by the Local Service Board on
certain projects and cross-cutting partnership priorities.
Revised arrangements for the partnership and strategy implementation were
debated and amended in HCNPT/JEG on 26 July and were considered by the
HSCWB Partnership Board on 17 September. The revised partnership
arrangements are now operational. A Monitoring and Evaluation Framework
will be developed to support the implementation of this Strategy. That
Framework will use the Results Based Accountability conceptual model
with population measures identified to describe and track the long term
improvements in health outcomes for local people and performance
measures identified for each of the projects to track the project outputs. That
Framework will be published alongside this Strategy once the Partnership
has approved its content.
The priorities are summarised below:
4.1
HEALTH IMPROVEMENT PRIORITIES
Priority 1 – Reducing Obesity
 The project lead will have responsibility for bringing together the
work of the physical activity and nutrition local strategic health
improvement planning groups. Action will be taken to implement the
national obesity pathway on a local authority/locality basis. The
group will start by carrying out an evaluation of the effectiveness of
current projects to reduce obesity locally such as school-based multi
faceted interventions and current interventions for targeted population
groups. Then taking the evidence from this evaluation and agreeing
the critical steps to core this work into school curriculum and other
public service delivery mechanisms for children and vulnerable adults
on a long-term basis making the work sustainable.
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41
 The group will also ensure that the learning from the evaluation will
be scoped into the Local Development Planning Health Project Board
to ensure that impact assessment tools being developed for spatial
planning will consider the learning to increase physical activity levels
and improve nutrition from a spatial perspective.
Overarching Outcome: A reduction in obesity in targeted groups as
identified by the Obesity Project Team with corresponding improvements in
participation rates in physical activity and in reducing unhealthy eating.
Ensuring that the WAG obesity pathway is utilised within the project with
evaluation methods for measuring success agreed in the initial project brief.
Priority 2 – Reducing Risk-Taking Lifestyle Behaviours
 The project lead will bring together the scoping work carried out for
the alcohol strategic health improvement plan and the
recommendations from the Neath Port Talbot alcohol scrutiny project
and will be responsible for ensuring that these are progressed at a
national, ABMU-wide and local authority/locality level, identifying
areas of work where national lobbying and campaigning will be
necessary to bring about long-term changes in policy direction and
resource allocation.
 The project lead will bring together the work of the tobacco strategic
health improvement planning group and the ABMU Health Board
joint initiatives with Stop Smoking Wales to improve uptake of
smoking cessation in targeted groups, specifically; pregnant women,
people due for elective surgery, children and young people and men in
low income brackets. The project lead will additionally be
responsible for proactively tackling the current inequity that exists in
access to pharmacy support for smoking cessation within the county
borough to bring access levels into line with neighbouring local
authorities/localities.
 A project lead will be identified to develop a project plan and project
manage a revised and more consistent approach to sexual health and
relationship education in schools within the county borough. The
outcome would be to reduce the growing number of teenage
conceptions in 13 – 15 year olds within the county borough and to
stem the growing number of sexually transmitted infections in
younger people.
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 Overarching Outcome: To reduce significant risk-to-health lifestyle
behaviours in targeted groups. Three specific projects will be taken
forward in the life of the revised strategy with the overarching aim of:
o A reduction in harmful drinking levels in targeted groups as
identified by the Alcohol Project Team. The team will take into
consideration the research commissioned by WAG on harmful
drinking levels in young people and will develop local
initiatives to minimize risk to health in the locally agreed target
group. Evaluation methods for measuring success will be
indicated in the initial project brief.
o A reduction in smoking levels in pregnant women; children and
young people, men in low income brackets and those having
elective surgery;.
o A reduction in teenaged conceptions in the 13 – 15 age groups
and an overall reduction in sexually transmitted infections. A
sexual health project team will develop a project brief with
evaluation methods scoped into brief.
Priority 3 – Increasing Uptake levels of Immunisation and Vaccinations
 The project lead will be responsible for proactively managing and
tackling low uptake levels in all nationally targeted immunisation and
vaccinations for children under the age of five and the influenza
immunisation and vaccination of vulnerable adult groups.
Overarching Outcome: An increase in the uptake of immunisation and
vaccinations in the under 5 age group and an increase in the uptake of flu
vaccination in older people and other vulnerable groups. A project team will
be established to develop a project brief to tackle the inequalities that have
been identified in the HNA. There are national targets and evaluation
methodology already in place for this work.
Priority 4 – Improving Emotional Wellbeing in Targeted Groups
 The project lead will take forward an interagency project to improve
the identification and self-care pathway support for people who have
high levels of stress and anxiety as a consequence of sudden and
extreme life circumstance changes such as; redundancy, home
repossession, homelessness and relationship breakdown. Specifically
where people are showing early signs of significant deteriorating
mental health and are not known to mental health services.
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43
Overarching Outcome: An improvement in mental wellbeing with an
increase in access to early intervention services such as stresspac,
bibliotherapy and third sector support. The emotional wellbeing strategic
plan will be used to develop a project plan to develop a wider mental health
pathway
Priority 5 – Health Improvement in the Workplace
 The project lead will be responsible for the further development of
workplace health initiatives including the Health Challenge Neath
Port Talbot Business Campaign and corporate health promotion
initiatives to improve the health of the partnership workforce and
reduce sickness levels.
There will be a reduction in days lost due to sickness in partner agencies and
in participating workplaces and evidence that the initial 22 businesses signed
up are adopting health improvement initiatives in the workplace.
Priority 6 - Dental Health of Younger Children
 A project lead will need to be identified to address the issues related to
the significant higher percentage of delayed, missing and filled teeth
in children under the age of 5 in Neath Port Talbot, which is 64.48%
compared to the Welsh average of 52.63%. There appears to be
inconsistency in the DS2 programme as some schools within the
county borough have declined involvement.
Overarching Outcome: a reduction in the % of children and young people
with missing, decayed or filled teeth.
Priority 7 - Cancer Screening (Breast and Testicular)
 Information on screening coverage for breast cancer shows that Neath
Port Talbot has the third lowest coverage rate out of 22 local
authorities in Wales. A person needs to be identified to link into
Public Health Wales and ensure that health promotion campaigns on
breast cancer screening are appropriately targeted within the county
borough/locality.
 Consultation responses received in relation to the draft Strategy
indicated support for a higher profile to be given to Testicular Cancer.
The Partnership will undertake education and health promotion
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44
initiatives over the three years of the Strategy to ensure men are
encouraged to undertake self-examination with a view to early
identification and access to treatment.
Overarching Outcome: A higher percentage of the target population
accessing screening services or undertaking self-examination.
4.2
SERVICE REMODELLING AND SERVICE INTEGRATION
PRIORITIES
Priority 8 – Transforming Older People Services
 The project lead will be responsible for procuring the development of
four replacement residential care homes from an external provider.
 The project lead will be responsible for ensuring that there are
integrated intermediate care services based on local needs and which
offer value for money.
 The project lead will be responsible for improving the efficiency of
the Home Care Service improving its competitiveness and ensuring
that higher skill level within that workforce is appropriately utilised.
 The project lead will be responsible for ensuring that prevention and
self-care options are developed with the third sector.
Outcome measures are currently being developed for this programme.
Priority 9 – Developing Community Networks
 The project lead will be responsible for ensuring that integrated health
and social care community network teams are established within the
county borough linked into the work above.
Outcome measures are currently being developed.
Priority 10 - Improving Community Mental Health Services
 The project lead will be responsible for ensuring that Community
Mental Health Teams are included in the ABMU Health Board review
of mental health services and that there is a locality focus on tackling
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45
the significant health inequity that exists within the county borough,
specifically self-harming behaviours in younger males.
Outcome measures are currently being developed
Priority 11 – Community Support for People with Learning Disabilities
 The project lead will be responsible for taking forward the
developments to remodel community services for people with learning
disabilities including; the development of affordable supported
accommodation, extending day service and vocational opportunities
and more efficient arrangements for ensuring continuing health care
needs are met.
Outcome measures are currently being developed
Priority 12 – Improving Transition and Transfers of Care
 The project lead will be responsible for identifying delays in hospital
discharges and will proactively seek solutions to tackle delays.
 The project lead will be responsible for managing the efficient
transfers of care where people are identified as meeting continuing
health care criterion.
 The project lead will be responsible for ensuring that children who
require health and social care support into adulthood because of
disability or vulnerability can access adult service provision or direct
payments without delay.
Progress will be tracked by analysing delayed transfers of care and the
reasons for those delays. Measures for determining continuing health care
transitions are currently used and will be brought into partnership view in
this next phase. New measures to assess the effectiveness with which
transitions from child to adult services are handled will need to be be
developed.
Priority 13- Reducing inequity in service access for vulnerable groups

Autism Spectrum Disorder – the project lead will coordinate a review
of the disability registration process ensuring that the full range of
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46
needs of all significant disability population groups are identified and
tracked appropriately for planning and service remodeling purposes.
 Homeless and Vulnerable Groups - the Health Board project lead will
ensure that the Homeless and Vulnerable Groups Action Plan is fully
implemented and that health access inequity identified within the
locality is proactively tackled.
 Improving support services to Carers – the project lead will review the
current strategy for carers and bring to the attention of the partnership
any implications for interagency service planning that may occur as a
consequence of likely changes in legislation.
Priority 14 – Stroke
Development of stroke services is a priority for the Welsh Assembly
Government. Several workstreams have developed to standardise stroke
care and improve patient outcomes across Wales. For the acute phase,
rehabilitation phase and Transient Ischaemic Attacks (TIA) a specific
methodology is used which collects data on meaningful clinical intervention.
Monitoring activity within the acute phase is an ongoing, on a daily basis
which allows for the review and measurement of practices and timely
improvements wherever possible. The acute phase has achieved the
following: Early medical review in the emergency department
 Early CT brain scan
 Early diagnosis
 Early swallow screening and assessment
 Early aspirin (if no haemorrhage)
 Early risk factor management
 Early access to therapies
Since November 2009 all suspected stroke patients have received acute care
from either the Princess of Wales Hospital, Bridgend or Morriston Hospital,
Swansea with patients from NPT then receiving rehabilitation at the Stroke
rehabilitation Unit at Cimla Hospital. Priorities for the coming months in
Neath Port Talbot are to measure the outcomes for patients following their
rehabilitation, and for those suffering from Transient Ischaemic Attack
(TIA). These priorities will be reviewed and measured in order that stroke
services are responsive to individual needs.
Outcome measures for all of the above are being developed
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QUICK GLANCE SUMMARY OF SECTION 4 – MOVING FORWARD


Partnership agencies have a better understanding of each others roles and
responsibilities since the partnership has been established.
The partnership has agreed a number of priority projects for the next strategy
round which include:
Health Improvement Priorities
1. Reducing obesity
2. Reducing risk tacking lifestyle behaviour - specifically alcohol misuse and
smoking
3. Increasing uptake of immunisation and vaccination in children under five and
vulnerable adults
4. Improving emotional wellbeing in targeted groups
5. Workplace health in private business and the public sector
6. Dental health of younger children
7,. Cancer Screening (Breast and Testicular)
Service Remodelling and Service Integration Priorities
8. Transforming Older People Services
9. Developing Community Networks
10. Improving Community Mental Health Services
11. Remodelling Services for People with Learning Disabilities
12. Improving Transitions and Transfers of Care
13. Reducing inequity in service access for targeted vulnerable groups
14. Development of stroke services
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5.
RESOURCE CHALLENGES AND OPPORTUNITIES
5.1
NPT COUNCIL FORWARD FINANCIAL PLAN 2009 – 2014
Neath Port Talbot County Borough Council developed a five year forward
financial plan (FFP) based on work carried out by Deloittes and this was
approved by Council in March 2009. The report forecasted a significant
funding gap for the Council by 2014 as a consequence of existing service
pressures, particularly affecting children and adult services. The proposed
outcome of the FFP is to reduce budget pressures by £40m in five years
whilst protecting and in some instances improving services. The Council’s
approach to budget management in the past has been to seek out annual
incremental efficiency and economy savings through closely monitoring
budgets within service Directorates. It was agreed that a more radical
approach is required over the next 4 – 5 years to ensure that the agreed
outcome and the stability of the Council’s finances are achieved.
In response to the projected financial gap, the Council invested in capacity to
take forward a significant change programme that aims to best balance
improvement of services, especially to the most vulnerable with the need to
deliver significant cashable savings. The transformation programme was
initiated in 2008 and involves service re-design, procurement savings,
rationalisation of assets, process improvement work and tactical
“housekeeping” savings. The transformation programme is supported by a
comprehensive workforce strategy. Good progress has been made in the first
year of the strategy with savings delivered largely to plan and service
modernisation accelerated.
However, since the initial Forward Financial Plan was developed, the UK
public sector budget position has worsened with large cuts in public
spending announced on 20th October 2010. The Council is currently
planning on assumptions that expect further, significant additional savings,
beyond the scope of the existing Forward Financial Plan, to be made. The
need to modernise social care services is an integral part of the Council’s
Corporate Plan and the aims are shared with the Local Health Board and
wider partners. In a number of instances bolder actions to integrate services
are needed in the best interest of citizens. The challenging financial climate
emphasises the need for senior managers to ensure scarce capacity is
concentrated on the changes that will make the most difference. The capacity
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for change has been significantly weakened by the Welsh Assembly
Government’s decision to withdraw the Joint Working Special Grant.
Safeguarding
In order to ensure that safeguarding activity is more efficient and effective
over the next FFP period the focus will be:
 To continue to secure a skilled and competent social care workforce
focused on safeguarding and promoting the rights of the most
vulnerable children and young people.
 To integrate planning and operational service delivery between social
care, education, NHS services and the third sector where appropriate
to ensure that services are safe and responsive to the needs of
individual children and their families.
 To review the effectiveness of commissioned family support services
and take any appropriate action to improve services.
 To ensure that early preventative work is central to the work of the
Children and Young People’s Partnership.
 To manage demand more effectively with better intelligence on need.
 To improve the links and transfers of care between children and adult
services.
 To improve local support and reduce the numbers of out of county
placements.
 To strengthen fostering opportunities.
Adult Care
In order to ensure that adult care is more efficient and effective over the next
FFP period the focus will be:
 To promote the independence of vulnerable adults and to safeguard
adults who are at risk of abuse.
 To ensure that remodeled services have been shaped by appropriate
engagement of older people and unpaid carers
 Options of care and support for older people to live independently at
home or in their own communities, which are based on individual
preference.
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 A culture of care and support delivery that is based on individual
potential, dignity, respect and which helps to minimise risks and
protect people from harm.
 Needs-led and not service driven
 Meeting statutory duties and care standards
 Targeted at the most vulnerable/people with higher level needs
 Able to provide efficient and timely assessment and service delivery
 Cost effective and deliverable within service budget
 Integrated into a wider interagency care and support pathway (not a
stand-alone service)
 Seamless at the point of delivery
 Able to be responsive to rapid change
The core of adult care will continue to be a strong social work service that
assesses needs and plans with service users, carers and other
professionals/agencies, to enable people to continue to live safely in the
community and as independently as possible.
The increasing number of older people and the growing population of
younger adults living with disability will place significant pressure on the
service and the wider council budget. However, this is not just about
increased numbers. It is unlikely that people, in future, will find acceptable
some of the services currently commissioned. National research and rising
expectations means that there will be pressure e.g. on housing services, to
enable people to cope with increased frailty and disability in the community.
People will expect a more personalised service and a wider degree of choice
over the way in which their care needs can be met. Likewise, the growth in
technologies will present new opportunities to redesign services. Accessing
wider community services will be a challenge for the whole Council.
The core of directly provided services will need to focus more on reablement
and rehabilitation. Services will aim to help people regain and retain their
independent living skills, compared with more traditional services where
people have services provided for them. These will increasingly need to be
delivered in conjunction with the Health Service, with both services
becoming much more integrated from a service user’s perspective.
Traditional community services could become increasingly unaffordable and
to protect people’s ability to access these services, it could be necessary to
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transfer blocks of direct service to alternative providers, with a strong
preference that these to be not-for-profit entities e.g. community mutuals.
Notwithstanding the reduced resources, we will also need to ensure that
“intensive care” services remain available for people who need them when
disability, frailty or health needs render it unsafe for people to remain within
their community.
5.2
AMBU Health Board Financial Outlook
The financial outlook for health mirrors that of local government. It is likely
that a period of reductions in budgets will have to be managed by the NHS.
National work has identified that the potential range for allocation annual
changes could be between 0% and -3%, in each of the years ahead. Given
that NHS inflation, demand and cost pressures can lie in the range of
between +4% and +8%, it is evident that a prolonged period of very
substantial annual savings requirement is highly likely to be required over
the next 5 years or so. The ABMU Health Board have therefore adopted a
7% savings scenario that forms the basis of the forward ABM Financial Plan
and against which the service response captured in the 5 Year Quality and
Service Framework needs to be considered.
Providing quality services that are appropriately delivered, in the right
setting by the right people, is at the centre of the approach taken by ABMU
in planning and delivering services. This approach needs to be developed
and applied in the context of the financial resources that are forecast as being
available to the Health Board.
It is important that the forward Plan realises the opportunities, available to
ABMU in being a new, fully integrated healthcare organisation, that were
not available in the previous NHS management arrangements in Wales.
Given the likely economic context, the ABMU Health Board’s 5 Year
Quality and Service Framework will need to develop plans that contain
action in the following areas:


Strategic Service Changes
Improving Service Cost Efficiency
Reducing Waste and Harm
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


Transforming the Delivery of Services
Workforce Strategy and Controls
Rigorous Cost Containment.
It is evident that the actions that will flow from the above will need to be
planned, implemented and sustained over the whole 5-year planning period.
It is imperative for robust service and financial planning that each activity is
outlined, not only in its in-year contribution, but also in its recurring
contribution.
It is also critical that measures are taken forward with focus and strong coordination of managerial and clinical resources. It is important to commence
the preparation of planning for, and stakeholder management of, service
changes, even though their full impact may fall in future years.
Partnership working with Local Authority within the three Localities
(Bridgend, Neath Port Talbot and Swansea), to plan and deliver integrated
service provision should underpin service planning. Additionally, close
working with the Third Sector to maintain and improve services for clients
will continue to be a key part of plans.
The Health Board faces a major Service Redesign, Transformation and
Value for Money agenda, arising from the challenging Public Finance
environment ahead. This will require the Health Board to significantly
enhance the initial work done to date to shape a Quality, Service, Workforce
and Financial Strategy that covers a medium term period of up to five years.
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Agenda item 4
APPENDIX 1
NATIONAL AND LOCAL STRATEGIC INFLUENCES
The development and implementation of the local Health Social Care and
Wellbeing Strategy 2011 – 2014 has been influenced by a range of national
strategies. The key influences are outlined below:
1. Wellbeing in Wales (2002) - (*which led to the Health Challenge Wales
launch in 2006 and more recently has included Change 4 Life). WAG’s
recognition of the need to take action to prevent ill-health through health
improvement projects and to reduce health inequalities through integrated
approaches to policy and project development related to the socioeconomic determinants of poor health. The NPT HSCWB Partnership
localised Health Challenge Wales into ‘Health Challenge Neath Port
Talbot’ with its own health improvement branding, website and range of
health improvement projects. A number of Strategic Health Improvement
Plans were established from this work including a Nutrition Plan;
Physical Activity Plan; Infection Control Plan; Tobacco Control Plan;
Quality of Life for Older People Plan and more recently an Emotional
Wellbeing Plan. The learning from the Strategic Health Improvement
Plans (SHIPs) will be subsumed into the Project Boards in the revised
HSCWB Partnership Structure, which will be based on the key priorities
identified in this revised strategy.
2. Wales: A Better Country (2003) - WAG’s commitment to improve
health, prosperity and social justice across Wales with an emphasis on
smarter working through partnerships. The Neath Port Talbot HSCWB
partnership has ensured that health and wellbeing are embedded into all
statutory strategies such as the Community Plan; Local Development
Plan; Children and Young People’s Plan; and Community Safety Plan.
3. Making the Connections: Delivering Beyond the Boundaries (2006) WAG’s commitment and action plan for improving public services
through integration. The NPT partnership has a good history of
integrated service development with the development of Residential and
Community Re-ablement (*now absorbed into the CIIS service) and
Child and Adolescent Mental Health Services. There are also excellent
joint working arrangements between health and social care in Older
People Services, Mental Health Services and Learning Disability
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Services. There is a section 33 agreement in place for Joint Equipment
Services and it is the intention of the HSCWB Partnership to move
towards a section 33 agreement for the CIIS service in the next financial
year.
4. Designed for Life: Creating World Class Health and Social Care
Services for Wales (2006) - WAG’s ten year strategy for reforming NHS
secondary, primary, tertiary and social care to reduce waiting times for
services with further emphasis on partnership working across the NHS,
Public Health, Local Government and third sector, with a shift of
emphasis from a ‘sickness- based’ service to a more holistic ‘health
service.’ As indicated above Health Challenge Neath Port Talbot, has
taken the lead in tackling local health inequalities and developing health
improvement projects to prevent ill-health and the Joint Executive Group
has led the integration of health, social care and other community
services.
5. Fulfilled Lives and Supportive Communities (2007) - WAG’s ten year
direction for Social Services to improve governance and accountability,
commissioning, performance management, partnerships and workforce
with a significant emphasis on partnership working. Contracting and
Procurement has been strengthened in Neath Port Talbot and is now more
aligned to performance management processes and key service priorities.
6. Community Services Framework (2007) - WAG’s national framework
to develop a community-based approach to meeting need including
ensuring that clear pathways are in place between and across agencies,
directorates and community services such as the links between; primary
care, generic community health services, specialist clinical outreach
services, social services and health promotion. Pathway developments
will be scoped into the partnership project plans that relate to specific
priorities as indicated in the body of the revised strategy.
7. Designed to Improve Health and the Management of Chronic
Conditions in Wales (2007) - Recognition from WAG that there are
higher than average levels of chronic disease in Wales compared to the
UK. The WAG suggestion was to:
 Increase the emphasis on partnership working and service
integration
HSCWB Strategy
55
 Develop more effective health promotion, prevention, self care and
early intervention projects and/or services
 Improve public information to help people manage their own
health and wellbeing to tackle health inequalities across Wales
8. Designed to Add Value (2008) – WAG’s strategic direction for the third
sector in supporting health and social care was WAGs recognition of the
third sector contribution to health and social care service development
and delivery. Again there was an emphasis on stronger coordinated
partnerships across statutory, independent and the third sector, utilising
the resources within communities and helping to build community
cohesion. NPT CVS has worked closely with the HSCWB Partnership
(and is an equal stakeholder within the partnership), to develop services.
Examples of local NPT projects led by the third sector include; the
development of social enterprises with one valleys project specifically
focused around a Health and Wellbeing centre; the development of a
directory of local support services to help people improve or maintain
their health within the county borough, which is available on the Health
Challenge Neath Port Talbot website and NHS Direct; and a Lifestyle
Coaching pilot in partnership with two General Practitioners.
9. Rural Health Plan (2009) - WAG’s commitment to ensure that the
future health needs of communities are met in ways that reflect the
particular conditions and characteristics of rural Wales. The key three
themes within the plan are to:
 Improve access to services from emergency to community services
 Move towards integrated models of service delivery across
agencies
 Improve community cohesion and engagement
10. Our Healthy Future (2010) - WAG’s Public Health Strategy for Wales
that takes a more holistic approach to health improvement.
It
acknowledges the wider determinants of health and indicates six key
action areas should be considered to improve and sustain the health of the
nation, communities and individuals. The six key action areas are:
 Health and Wellbeing through the life course
 Reducing inequity in health between the poorest and the more
prosperous
 Healthy sustainable communities
HSCWB Strategy
56
 Prevention and early intervention to avoid ill health
 Health as a shared goal for all
 Strengthening the evidence-base and monitoring progress
11. Setting the Direction: Primary and Community Services Strategic
Delivery Programme (2010) - WAG’s commitment to delivering worldclass integrated health care in Wales. Indicating the need for a change in
approach to developing both policy and service delivery models for
primary and community care. The key underlying principles for
improvement include:
 Universal population registration and open access to effectively
organised services within the community
 First contact with generalist physicians that deal with
undifferentiated problems supported by an integrated community
team
 Localised primary care team-working serving discrete populations
 Focus on prevention, early intervention and improving public
health not just treatment
 Coordinated care where generalists work closely with specialists
and wider support in the community to prevent ill-health, reduce
dependency and effectively treat illness
 A highly skilled and integrated workforce
 Health and Social Care working together across the entire patient
journey ensuring that services are accessible and easily navigated
 Robust information and communication systems to support
effective decision-making and public engagement
 Active involvement of citizens and their carers in decisions about
their care and wellbeing
Local HSCWB strategic links include contributions to the:



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


Community Plan
Children and Young People’s Plan
Local Development Plan
NPT Valleys Strategy
Homelessness and Vulnerable Groups Health Action Plan
Strategic Housing Plan
Substance Misuse Action Plan
HSCWB Strategy
57
 Population specific plans for Older People; Mental Health; Learning
Disability; Physical and Sensory Disability; Carers; Transition to
Adulthood and Autistic Spectrum Disorder
HSCWB Strategy
58
Agenda item 5
Neath Port Talbot Children and Young People’s Partnership Development of Children and Young People’s Plan 2011­2014 1. Introduction Neath Port Talbot Children and Young People’s Partnership commissioned Brian Atkins and Sue Brunton‐Reed from Effective Training and Consultancy Limited to provide support to develop and write the second Children and Young People’s Plan 2011‐14. A draft was produced in October 2010 and further work was commissioned in December 2010 to support a consultation process, which engaged and sought views of a range of key stakeholders. Three events were convened on December 16th 2010, January 12th and 25th 2011, attended by a large number of partner agency representatives from across the Borough. In addition, all stakeholders were invited to comment on the draft plan through a structured questionnaire, which will be returned to the partnership team. All of the consultation meetings enjoyed lively debate and discussion both within small groups, and within the open forum. This summary report attempts to identify the key issues raised in the consultation, and reflect the commitment of participants to the future task. Detailed notes of the consultation feedback were taken and are available from the Partnership Team. 2. Process followed Following a short presentation outlining the development of the plan, a summary of the content and an outline of the consultation opportunities, participants were invited to work in small mixed agency groups to review and comment on each Service Delivery Priority area, the Child Poverty Strategy section, Workforce Development section and the Performance Management process. This detailed feedback from each of the three events is attached at Appendix 1. 3. Summary of key themes and issues – Vision, Principles and Service Delivery Priorities 3.1 Vision And Principles The vision of the Partnership is that: Children and Young People in Neath Port Talbot will be healthy, confident, active individuals who achieve their potential within a safe home and community that is free from poverty. Key issues from consultation feedback effective training and consultancy limited 01604 643610 email [email protected] Agenda item 5
There was general agreement that the vision statement was still relevant. There was a significant lobby suggesting that ‘abuse and exploitation’ should be added to the vision statement to read…… community that is free from poverty, abuse and exploitation. The vision was recognised as an aspirational overarching statement, and practical steps were needed to ensure that it was not just a wish list. Clear structures should be in place to monitor the achievement of outcomes by strategic levels within the partnership. This would include the coordination of services and funding streams to achieve the vision. Principles Working Together, we will: 
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
Streamline partnership planning and implementation processes to improve effectiveness, reduce duplication and ensure accountability for implementation Use evidence and information from best practice to inform our decision making Make decisions about resource allocation according to our priorities and pool or align our budgets where appropriate, supporting effective local and regional commissioning arrangements where appropriate Share information to inform decision making Improve communication between partnerships and within and across agencies Develop annual action plans to support implementation against any medium term strategy, ensuring that critical success factors are clearly identified Effectively monitor the quality and performance of our services Prioritise findings from key service reviews and incorporate into the strategic plan In organising our services to deliver better outcomes we will: 
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Intervene as early as possible when we identify problems to avoid problems escalating Develop more integrated ways of working and delivering services locally, bringing together front line workers, and develop skills and confidence of our front line staff to deliver effective interventions Extend the involvement and participation of children, young people and their families in planning and delivering services to meet needs Work with third sector organisations at a strategic and operational level to promote effective partnerships and maximize all resources Promote fairness and equality of opportunity and access to services for all children Develop clear, coordinated public information about services provided by partnership agencies Continually challenge mainstream universal services to ensure that they address the needs of the most vulnerable effective training and consultancy limited 01604 643610 email [email protected] Agenda item 5
There was again general agreement with the principles of working together and how they should be achieved. Comments were grouped into a number of specific areas: 
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3.2
To more clearly link the policy context to education and pupil inclusion strategies. A need for more emphasis on sport and physical activities. The need to join up funding streams to achieve outcomes. The need for more clarity about how the key challenges have been identified, and local/government priorities have been embedded into the plan. The need for more clarity about achievement from the previous plan aims. The role of strategic management from the partnership in pushing forward joint working to achieve goals Service Delivery Priority 1 Further develop prevention, parenting and family support services The partnership aims to develop a continuum of preventative services throughout the whole age range covered by the plan, to include parenting and family support services. These services aim to support early interventions with families, delivered in a timely way, to reduce the need for more intensive or specialist services at levels 3 and 4 Key issues from consultation feedback Much of the feedback in this section emphasise the need to create stronger links with services for adults, including adult mental health and substance misuse issues. There was a strong lobby focusing on the importance of domestic abuse within the family, and the need to coordinate services to address this. The team around the child (TAC) approach was emphasised, as was the general need for coordinating parenting support services, perhaps under a dedicated parenting coordinator. The need for a more robust approach to support for young carers was also supported. 3.3
Service Delivery Priority 2 To improve health and well­being services Key issues from consultation feedback The actions under this priority were strongly supported with most focus being on the practical steps needed to ensure effective implementation. However strong effective training and consultancy limited 01604 643610 email [email protected] Agenda item 5
views were expressed that physical health issues should be included under this Service Priority as well as emotional health. Particular support was expressed for: 
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The need for further development of CAMHS services. The shortage of counsellors and the need for support for children while they are on a CAMHS waiting list. The need for these services to be developed around the needs of children and families are not the service. The need for positive anti‐bullying strategies, including teaching young people to be more assertive. Recognition of the impact of domestic abuse on emotional well‐being. The need for clear inclusion of education initiatives in this area of work. An emphasis on the development of physical activities to improve emotional well‐being. The need for a clear needs analysis to determine priorities. The need for this priority to also apply to colleges, and students who should receive CAMHS services post 16 The importance of addressing the needs of ethnic minorities 3.4
Service Delivery Priority 3 Participation, engagement and advocacy Key issues from consultation feedback There was a good level of support for this priority area. More information was needed about the Young Wales model – many delegates were unaware of this model. There is a need for more clarity of communication about the participation strategy, and how people can get involved. There should be more emphasis on training and supporting children and young people to have a voice through education. Participation should be embedded in the culture of organisations and led from the strategic level. The importance of engaging with ethnic minorities and traveller children 3.5
Service Delivery Priority 4 Ensure that children with disabilities and / or autistic spectrum disorder can access universal and specialist services Key issues from consultation feedback Support for developing a multi agency strategy for disabled children was expressed. There was a very strong lobby in this priority area for focusing on disabled children as a whole, and not a specific focus on autistic spectrum disorder. ASD issues could effective training and consultancy limited 01604 643610 email [email protected] Agenda item 5
be addressed within the disability strategy. Children with additional learning needs (including SEN and LAC) could also be included. There was also a strong focus on the importance of transitions between adult and children's services, and recognition that this is a 0 to 25 strategy. Multiagency working is again essential to secure the best outcomes 4. Crosscutting priority areas 4.1 Workforce Development. Workforce development priorities 
Develop a Children and Young People’s Workforce Development Strategy which identifies core competences required to deliver integrated services, and put together a plan to address these 
Maximise partnership training opportunities and facilitate co‐training between partner agencies where possible 
Work together to promote staff recruitment and retention across the children’s workforce Key issues from consultation feedback There was a strong support for the priorities. Key themes for implementation included: 


A process to develop core competencies across services, maybe having an extended practitioner role with people able to work in more than one area or service. Key core competencies would include child development and safeguarding The need for a workforce development group under the partnership to coordinate developments in this area, including opportunities for shared training and recruitment. Core competencies may need to move away from a dependence on qualifications towards recognition of core skills and practice experience 4.2 Child Poverty Strategy: ­ delivery priorities a. To reduce the number of families living in workless households b. To improve the skill level of parents and young people in low income families so that they can secure well­paid employment effective training and consultancy limited 01604 643610 email [email protected] Agenda item 5
c. To reduce inequalities that exist in the health, education and economic outcomes for children living in poverty, by improving outcomes of the poorest Key issues from consultation feedback A clear definition of poverty is needed, which includes poverty of opportunity as well as economic poverty. The plan needs to reflect that it is for all children and young people and not just those in social care settings and environments. There should be more emphasis on aspiration, and helping young people to move out of poverty by their own efforts, supported by mentors and role models. There should be closer links to the economic regeneration plan, as well as environmental and transport sectors not covered by the CYP. The plan is not limited to Cymorth funded projects. The project should build on the work of Genesis, but also include reference to the work of other groups 4.3 Performance Management. Key issues from consultation feedback The groups addressed the following questions 

What is the most effective way for agencies to report progress on the plan to the Board? The key issues are the need for a simple, common reporting framework, with clear identification of success criteria. There should be a common reporting system for both grant and mainstream funded activities. Outcomes at the population level would give an indicator of overall progress. Feedback from service users, and children, young people is an important area of information for monitoring. Results Based Accountability methodology should be used. How should the Board use information provided to oversee progress? The Board should monitor, support and challenge partner agencies. The red, amber, green, reporting model is useful, and as well as giving attention to poor performing areas, green issues should also be investigated to see why they are working well. There should be clear links to using information for the commissioning process. It is important to clarify accountability – should this sit with the chair of each priority group, or with the person monitoring at agency level? 
Core aim monitoring framework. There is a need to clearly differentiate in the reporting matrix between government and local aims. Local targets should be set annually. Some delegates felt that an additional column should be added to identify responsibility for the target and reporting progress. effective training and consultancy limited 01604 643610 email [email protected] Agenda item 5
These issues were discussed in the consultation meetings by the consultants – see note below. It should be noted that the monitoring framework is based as required on the WAG Core Aims. It is therefore separated from responsibility for delivery groups, as each delivery group may impact on more than one core aim. This is an important principle for the monitoring framework. The expectation is that each Service Delivery Group will develop an annual work plan with targets, responsibilities and timescales. 
How should the Board hold agencies to account for their role in implementation of the plan? At agency level there needs to be discussion and dialogue, which should be built into the process. It is important that agencies report against the shared common structure, and not evidence outcomes in their own way. Results Based Accountability methodology should be used to enhance the focus on achieving required joint outcomes. The core aims need to be addressed. 5. Gaps The following gaps were identified in open discussion: 
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Domestic abuse is a crosscutting issue and should be reflected across all service priorities. This is a 0 to 25 plan, and should emphasise all children and young people within these boundaries, and in particular transitional services, and access to support services for the whole family. Insufficient focus on physical well being, and prevention of obesity Sue Brunton Reed Brian Atkins February 2011 effective training and consultancy limited 01604 643610 email [email protected] Agenda item 5
Draft Neath Port Talbot
Children and Young People’s
Plan
2011 – 2014
‘Putting Our Children and Young People First’
Partners and Health Challenge NPT Logos Contents
Page
Foreword
1
Introduction
2
2
Partnership Priorities
3
3
Our Vision and Principles
6
4
Understanding Local Needs
7
5
Progress on the Seven Core Aims
9
6
Service Delivery Priorities for 20112014
16
Child Poverty Strategy
27
7
Workforce Development
32
8
Monitoring Progress
34
Appendix 1: the Children and Families
(Wales) Measure 2010 13 Broad Aims
Appendix 2: the policy context
35
Appendix 3 – summary of actions to
support priorities
38
36
1
Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
1.
Introduction
The Children and Young People’s Plan outlines the priorities for all agencies in
Neath Port Talbot working with children and young people aged from birth to 25
years. Since our first plan was produced in 2008, the Children and Young People’s
Partnership has been working hard to improve outcomes for children young people
and their families locally.
The local authority and the Health Board have a statutory duty to co-operate with
key partners in producing this revised and updated plan for 2011-14. The partners
in the Children and Young People’s Partnership have worked together to develop
this plan and to agree shared ownership of the priorities and actions. The Plan is
aligned with Neath Port Talbot Community Plan, the Health, Social Care and
Wellbeing Strategy, the Community Safety Strategy and with other local plans, and
this Plan will inform the development of joint commissioning strategies for our
priority service areas.
The Plan follows guidance from the Welsh Assembly Government which reinforces
how Children and Young People’s Partnerships should bring together and coordinate services for children and young people to secure the best outcomes from
limited resources. The plan focuses particularly on the new duties in the Children
and Families (Wales) Measure 2010 for all partners in relation to child poverty,
integrated family support services, participation, play and disabled children.
The basis for all our work with children and young people is the UN Convention on
the Rights of the Child and this Plan aims to address the seven core aims that all
children and young people:
 Have a flying start in life
 Have a comprehensive range of education and learning opportunities
 Enjoy the best possible health, and are free from abuse, victimization and
exploitation
 Have access to play, leisure, sporting and cultural activities
 Are listened to, treated with respect, and have their race and cultural identity
recognised
 Have a safe home and a community which supports physical and emotional
wellbeing
 Are not disadvantaged by child poverty
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
2.
Partnership Priorities
In developing this Plan we have taken into account the current resource challenges
and the need for all partners to achieve significant savings, which could impact on
service development. The focus therefore has been on identifying key priorities for
multi-agency service delivery that will help us build capacity and sustain our
developments.
The priorities have been identified by updating our needs assessment, reviewing
progress on the previous plan, working with partners to identify their challenges and
priorities, and by drawing on consultation with children, young people and families.
The plan focuses on a small number of key development areas that require partners
to work together, are sustainable, achievable and likely to make the most difference
to outcomes under the seven Core Aims for children and young people.
The Neath Port Talbot Children and Young People’s Partnership is the key vehicle
for driving forward the implementation and monitoring of this Plan. Its role is to
promote collaboration and co-operation between partners, who will each continue to
work to their statutory duties and responsibilities.
The Partnership has representation from the County Borough Council, ABM
University Health Board, the Council for Voluntary Service, South Wales Police,
Mid and West Wales Fire and Rescue Service, Public Health Wales, the Local
Probation Board, the Youth Offending Team, the Local Safeguarding Children’s
Board, the 14-19 Network, Job Centre Plus, NPT College and local schools.
Since 2004, the Partnership has had a legal responsibility under the Children Act
(2004) to improve the well being of all children and young people aged from 0 to 25
years. The Partnership will continue working with other strategic partnerships,
including the Local Safeguarding Children’s Board, the Health Social Care and
Wellbeing Partnership and Community Safety Partnership, in delivering this plan,
and some cross cutting themes and joint priorities have been identified which will
be led by one identified partnership to promote consistency and avoid duplication.
These themes and priorities are based on a shared analysis of need and informed by
research undertaken on behalf of the partnership by Dr. Wendy Ball (2010) into the
reasons for the increasing demand on our Children’s Services.
We have agreed that a focus on prevention and early intervention is essential and
that the needs of the poorest and the protection of the most vulnerable should be our
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
main concerns. We will work together on some of the most serious matters
affecting the well-being of children, young people and families, including
 Substance and alcohol misuse
 Domestic abuse
 Emotional well-being
In addressing these and other problems we have agreed to increase participation,
involvement and consultation with our service users and partners.
This plan incorporates the delivery of universal services that are available to all
children and young people with a specific focus on how agencies can collaborate to
provide enhanced services to the most vulnerable children and young people.
A common framework for identifying needs and interventions has been agreed by
the Partnership which incorporates four levels or tiers of service:
Tier 1 – Universal: Services available to all children and young people.
Tier 2 – Targeted: Services for vulnerable groups or communities who require
support to access universal services, preventative services, or referral and
assessment to access more intensive levels of intervention.
Tier 3 – Specialist: Specialised community based services for children and young
people to meet an identified and assessed need.
Tier 4 – Intensive Specialist: Services for children and young people living away
from home, either in hospital, children’s homes, foster care or custody.
The main focus for our multi agency service development work over this period
will be on working together at tiers 2 and 3 (see diagram overleaf). We will
continue to improve the access to and the quality of universal services. We
recognise that children’s needs change over time and they may move between levels
of service. Service providers from higher tiers of specialism will continue to work
with universal service providers to help them meet the needs of children and young
people wherever possible.
We want to build on the positive developments in multi agency working, increasing
our focus on community based service delivery, providing local services to meet
local needs. In this way we will continue to commission and deliver quality
services within the constraints of the budget reductions we all face.
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
3.
Our Vision and Principles
Children and Young People in Neath Port Talbot will be healthy, confident,
active individuals who achieve their potential within a safe home and
community that is free from poverty, abuse and exploitation.
How we will work together and deliver our services
Working Together, we will:
 Streamline partnership planning and implementation processes to improve
effectiveness, reduce duplication and ensure accountability for implementation
 Use evidence and information from best practice to inform our decision making
 Make decisions about resource allocation according to our priorities and pool or
align our budgets where appropriate, supporting effective local and regional
commissioning arrangements where appropriate
 Share information to inform decision making
 Improve communication between partnerships and within and across agencies
 Develop annual action plans to support implementation against any medium
term strategy, ensuring that critical success factors are clearly identified
 Effectively monitor the quality and performance of our services
 Prioritise findings from key service reviews and incorporate into the strategic
plan
In organising our services to deliver better outcomes we will:
 Intervene as early as possible when we identify problems to avoid problems
escalating
 Develop more integrated ways of working and delivering services locally,
bringing together front line workers, and develop skills and confidence of our
front line staff to deliver effective interventions
 Extend the involvement and participation of children, young people and their
families in planning and delivering services to meet needs
 Work with third sector organisations at a strategic and operational level to
promote effective partnerships and maximize all resources
 Promote fairness and equality of opportunity and access to services for all
children
 Develop clear, coordinated public information about services provided by
partnership agencies
 Continually challenge mainstream universal services to ensure that they address
the needs of the most vulnerable
6
Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
4.
Understanding Local Needs ~ A Summary
The priorities and direction in this plan are based on our analysis of local needs,
informed by a detailed needs assessment of the health and wellbeing of the
population of Neath Port Talbot (2010) which builds on the needs assessment
completed for our previous plan. Here is a summary of key information and issues.
There are estimated to be 41,828 children and young people aged from 0 to 25 years
growing up in Neath Port Talbot.
The County Borough is made up of urban and rural communities and has the 8th
highest population density of the 22 local authorities in Wales with an estimated
population of 137,425. From 2009 to 2021 it is expected that the population will
grow by 7,000, an increase of about 5%. Whilst generally the population under 65
will remain stable, the expected increase in the population over 65 is significant.
Ninety per cent of the population of the Borough was born in Wales and 21% of the
population can speak Welsh (compared with 25.6 % of the total population of
Wales). The highest percentage of Welsh speakers is in the 10-15 year age group
(36%).
At the last census, black and minority ethnic groups accounted for 1.1% of the
population. In schools, however, the proportion of pupils from ethnic minority
backgrounds (non-white British) is 4.6% in comparison with the Wales average of
8.2%.
In October 2008, there were 135 children whose names were placed on the Child
Protection Register, and 283 children looked after by the local authority. Since 2009
there has been a significant rise in these numbers, resulting in increasing demands
on services. By February 2011 the number of children on the Child Protection
Register had risen to 185 and the number of children looked after had risen to 442.
Neath Port Talbot has 17 areas in the top 10% of the most deprived communities in
Wales. This is the third highest in Wales. There are 12 designated Communities
First areas in the county borough.
The gross weekly pay for full time workers is below the Welsh average and there is
heavy dependence on benefits with 27.7% of the working age population claiming
benefits, compared to 20.4% in Wales.
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
In 2009 the employment rate in Neath Port Talbot was 60.7%. This was the second
lowest amongst all Welsh local authorities. The percentage of working age adults
with no qualifications has gradually fallen since 2000 while the percentage of
working age adults with qualifications at NQF level 4+ has gradually risen since
2001.
In 2007/8 there were approximately 9000 secondary school pupils in the Neath Port
Talbot. In 2008, the number of 16+students gaining 2 A levels A-C was 80.5%, the
joint third highest attainment level in Wales. 88% of pupils achieved 5 GCSE
grades A* to G.
The percentage of pupils in compulsory education entitled to free school meals is
24.9% and 20.1% in primary and secondary schools respectively. Overall, 22.7%
of pupils are entitled to free school meals compared with 18.9% nationally. This is
the fourth highest in Wales.
A major challenge for the partnership is improving the health of the population,
with life expectancy in Neath Port Talbot amongst the worst in Great Britain. In
Neath Port Talbot we have high levels of chronic conditions such as heart disease,
diabetes, respiratory disorders and stroke. The Welsh Health Survey shows that our
residents have higher than average levels of obesity and smoking.
The Partnership welcomes the introduction of the public health strategy for Wales
‘Our Health Future’ (2010) and the Primary and Community Services Strategic
Delivery Programme ‘Setting the Direction’ (2010) in helping to drive health
improvement in the years ahead.
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
5.
Progress on Core Aims
The first Children and Young People’s Plan identified outcomes and priorities for
children and young people under each of the seven core aims. The Partnership
agencies have worked together over the last three years to achieve these outcomes
and the progress made is outlined in the sections below:
Core Aim 1 – all children and young people have a flying start in life
The Welsh Assembly Government outcomes are that every child and young person
is healthy at birth and through the early years; is well nourished; achieves
developmental milestones; has any special needs addressed; and makes good and
secure attachments.
The challenges identified in the previous plan were:
 Below average birth weight rate for all live births, below average uptake rate
for MMR and well below average breastfeeding rates
 Relatively high and increasing rates of children aged under 5 diagnosed with
autistic spectrum disorder
 The need to increase the number of day childcare places for children aged
under five
 Accessibility of information for parents and service providers
 To improve children’s preparedness to begin formal education and to ensure
a smooth transition from early years to primary school
Summary of progress since the last plan was published:
 The percentage of babies born with low birth weight has improved and is
now below the all Wales figure at 7.2%.
 There has been a marked improvement in the uptake of MMR by 24 months,
now at 92.5%
 Uptake rates for breastfeeding in 2008 showed that NPT still has one of the
lowest rates in Wales at 32%. However, in Flying Start areas an uptake rate
of 45% has been achieved in families in receipt of Flying Start services.
 The number of pre-school day care places has increased from 840 in 2007 to
912 in 2010.
 The Autumn Term 2009 Teacher Assessments showed an improvement in
children’s preparedness to begin formal education. Reading and writing
indicators are noticeably stronger; and there is evidence that Flying Start
initiatives are having a positive impact on pupils’ preparedness for learning.
 The Family Information Service (FIS) is in place for parents and carers
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Core Aim 2 - all children and young people have a comprehensive range of
education and learning opportunities
The Welsh Assembly Government outcomes are that every child and young person
achieves early learning goals; engages in full-time education; achieves their full
learning potential; experiences early identification and removal of barriers to
learning; and that every pupil and young person (16-19) engages in purposeful
formal and informal education, training and employment.
The challenges identified in the previous plan were:
 Preparing children to begin formal education
 Improving the percentage of pupils achieving Key Stages 1 and 2 Core
Subject Indicators
 Improving school attendance and reducing the number of primary and
secondary school permanent exclusions
 Transition planning at all key stages
 Improving the standard of school buildings and youth facilities
 Youth support service provision, particularly for young people aged 18-25
 Supporting young people not in employment, education and training,
including those formerly looked after
 Access to education and youth support services through the Welsh medium.
Summary of progress since the last plan was published:
 Performance at the end of Key Stage 1 and 2 has improved year on year
 All schools meet the requirements of the Learning and Skills measure
 The rate of unauthorised absence is one of the lowest in Wales at 0.4%
compared with a national average of 1%
 Over the last four years the number of days pupils were excluded from school
on a fixed term basis has reduced by 726 days, and the number of permanent
exclusions has decreased to 23 (2 primary, 18 secondary and 3 in PRU)
 A Transition Effectiveness Review was developed in 2008/9. Clusters of
schools now review progress and identify areas for further development with
their transition plans using a self evaluation framework.
 In 2009, the figure for young people not in Education, Employment or
Training (NEET) reduced by 0.6%. However, NPT still has the 5th highest
figure in Wales. A local NEET Strategy has been developed.
 The number of young people leaving education without a recognised
qualification has fallen significantly and is better than the average for Wales
 Support for school improvement is good and support for additional learning
needs (ALN) is excellent according to a recent inspection by Estyn.
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Core Aim 3 - all children and young people enjoy the best possible health, and
are free from abuse, victimization and exploitation
The Welsh Assembly Government outcomes are that every child and young person
has a healthy lifestyle, is healthy, adopts healthy sexual behaviours, has access to
specialist services and is safe and protected from abuse, victimisation and
exploitation.
The challenges identified in the previous plan were:
 Improving access to emotional health and wellbeing services
 Ensuring equitable access to school health nurses and paediatric therapy
services
 Reducing the conception rate for young women under 16 years old
 Addressing the incidence of sexually transmitted infections
 Discouraging young people from smoking, drinking and substance misuse
 Engaging more young people in physical activity
 Meeting the needs of an increasing number of Children in Need, children
diagnosed with autistic spectrum disorder, and the high number of young
carers
Summary of progress since the last plan was published:
 Social Services have led a review of Children and Young People’s Family
Support Services as part of an overall ‘systems review’ of frontline services.
As an outcome of this, multi-agency integrated teams have been established
and family support services have been redesigned
 Three Community Network Teams have been established across the County
Borough to improve primary and community health services
 A review of emotional health and well being services has been undertaken
 Comic relief funding has enabled the Mental Health therapist to provide
therapeutic play for home educated children and young people.
 The Healthy Schools Scheme is now established in all our schools
 A review of Speech and Language Therapy services has been completed
 A substance misuse worker has been established to provide advice in schools
 School based counselling services are now available in all secondary schools
 All primary and secondary schools now have a named school nurse
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Core Aim 4 - all children and young people have access to play, leisure,
sporting and cultural activities
The Welsh Assembly Government outcomes are that every child and young person
engages in age appropriate play; participates in sport, leisure and cultural activities;
and is able to achieve their potential.
The challenges identified in the previous plan were:
 Developing play and youth support provision for 8-13 year olds
 Reducing the proportion of girls and boys classed as obese
 Improving access to play, sport, leisure and cultural opportunities for
disabled and/or vulnerable children and young people
 Engaging girls aged 11 – 16 in sport and increasing the activity levels of
young people aged 15 and 24
 Developing youth support service provision, particularly for young people
aged 18 – 25 and through the Welsh medium
 The availability and promotion of appropriate play training and shortage of
qualified play workers, youth workers and specialist sports coaches
 The reduction of natural play spaces
Summary of progress since the last plan was published:
 A Play Development team has been established to deliver playschemes, after
school activities and support for communities to develop play opportunities
 OCN Level 1 Play in School has been available for lunchtime supervisors in
four NPT Primary schools
 In 2009/10, an increasing number of young people aged 8-13 accessed youth
service provision
 Menter Iaith Port Talbot have supported Neath College in continuing the
CLWB Croeso for Welsh speakers and learners
 The 5x60 secondary school sports scheme is now well established in all our
comprehensive schools with a range of extra curricula activities available for
pupils of all abilities focusing on non-traditional sports and activities
 The Mentor Allan Programme has had excellent success in involving young
people aged 11-25 who were at risk of disengagement in outdoor activities
 The Local Authority Partnership Agreement (LAPA) with Sports Wales has
supported the development of new opportunities for physical activity,
including a surf school at Aberafan beach, orienteering in Margam Park,
canoeing and the relaunch of the Aquatic Academy
 Disability Sport has continued to grow in strength in NPT and two highly
successful festivals of sport for disabled children have been organised
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Core Aim 5 - all children and young people are listened to, treated with
respect, and have their race and cultural identity recognised
The Welsh Assembly Government outcomes are that every child and young person
engages in meaningful decision making on issues that affect their lives; knows
about their rights and how to obtain them; is valued and respected as a member of
society; and is able to freely express their cultural identity and race.
The challenge identified in the previous plan was:
 To successfully implement the Participation Strategy
Summary of progress since the last plan was published:
 Children and young people have had their voices heard through the
development of a participation framework.
 Organisations have been trained and supported to meet the National
Participation Standards and 144 children, young people and professionals
have been trained on children’s rights and participation.
 A Children’s Rights questionnaire has been completed
 A group of young people meets regularly and contributes to consultation on
service development and delivery
 National guidance on providing advocacy services has been implemented
 Children and young people have also had their voices heard through youth
forums, the Youth Council, in the Big Lottery bid to establish the Children’s
Rights Unit, various consultations, meetings with the local councillors, and
through experiencing democracy at first hand in the Senedd and Parliament.
 The participation of parents/carers and families has been strengthened by
involvement in the Speech and Language Review, Children’s Social Services
Review, planning for universal advocacy and through the Parents Network.
 Young People have attended the Senedd as guests of Gwenda Thomas AM.
 A consultation was developed with Ystalyfera and Godre’r Graig ICC on the
future needs of parents and children from the service.
 The consultation framework developed for the Family Support Services
Review has been extended to include all Children’s Social Services.
 Communities First has supported young people to engage with a wide range
of training opportunities, to chair their local Communities First Partnership
meetings and to meet with the Children’s Commissioner for Wales to discuss
their volunteering activities.
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Core Aim 6 - All children and young people have a safe home and a
community which supports physical and emotional wellbeing
The Welsh Assembly Government outcomes are that every child and young person
is safe from crime and the effects of crime; is safe from injury and death resulting
from preventable accidents; is safe from environmental pollution; and lives in a
decent home.
The challenges identified in the previous plan, were:
 The increasing rate of suicide by young people
 The shortfall in affordable housing
 The level of unfitness of private sector dwellings and the proportion of public
sector housing meeting the Welsh Housing Quality Standard
 The number of homeless and potentially homeless young people
 The number of wards where incidents of anti-social behaviour are
consistently higher than elsewhere
 The number of children and young people who are victims of violent crime
 The number of children and young people aged under 18 attending the Local
Accident Centre in Neath Port Talbot Hospital
Summary of progress since the last plan was published:
 The number of suicides of young people halved from 8 in 2008 to 4 in 2009
 The five year homelessness strategy is being implemented
 Borough Council housing stock is transferring to NPT Homes over a 6 year
period, with an anticipated rise in quality of stock.
 Relationships have been developed with private landlords and a social letting
agency has been established which provides bonds for vulnerable adults and
young people to assist them to access housing
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Core Aim 7 – children and young people are not disadvantaged by child
poverty
The Welsh Assembly Government’s outcome is that every child and young person
is free from poverty due to low income.
The challenges identified in the previous plan were:
 Developing the attitudes, behaviours and skills required for the workplace
 Improving support mechanisms that enable individuals to remain in work and
progress
 Improving the structure, co-ordination and impact of welfare benefit and debt
advice for families and young people
Summary of progress since the last plan was published:
 A well-resourced Welfare Rights service is in place, with a successful
Communities First (CF) Outcomes Fund application enabling the delivery of
outreach surgeries in all CF areas.
 ‘Developing Young People’ CF Outcome Fund demonstration project
 Credit Union collection points established in all Communities First areas, and
linking with local schools
 Links have been established with Valley Enterprises and the Enterprise
Learning Forum to develop entrepreneurial skills
A Child Poverty Strategy for Neath Port Talbot has been included as an integral part
of this Children and Young People’s Plan under Priority 7 to ensure that children
and young people living in poverty have the same life chances and opportunities as
others. 15
Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
6.
Service Delivery Priorities 2011-2014
Summary of Priorities:
 Further develop prevention, parenting and family support services
 Improve the physical health and emotional wellbeing of children and young
people
 Support children and young people to fulfil their potential
 Further develop participation, engagement and advocacy for children, young
people and their families
 Ensure that disabled children can access mainstream, universal and specialist
services
 Ensure that children and young people living in poverty have the same life
chances and opportunities as others
 To reduce the number of families living in workless households
 To improve the skill level of parents and young people in low income
families so that they can secure well-paid employment
 To reduce inequalities in the health, education and economic outcomes for
children living in poverty, by improving outcomes of the poorest.
The following priorities have been identified for service development over the next
three years:
Priority 1: Further develop prevention, parenting and family support services
The partnership aims to develop a continuum of preventative services throughout
the whole age range covered by the plan, to include parenting and family support
services. These services aim to support early interventions with families, delivered
in a timely way, to reduce the need for more intensive or specialist services at levels
3 and 4 (See diagram on page?)
Children and young people’s services have undertaken a ‘systems review’ of key
processes in the provision of safeguarding and other services to families. Working
with statutory and third sector partners a new approach to partnership working has
been developed and piloted in Sandfields and Cwrt Sart. The new approach
provides consultation and advice to professionals supporting families, whilst also
delivering statutory children’s social services within an integrated multi-agency
team. The approach has proved successful in…
Mention Wendy Ball’s research and incidence/significance of DA/SM/EWB
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Domestic abuse is a key factor in many child protection situations, and it is the
second highest cause of homelessness in Neath Port Talbot. Both of these factors
can have a significantly negative impact on the physical health, emotional wellbeing
and educational achievement for children and young people.
Meanwhile, the Team Around the Child/ Family approach, which involves different
professionals working together to support children and families guided by a
nominated key worker has also been piloted.
In addition, early years and parenting support services are working to improve
coordination in the delivery of these services in local neighbourhood areas, to
ensure maximum benefit to families from these resources. This approach will help
ensure that young children are well physically and emotionally prepared to start
school and to make good progress thereafter.
The key actions supporting this priority include:
 Continue to trial new ways of partnership working in both preventative and
statutory safeguarding services (FS1).
 Develop approaches to commissioning Family Support Services which will
meet the needs identified by the Systems Review (FS2)
 Develop new models of service delivery in line with ‘Families First’
principles
 Further develop the Team Around the Child / Family approach as key
mechanisms for providing services on a multi-agency basis (FS3)
 Coordinate early years and parenting support services including inputs from
partnership agencies, WAG, Cymorth and EU funded services (FS4)
 Review the ‘O Gam i Gam’ Special Needs and Assisted Places Scheme to
ensure resources are targeted to those in the greatest need (XXXX)
 Improve speech and language services and implement the recommendations
of the Speech and Language Therapy review (FS11)
 Coordinate delivery of accident and injury prevention messages (XXXX)
 Develop improved parental mental health services. Parental mental ill health
is a key factor in children’s safeguarding and provision of support services
can help reduce risk to children (FS7)
 Further develop services to support young carers, including young adult
carers (FS8)
 Develop and coordinate services to address the damage caused in families by
alcohol and substance misuse (FS9)
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
 Reduce the incidence of domestic abuse and its impact on children and young
people and work with all sectors to further develop, co-ordinate promote and
improve services for those affected by domestic abuse (FS10)
Priority 2: Support children and young people to fulfil their potential
The Partnership is committed to ensuring that all children and young people achieve
their full learning potential, that barriers to learning are identified and removed
early, and that every pupil and young person engages in purposeful formal and
informal education, training and employment.
This commitment is supported by the partnership approach to delivering the County
Borough Council’s Inclusion Strategy for 2011-15 which aspires to deliver an
inclusive education service that:
 Celebrates diversity and respects everyone’s right to education in their local
community
 Provides access to high quality learning experiences for every child and adult
 Encourages and supports individuals to realise their ambitions, achieve their
potential and become active and responsible members of society.
At the heart of the Inclusion Strategy is raised achievement for all. This means
ensuring that all children and young people are included equally in the drive to raise
standards and secure optimal life chances. Although the strategy is about the
progress of all, the following are at particular risk of disengagement from school
and may risk social exclusion, marginalisation and underachievement.
 Minority ethnic groups including pupils learning English as an additional
language
 Children of families seeking asylum or who have refugee status/
unaccompanied asylum seeking children
 Gypsies and travellers
 Pupils with additional learning needs
 Disabled pupils
 More able and talented pupils
 Children and young people in need or looked after by the local authority
 Pupils with medical needs
 Young parents and pregnant young women
 Young offenders
 Young carers
 Lesbian, gay, bisexual and transgender pupils
 School phobics and school refusers
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
 Pupils who perform or who have employment; and
 Children educated at home by their parents
The key activities in the Inclusion Strategy supporting this priority include:
 Promote consistent practice in identifying and meeting the learning needs of
all children
 Increase capacity of all schools to meet the individual learning and wellbeing
needs of all pupils
 Ensure early identification and intervention for pupils with additional
learning needs
 Ensure all pupils, including those with additional learning needs attend a
local mainstream school as far as possible
 Provide an appropriate level of support and challenge to schools, pupil
referral units and other learning providers
 Continue to develop clear joint working arrangements with all partners
Other actions supporting this priority include:
 Better prepare children for learning on entering formal education (XXXX)
 Maintain improvement in performance at end of Key Stage 1 and 2 (XXXX)
 Reduce fixed term and permanent exclusions (XXXX)
 Improve attendance in both Primary and Secondary sectors with particular
focus on Primary and Additional Learning Needs (XXXX)
 Reduce the number of NEET young people aged 16-19 (XXXX)
 Improve access to youth support services through the medium of Welsh
(XXXX)
 Provide increased opportunities for young people to gain recognition of
formal, informal and non formal education outside the school setting
(XXXX)
 Improve the identification of young carers and their access to all youth
support services that will help them achieve their full potential (XXXX)
 Reduce the dependency of young people on smoking, alcohol, illegal and
prescription drugs (XXXX)
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Priority 3: To improve the physical health and emotional wellbeing of children
and young people
Prof. Stephen Monaghan, the Director of Public Health for ABMU Health Board
highlights in his Interim Annual Report (2011) some important considerations
around this priority for partnership working locally.
‘The most effective way to improve health across a population and to reduce avoidable
health inequalities (health inequities) is by upstream policy interventions that create an
environment (economic, social, cultural and physical) that fosters healthy living.
Examples are improving access to high nutrient foods, safe places for physical activity,
improving the quality of housing or increasing level of employment.’
‘The burden of public health priority conditions like cardiovascular disease, cancer,
obesity, alcohol, injuries and mental health disproportionately falls upon lower social
economic groups. The long term benefits of intervening early in the life course to prevent
the development of risky behaviours or chronic conditions are also key to improving
health through the life course. Examples are improved infant and maternal health and
nutrition, childhood socialisation schemes to reduce violence.’
The key actions supporting this priority include:
 Reconsider the recommendations of the emotional health and well-being
review in the light of current capacity and resources (EHWB1)
 Continue to develop services to address suicide and self harm issues among
young people (EHWB3)
 Further develop local therapeutic support services for looked after children
(EHWB6)
 Improve access to emotional health and well being services for all young
people including those outside of mainstream education (XXXX)
 Implement the Anti-bullying Strategy so as to reduce the incidence of
bullying across all settings (EHWB4)
 Support schools to maintain initiatives both in schools and local communities
that support improved emotional wellbeing, physical activity and healthy
eating, and which reduce accidents and injuries (XXXX)
 Discourage young people from starting to smoke and encourage a smoke free
environment (XXXX)
 Encourage pregnant women to quit smoking (XXXX)
 Improve children’s dental health (XXXX)
 Improve uptake of breastfeeding rates (XXXX)
 Reduce teenage pregnancy rates (XXXX)
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
 Further develop and coordinate counselling and advice services to reduce risk
taking behaviour for young people, including sexual health and relationship
advice services (EHWB2)
 Develop a strategy to address alcohol and substance misuse by young people
(EHWB5)
 Further develop plans, services and activities to improve levels of physical
activity, diet and address rising obesity (FS12)
 Improve the uptake of all routine childhood vaccinations (including MMR)
(XXXX)
 Develop a strategy for play to help focus, prioritise and co-ordinate play
services for children (FS5)
 Further develop initiatives to promote the engagement of more young people
in sports, leisure and cultural activities, ensuring that these activities are
accessed by young people who have left school and by disadvantaged groups
including ethnic minorities, disabled children, young offenders and Looked
After Children (FS6)
Insert text on the Local Creating an Active Wales Plan
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Priority 4: Ensure that disabled children can access mainstream, universal and
specialist services
Disabled children have the same rights as other children to access all services and
the aim of the Partnership is that they should be supported to do so. We recognise
that these children and young people are some of the most vulnerable in our
community and our task must be to support them and their parents and carers so that
they can live fulfilled and sustained lives.
This priority is supported by activities in the Inclusion Strategy 2011-15 (see
Priority 2 for details).
The key actions supporting this priority include:
 Implement the Autistic Spectrum Disorder (ASD) Strategic Action Plan for
Wales and ensure the needs of children are identified and tracked
appropriately for service planning purposes (CWD1)
 Develop a strategy for disabled children in Neath Port Talbot (CWD2)
 Improve disabled young people’s access to the full range of youth support
services to enable them to achieve greater levels of independence.
 Improve the links and transition arrangements between children’s and adult
care services (CWD3)
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Priority 5: Further develop participation, engagement and advocacy for
children, young people and their families
The Partnership strongly supports the effective involvement of children, young
people and their families in the design, development and delivery of all services.
Opportunities for the co-production of services with children, young people and
their families will be explored. The implementation of a children’s rights ethos
in all service delivery remains a priority.
Progress has been aided greatly by the political will within the county, the
leadership shown by the Children and Young People’s Partnership and the
commitment of the Participation Project Team. There is a healthy determination
at all levels for children, young people and their families to be involved in
decisions that affect their lives, whether through participation, advocacy or
through the knowledge of their rights.
Children and young people have had their voices heard through the development
of the participation framework. Across the County Borough, 144 children,
young people and professionals have been trained on children’s rights and
participation and many organisations have been trained and supported to meet
the National Participation Standards. Some 69 organisations have signed up to
the Standards, 16 have met the Standards and 36 have included participation in
their action plans.
Children and young people have also had their voices heard through
involvement in consultations; the formation of youth forums; the strengthening
of the Youth Council; meetings with the Cabinet, Lead Director and Lead
Cabinet Member for Children; training; advising on the Big Lottery Bid to
establish the Children’s Rights Unit; and through experiencing democracy at
first hand, questioning Councillors, MPs and AMs, and visiting the Senedd and
Parliament.
Pupils from Ysgol Gyfun Ystalyfera attended the Senedd as guests of Gwenda
Thomas AM. Peter Hain also visited the school and follow up visits to the
Senedd and Parliament were arranged.
There has been a strengthening of families’ participation through involvement in
the Speech and Language Review, Children’s Social Services Review, planning
for Universal Advocacy and through the increasing representational role played
by the Parents Network.
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
The key actions supporting this priority include:
 Continue to develop and implement the participation strategy for children and
young people (P1)
 Increase opportunities for young people to participate in decision making
through the development of local youth forums and a formally elected Youth
Council (XXXX)
 Implement the Young Wales model for delivering advocacy services for
children and young people (P2)
 Actively consult with children and young people and parents/carers over the
work of the Local Safeguarding Children’s Board, including strengthening
links with the Youth Council, Parents Network and Youth Support Service
(XXXX)
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Priority 6: All children and young people have a safe home and a community
which supports physical and emotional wellbeing
The Community Safety Partnership ‘Safer Neath Port Talbot’ has operational and
strategic responsibility for amongst other issues, Substance Misuse, Domestic
Abuse, Youth Offending, Anti-Social Behaviour, targeted Prevention and Early
Intervention, Community Safety, the prevention of crime and re-offending, Fire
Safety etc.
The current strategic priorities of the Community Safety Partnership Plan are:
o Crime and the Fear of Crime
o Prolific and Other Priority Offenders
o Anti-social Behaviour
o Domestic Abuse
o Substance Misuse
o Young People
o Deliberate Fires
o Partnership Working
All of these priorities have elements that include young people as victims,
perpetrators or as the recipients of services. Consequently, these are also priorities
for the Children and Young People’s Partnership. Our shared analysis of need
between the Partnerships acknowledged that we require far greater joined up
working and thinking between partnerships under the auspices of the Local Service
Board, with a particular focus on substance and alcohol misuse, domestic abuse and
emotional well-being.
The key actions supporting this priority include:
 Focus cross partnership effort on tackling substance and alcohol misuse,
domestic abuse and emotional well-being.
 Further develop services to prevent the cycle of young people who observe or
are caught up in domestic abuse going on to become perpetrators.
 Reduce the dependency of young people on smoking, alcohol, illegal and
prescription drugs (XXXX)
 Make more activities available in local communities for children and young
people most at risk to prevent them becoming involved in crime and antisocial behaviour
 Encourage and help young people who have offended or are at risk of
offending to receive the Welsh Assembly Governments core entitlements,
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011








including an integrated young person’s substance misuse treatment and
prevention service, a comprehensive CAMHS service to those age 16-18 not
in full-time education, parenting services for those with low IQ, training
providers willing to support young people with criminal records, and an
education provision appropriate to the needs of these young people
Further develop services for young people who are victims of crime
Support wider adoption of a restorative approach to crime
Invest partnership effort in those young people at highest risk to the
community to prevent them escalating into custody, or for those already in
custody to break the cycle. Specialised provision is necessary for these young
people who pose a threat both to communities and to other young people
Use opportunities from the individual and community reports of anti-social
behaviour activity to direct resources by ensuring that agencies determine
jointly the most appropriate way to respond to concerns. (The majority of
Anti-Social Behaviour offenders, who are identified, are young people.
Unfortunately, this leads to the erroneous assumption that all or a majority of
young people are involved in Anti-Social Behaviour, which leads to labelling
and the fear of crime.)
Further develop Prevention and Early Intervention services including the
Youth Bureau, anti-social behaviour prevention work and the Children’s
Inclusion Project (CHiP)
Ensure close working between the Systems Review and preventative services
in the fields of substance misuse, domestic abuse and prevention of offending
and reoffending.
Support the All School Core Liaison Programme and Crucial Crew, where
the use of peer educators is particularly effective, in delivering safety
messages to children and young people.
Target provision to prevent deliberate fire setting through activities such as
Phoenix courses as well as more generic activities such as Young Firefighters
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Priority 7: To ensure that children and young people living in poverty have the
same life chances and opportunities as others
A Child Poverty Strategy for Neath Port Talbot
Our commitment to tackling child poverty is reflected by prioritising the needs of
the poorest and protecting the most vulnerable people in our communities. In Neath
Port Talbot the rate of severe child poverty is 16%. This is the 10th highest in Wales
and similar to the rates found in Merthyr Tydfil, Carmarthenshire and Cardiff).
WAG define poverty as ‘a long term state of not having sufficient resources to
afford food, reasonable living conditions or amenities or to participate in activities
(such as access to attractive neighbourhoods and open spaces) that are taken for
granted by others in society.
Severe poverty is defined as….
Some of the deepest pockets of poverty fall in places where generations of families
have been out of work and have little hope or expectation of finding work. The
prospects of C&YP getting out of this deprivation requires a combination of their
personal efforts, their parents and the strident efforts of our education, social
services and health organisations.
The Child Poverty Strategy for Wales was launched in February 2011. In this
strategy the Welsh Assembly Government affirms its aspiration to eradicate child
poverty by 2020 and to halve child poverty by 2010 compared with 1997 figures.
This strategy is reinforced by the new duties in the Children and Families (Wales)
Measure 2010, which requires local authorities to develop a strategy to tackle child
poverty that complements the Assembly Governments own approach. The Measure
includes 13 broad aims for contributing to the eradication of child poverty in Wales
(see Appendix 1).
What we know about child poverty
Child Poverty has been found to affect childhood experiences profoundly and
ultimately to limit future life chances for employment and training, for positive and
enduring family and social relationships, and for good physical and mental health
and longevity (Bradshaw and Mayhew, 2005).
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Research indicates that children in low income families often miss out on activities
such as after-school clubs, school trips and inviting their friends back for tea. They
may go without warm coats in winter, proper meals and heat in the home; and poor
children often have little or no space to play, and live in areas with few shops or
amenities (Crowley and Vulliam 2006)
Children who grow up in poverty are far less likely to do well in school and are
much more likely to leave the education system with no qualifications (Rafo et al
2007). Adults with poor basic literacy and numeracy skills are up to five times more
likely to be unemployed or out of the labour market than those with adequate skills
(renewal.net).
Children from the lower socio economic groups are four times more likely to die in
an accident and have nearly twice the rate of longstanding illness than those living
in households with high incomes (Bradshaw and Mayhew 2005). Babies born into
poor families are more likely to be premature and have low birth weight (Palmer
2005)
Research findings published by the Dept. for Children, Schools and Families (2007)
show that:
 Children in poorer families are more likely to suffer from respiratory
infection, gastro-enteritis, dental caries and tuberculosis
 Poverty can seriously affect the quality of a child’s diet
 Children from unskilled, working-class backgrounds are almost three times
as likely to have a mental disorder as children from professional backgrounds
(14.5% compared to 5.2%). The rate for families where the parents had never
worked was more than four times higher at 21.1%.
 Children of parents who have never worked or are long term unemployed are
13 times more likely to die from unintentional injury and 37 times more
likely to die from exposure to fire
Child poverty is a result of complex and varied factors which act at both the
individual and community level. However, there are some key characteristics which
put children and families at risk of living in poverty and deprivation. The
Households Below Average Income (2005-06) report finds that families with the
following characteristics have a higher than average risk of poverty:
 children in workless families, where the risk of poverty remains high, at 58
per cent, which is considerably above the average of 22 per cent;
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
 children in couple families where one adult works part-time have a 44 per
cent risk of poverty;
 more than a third of all ethnic minority families live in poverty;
 children in families with one or more disabled adults face a high risk of
poverty at 31 per cent;
 children in families with four or more children have a 40 per cent risk of
poverty
Our child poverty strategy will consider the actions we can put in place to address
the particular circumstances of these ‘at risk’ groups and ensure sustainable routes
out of poverty for all children.
What we know about children and young people living in poverty in Neath
Port Talbot
A full report on data surrounding Child Poverty specifically for Neath Port Talbot
families is currently in development.
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Child Poverty Service Delivery Priorities
All the service delivery priorities outlined in Section 5 above will contribute to
reducing child poverty, particularly service and participation poverty. This section
of the plan focuses specifically on income poverty and access to employment and
training opportunities for young people and families.
A number of Welsh Assembly and EU funded programmes designed to tackle child
poverty are supported by the Partnership including:
 Communities First – provides targeted additional resources in the twelve
most deprived areas of Neath Port Talbot. In addition to ongoing family,
youth and intergenerational activities, the programme promotes opportunities
to empower and engage residents of all ages and supports agencies to deliver
services which address the full scope of issues relating to child poverty.
Dedicated CF outcome-funded youth workers deliver specific outcomes
relating to Health & Wellbeing, Volunteering, and Education & Training. CF
funded Welfare Rights workers provide community-based outreach support
on welfare and entitlements issues
 Cymorth – the children and youth support fund, provides targeted support
for children, young people and families within a framework of universal
provision, in order to improve the life chances of children and young people
from disadvantaged families
 Flying Start – provides intensive support for children during their early
years, targeted at families in selected school catchment areas
 Genesis – project to support lone parents…..
Need to detail here our intentions for working jointly at a strategic level through
LSB and CYPP
The Welsh Assembly Government has three strategic objectives for the child
poverty strategy under which we have grouped our priorities for service delivery
Priority 7a: To reduce the number of families living in workless households
 To build on work to develop the skills and confidence of disadvantaged
parents, including lone parents, to prepare them for work (CPS1)
 To improve access to transport to ensure families in workless households can
attend training and other support services (CPS2)
 To build on work to support community-based entrepreneurship and develop
local opportunities for employment (CPS3)
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
 To further develop affordable childcare so that opportunities to work can be
taken up (CPS4)
 To develop approaches to citizenship and community engagement (CPS5)
Priority 7b: To improve the skill level of parents and young people in low
income families so that they can secure well-paid employment
 To develop life skills training for parents and young people (CPS6)
 To establish a coordinated and consistent approach to providing services to
young people aged 16-18 that are not in a education or employment (NEET)
or at risk of becoming NEET (CPS7)
 To develop effective keeping in touch and tracking systems and processes to
ensure early intervention and better retention of young people in post 16
progression routes (CPS8)
 To co-ordinate the implementation of the Personal Information Sharing
Protocol agreed with relevant services to enable young people to easily
access additional support services with the minimum amount of disruption.
(CPS9)
 To continue to facilitate a range of informal and formal community based
learning opportunities (Communities First and relevant partners).
Priority 7c: To reduce inequalities that exist in the health, education and
economic outcomes for children living in poverty, by improving
outcomes of the poorest.
 To further develop training and employment opportunities for disadvantaged
groups including young carers, care leavers, young people with an offending
history, and unemployed 18 to 25-year-olds (CPS10)
 To support continuation of welfare benefits and advice services on a local or
regional basis to ensure income maximisation for the poorest groups
(CPS11)
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
7.
Workforce development
Our aim is to develop a workforce which is well qualified, flexible, well supported
and sustainable, holding a common core of skills and knowledge that will enable
staff to competently support children, young people and families to be safe and
become independent individuals.
The Welsh Assembly Government has set out its aspiration for an integrated
workforce that meets the needs of children, young people and families in “Stronger
Partnerships for Better Outcomes”. This includes an increased emphasis on
integrated service provision and requires professionals who value each other’s
contribution and are able to understand each other’s language.
The Children and Young People’s Workforce Development Network is developing
a Workforce Strategy and Common Core of Skills, Knowledge and Understanding
for the children and young people’s workforce in Wales which will address
structural issues and provide an overarching framework and support for the local
workforce plan to be developed by the Partnership.
This plan identifies priorities that have workforce implications and proposes new
ways of delivering services to children, young people and their families. In order to
achieve this, staff across partner agencies will need to have the opportunity to
develop their skills and expertise, and change the way in which they work with
colleagues to meet the new challenges and developments.
Outcomes:
We will focus in particular on a common approach to workforce development
across the Partnership which will:
 Facilitate delivery of an integrated workforce at a local level
 Deliver the outcomes in this plan
 Address the National Workforce Reform Agenda
Actions:
 Develop a Children and Young People’s Workforce Development Strategy
which identifies core competences required to deliver integrated services, and
put together a plan to address these (WD1)
 Maximise partnership training opportunities and facilitate co-training
between partner agencies where possible (WD2)
 Work together to promote staff recruitment and retention across the
children’s workforce (WD3)
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
 Provide training on children’s rights and participation, including foster carers
and child care staff (WD4)
33
Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
8.
Monitoring progress
The Partnership is committed to putting in place a robust mechanism to monitor and
review progress on this plan.
Each Service Priority area will be overseen by a multi agency delivery group,
chaired by the appointed lead agency. Each group will develop an annual action
plan with timescales, responsibilities and targets, and will report into the
Partnership Management Board on a twice yearly basis, outlining progress on
agreed actions, any barriers to progress, reasons and proposals to overcome them,
and impact on Core Aim indicators. Clear evidence will be required to enable
progress to be objectively monitored.
A new monitoring framework will be developed for the plan which will be annually
reviewed by the Partnership Team and reported to the Partnership Management
Board. Information from consultation with children, young people and families will
be integrated into the annual monitoring process.
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Appendix 1
The Children and Families (Wales) Measure 2010 requires local authorities to
develop a strategy to tackle child poverty that complements the Assembly
Government’s own approach.
The Measure includes the following 13 Broad Aims for contributing to the
eradication of child poverty in Wales:  Work with the UK Government to increase the income of families with
children
 Ensure that, as far as possible, children living in low-income families are not
materially deprived
 Promote and facilitate paid employment for parents/carers in low income
families
 Provide low income parents/carers with the skills needed to secure
employment
 Help young people take advantage of employment opportunities
 Support the parenting of children
 Reduce inequalities in educational attainment between children and young
people
 Help young persons participate effectively in education and training
 Reduce inequalities in health between children and between their
parents/carers so far as necessary to ensure children’s well-being
 Reduce inequalities in participation in cultural, sporting and leisure activities
between children and between parents/carers so far as necessary to ensure
children’s well-being
 Help young people participate effectively and responsibly in the life of their
communities
 Ensure that all children grow up in decent housing
 Ensure that all children grow up in safe and cohesive communities
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Appendix 2
The Policy Context
In developing this plan we have taken into account the information and direction
provided within some key national and local strategies, action plans, reports and
policies.
National
 Children and Families (Wales) Measure 2010
 Our Healthy Future (2010)
 Breaking the Barriers: Meeting the Challenges: Better support for children
and young people with emotional well-being and mental health needs – An
Action Plan for Wales (WAG 2010)
 Talk to Me - A National Action Plan to Reduce Suicide and Self Harm in
Wales (2009)
 A Guide to the Model for Delivering Advocacy Services for Children and
Young People (2009)
 Working Together to Reduce Harm – Substance Misuse Strategy for Wales
(2008-18)
 National Youth Service Strategy for Wales (2007)
 Safeguarding Children: Working Together under the Children Act (2004)
 Childcare Act 2006
 NSF for Children, Young People and Maternity Services for Wales (2006)
 ‘Tackling Domestic Abuse’ The All Wales National Strategy - a Joint
Approach’ Welsh Assembly Government (2005)
 The All Wales CAMHS Strategy ‘Everybody’s Business’ (2001)
 ‘Better Homes for People in Wales’ The National Housing Strategy (2001)
 Extending Entitlement – Supporting Young People in Wales (2000)
 School Effectiveness Framework
 Framework for Children’s Learning for 3 to 7 year olds in Wales (Foundation
Phase
 National Curriculum (Key Stage 2)
 Welsh Language Development
 Learning and Skills (Wales) Measure 2009
 Learning Pathways Policy
 Youth Support Service Guidance (Draft)
 Child Poverty Strategy
 SEN Code of Practice 2002
36
Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011











Children and Young People’s Act 2008
Pupil Inclusion and Support
Children and Young People Missing in Education 2010
Integrated Care for Children and Young People Age 18 Years and Under who
Misuse Substances 2010
Creating an Active Wales
Vision for Sport in Wales (Sports Wales)
Welsh Assembly Government- Participation Standards
Joint Carers Strategy 2010-14 (Draft)
Carers Strategies (Wales) Measure
Children and Young Persons Rights (Wales) Measure
Right to be Safe – strategy for tackling violence against women and girls.
Local
 Neath Port Talbot Community Plan 2010-2020
 Health Social Care and Wellbeing Strategy 2011-2014
 Improving Futures – suicide and self harm strategy (2008)
 Emotional Wellbeing and Mental Health Promotion Action Plan for Neath
Port Talbot 2010 -2015
 Local Safeguarding Children’s Board Business Plan
 Childcare Sufficiency Assessment 2010
 Play Audit 2010
 Inclusion Strategy 2011-15
 Literacy and Numeracy Plans
 Local Substance Misuse Strategy 2008 – 2011
 Participation Strategy for Children, Young People and their Families
 Safer Neath Port Talbot Partnership Plan (triennial annually updated)
 Youth Justice Plan (2009/10)
 Youth Crime and Anti-Social Behaviour Prevention Strategy
 14 -19 Network Strategic Plan 2010 -2013
 14 – 19 Annual Network Development Plans
 School Operational Plan
 Anti-Bullying Strategy
 Young Carers Action Plan
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Summary of Actions
Ref no
Action
Priority 1: Family Support Services
FS1
To trial new ways of partnership
working in both preventative and
statutory services through the ‘Systems
Review’
FS2
To develop approaches to
commissioning Family Support Services
which will meet the needs identified by
the Systems Review
FS3
To develop community networks and
Team Around the Child / Family
approach as the key mechanism for the
provision of services on a multiagency
basis
FS4
To coordinate early years and parenting
support services including inputs from
partnership agencies, WAG, Cymorth
and EU funded services
FS5
To develop a strategy for play to help
focus, prioritise and co-ordinate play
services for children
FS6
To further develop services to promote
engagement of young people in sports,
leisure and cultural activities
FS7
To develop improved parental mental
health services
FS8
To further develop services to support
young carers
FS9
To develop and coordinate services to
Link to Core
Aim
Appendix 3
Lead
Support
1,3
1,3,4,6,7
1,3,4,6,7
1,2,3,4,5,6,7
4
4
3,6,7
3.6.7
38
Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Ref no
Action
address the damage caused in families
by alcohol and substance misuse
FS10
To develop and co-ordinate services to
address the impact of domestic abuse
FS11
To improve speech and language
services and implement the
recommendations of the SALT review
FS12
To support the Healthy Schools Scheme
to develop services to improve levels of
physical activity, improve diet and
address rising obesity
Priority 2: Health and Wellbeing
EHWB1
To implement the recommendations of
the emotional health and well-being
review
EHWB2
To further develop and coordinate
counselling and advice services for
young people, including sexual health
advice services and the relationship
advisory drop in (RAD)
EHWB3
To support the Improving Futures
Strategy Group to continue to develop
services to address suicide and self harm
issues
EHWB4
To develop an effective anti-bullying
strategy
EHWB5
To develop a specific strategy for
addressing alcohol and substance
misuse by young people
Link to Core
Aim
Lead
Support
1,2,3,6,7
1,2
1,2,3,6
3,6
3,6
3,6
2,3,6
3,6
39
Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Ref no
EHWB6
Action
To develop local therapeutic support
services for looked after children so
they can be placed and supported locally
Priority 3: Participation, Engagement and Advocacy
P1
To continue to develop and implement
the participation strategy for children
and young people
P2
To implement the Young Wales model
for delivering advocacy services for
children and young people
P3
To explore and implement approaches
to children’s rights
Priority 4: Disabled Children
CWD1
To implement the Autistic Spectrum
Disorder Strategic Action Plan for
Wales and ensure the needs of children
with ASD are identified and tracked
appropriately for service planning
purposes
CWD2
To develop / review the strategy for
disabled children in Neath Port Talbot
CWD3
To improve transition arrangements into
adult care services
Child Poverty Strategy
CPS1
To build on work to develop the skills
and confidence of disadvantaged
parents, including lone parents, to
prepare them for work
CPS2
To improve access to transport to ensure
Link to Core
Aim
3,6
Lead
Support
5
5
1,2,3,4,5
1,2,3,4,5,6,7
3,6,7
3,6,7
7
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Ref no
CPS3
CPS4
CPS5
CPS6
CPS7
CPS8
CPS9
Action
families in workless households can
attend training and other support
services
To build on work to support
community-based entrepreneurship to
develop local opportunities for
employment
To further develop affordable childcare
so that opportunities to work can be
taken up
To develop approaches to citizenship
and community engagement and the coproduction of services
To develop life skills training for
parents and young people
To establish a coordinated and
consistent approach to providing
services to young people aged 16-18
that are not in a education or
employment (NEET) or at risk of
becoming NEET
To develop effective keeping in touch
and tracking systems and processes to
ensure early intervention and better
retention of young people in post 16
progression routes
To develop a low level Personal
Information Sharing Protocol agreed
with relevant services to enable young
people to easily access additional
Link to Core
Aim
Lead
Support
7
2,3,7
5,6,7
2,6,7
2,7
2,7
2,7
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Ref no
CPS10
CPS11
Action
support services with the minimum
amount of disruption
To develop training and employment
opportunities for disadvantaged groups
including young carers, care leavers,
young people with an offending history,
and unemployed 18 to 25-year-olds
To support continuation of welfare
benefits and advice services on a local
or regional basis to ensure income
maximisation for the poorest groups
Workforce Development
WD1
Develop a Children and Young People’s
Workforce Development Strategy which
identifies core competences required to
deliver integrated services, and put
together a plan to address these
WD2
Maximise partnership training
opportunities and facilitate co-training
between partner agencies where
possible
WD3
Work together to promote staff
recruitment and retention across the
children’s workforce
WD4
Provide training on children’s rights and
participation, including foster carers and
child care staff
Link to Core
Aim
Lead
Support
2,7
7
1,2,3,4,5,6,7
1,2,3,4,5,6,7
1,2,3,4,5,6,7
1,2,3,4,5,6,7
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Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
43
Neath Port Talbot Children and Young People’s Plan 2011-14 Final Draft Feb. 2011
Agenda item 5
Children and Young People’s Partnership
Prepared by:
Michael Catling
Name of Meeting:
Local Service Board
Date of Meeting:
14th March 2011
Agenda No:
Children and Young People’s Plan 2011-13
Purpose
To brief the LSB on progress with developing the new Children and Young
People’s Plan for 2011-2013, and to provide details of the outcome of the
consultation and progress with revision of the plan.
Background
The Children and Young People’s Plan outlines the priorities for all agencies in
Neath Port Talbot working with children and young people aged from birth to 25
years. The first such plan was developed for the period 2008-11.
The local authority and the Health Board have a statutory duty to co-operate with
key partners in producing a revised and updated plan for 2011-14. The partners
in the Children and Young People’s Partnership have worked together to develop
the plan and to agree shared ownership of the priorities and actions.
The Plan is aligned with Neath Port Talbot Community Plan, the Health, Social
Care and Wellbeing Strategy, the Community Safety Strategy and with other
local plans, and this Plan will inform the development of joint commissioning
strategies for our priority service areas.
The Plan follows guidance from the Welsh Assembly Government which
reinforces how Children and Young People’s Partnerships should bring together
and co-ordinate services for children and young people to secure the best
outcomes from limited resources.
The plan focuses particularly on the new duties in the Children and Families
(Wales) Measure 2010 for all partners in relation to child poverty, integrated
family support services, participation, play and disabled children.
In developing the new Plan we have taken into account the current resource
challenges and the need for all partners to achieve significant savings, which
could impact on service development. The focus therefore has been on
Report for LSB March 2011 Michael Catling CYPP Co-ordinator.
1
Agenda item 5
identifying key priorities for multi-agency service delivery that will help us build
capacity and sustain our developments.
The priorities have been identified by updating our needs assessment, reviewing
progress on the previous plan, working with partners to identify their challenges
and priorities, and by drawing on consultation with children, young people and
families.
The plan focuses on a small number of key development areas that require
partners to work together, are sustainable, achievable and likely to make the
most difference to outcomes under the seven Core Aims for children and young
people.
Summary of Priorities:
 Further develop prevention, parenting and family support services
 Improve the physical health and emotional wellbeing of children and
young people
 Support children and young people to fulfil their potential
 Further develop participation, engagement and advocacy for children,
young people and their families
 Ensure that disabled children can access mainstream, universal and
specialist services
 Ensure that children and young people living in poverty have the same life
chances and opportunities as others
 Reduce the number of families living in workless households
 Improve the skill level of parents and young people in low income
families so that they can secure well-paid employment
 Reduce inequalities in the health, education and economic outcomes for
children living in poverty, by improving outcomes of the poorest.
The three month formal consultation period on the draft plan finished on Jan 31st.
Independent consultants were commissioned to develop the draft and support the
consultation process. Three events were held in December and January and these
were well attended by partners and stakeholders. Organisations and individuals
were also invited to comment on the draft through a structured questionnaire to
which there has been a good response.
In addition, the Children and Young People and Families Participation Officer
supported organisations in gathering the views of children, young people and
their parents/carers concerning what they think about various actions in the Plan
and how they can be achieved.
Report for LSB March 2011 Michael Catling CYPP Co-ordinator.
2
Agenda item 5
Planned Action
The Plan revision will be undertaken by the Children and Young People’s
Partnership Manager. The revision will ensure the inclusion of:
 The shared priorities of domestic abuse, substance/alcohol misuse and
emotional wellbeing agreed with the LSCB, HSC&WB Partnership and
other local partnerships
 The priority to support children and young people to fulfil their potential,
which strengthens the plan in relation to education and youth support
services
 The priority of health improvement, based on those established in the
HSC&WB strategy and derived from the public health framework Our
Healthy Future, with CYPP leading on child dental health, sexual health
and obesity
 Stronger reference to youth offending and community safety
 A redesigned monitoring framework using the RBA approach
The Partnership is committed to putting in place a robust mechanism to monitor
and review progress on this plan. Each Service Priority area will be overseen by
a multi agency delivery group, chaired by an appointed lead agency following a
programme/project management approach.
Each group will develop an action plan with timescales, responsibilities and
targets, and will report to the Partnership Management Board outlining progress
on agreed actions, barriers to progress, proposals to overcome them and the
impact on our seven Core Aims for children and young people.
A new monitoring framework based on the results/outcome-based accountability
approach will be developed for the plan. The approach will be designed in close
co-operation with the HSC&WB Programme Executive Board. Information from
consultation with children, young people and families will be integrated into the
monitoring process.
Timetable for CYP Plan approval
 ABMU Board – 31st Jan
 CVS Board – 3rd Feb
 CBC Corporate Directors’ Group – 8th Feb
 CBC Cabinet Member Briefing - 16th Feb
 CYP Partnership Board - 28th Feb
 LSB - 14th March
 CYPE Scrutiny and Cabinet Board - 7th April
 Full Council - 20th April.
Report for LSB March 2011 Michael Catling CYPP Co-ordinator.
3
Agenda item 5
A seminar is due to be held with CYPE Scrutiny Members sometime before
April 7th where the draft plan can be informally discussed.
Recommendation
That the Local Service Board approves and supports delivery of the Plan subject
to the revisions outlined.
Important Information Attached
 Draft CYP Plan
 Consultation summary report from Sue Brunton-Reed and Brian Atkins
Report for LSB March 2011 Michael Catling CYPP Co-ordinator.
4
Agenda item 6
REPORT TO LOCAL SERVICE BOARD ON THE KEY
COMMON PRIORITIES FOR THE SAFEGUARDING
CHILDREN BOARD AND OTHER PARTNERSHIPS ACROSS
NEATH PORT TALBOT
Purpose of Report
This report sets out to explain the joint priorities of the Safeguarding
Children Board and the Children and Young Peoples Partnership, and to
request that the Local Service Board facilities and oversees progress in a
number of key areas.
Background
On 14th January, 2011, the Safeguarding Children Board held a joint
development event together with the Children and Young Peoples
Partnership. Also invited were representatives from the Safer Neath Port
Talbot Partnership and the Health, Social Care and Wellbeing
Partnership. The event heard each partnership discuss their current
strategic analysis of need and statement of priorities. Additionally a
presentation was made by Dr. Wendy Ball on her research into the
reasons for the demand on Neath Port Talbot Childrens Services.
Key Issues
Overall the themes and issues which emerged were that a focus on
prevention and early intervention is essential and that the changes in the
financial climate, particularly in relation to the benefits system need to be
considered in relation to how the community and service provision will
be impacted upon.
Within these themes, the key priorities identified were:
Substance and alcohol misuse
Domestic Abuse
Emotional wellbeing
Support for vulnerable groups
Participation, involvement and consultation with service users
It was concluded that the following developments will be essential in
order to address the above priorities:
Integrated and more accessible services – such as those that the
Children Services Systems Review is establishing.
1
Agenda item 6
-
Family focussed services cutting across adults and childrens
services and using:
developed services offering support for adults who are parents
Creating Team Around the Family approaches
Inspiring and developing services which focus on local
communities.
Developing a joint data set across the partnerships
Developments to date
Childrens Services Systems Review – this is well established and is in the
process of rolling out integrated teams of key professionals to school
bases within groups of communities. A Team Around the Child model is
being developed alongside the roll-in process.
Family Orientated Safeguarding – a strategic group has been established
which is seeking to break down current barriers between Adults and
Childrens Services. This group acknowledges the advancements made by
the Childrens Systems Review and the developing Transforming Adult
Social Care programme, but is also focussing on other developments
which might be made in tandem with the other two strategies. A Team
Around the Family approach is planned for development as a part of this
work.
Emotional Health and Wellbeing – this is an area of need that has been
recognised within both the HSCWB Plan and the Children and Young
Peoples Plan. A review of Emotional Health and Wellbeing was
commissioned by the Children and Young Peoples Partnership last year
which recommended the development of a new model of intervention
which set out to meet the current gaps in provision at tiers one and two, as
well as gaps in more intensive therapy provisions, not currently catered
for within the CAMHS service. It was not possible to implement this
model due to a lack of available resources. Some Social Services,
Education and Cymorth funding could have supported the model,
however CAMHS and ABMU were not able to identify any resources to
contribute to the development of the model and it has therefore not been
implemented.
The Welsh Assembly Government is developing a legislative measure
which will require all local authorities to develop a model of Integrated
Family Support Services. This model focuses on supporting parents of
children who are at risk of harm, in relation to parental substance and
alcohol misuse, domestic violence, parental mental health and parental
learning disability. There are currently three pioneer authorities across
2
Agenda item 6
Wales who have been provided with considerable funding from WAG to
develop this model. The ideology however complements the priorities
for development identified locally, except that locally it is the view that
the IFSS model should be delivered at an earlier point of intervention,
prior to children being identified at risk of harm. It is now planned that
the CYPP and SCB will obtain feedback from the pioneer authorities and
develop a strategy for local implementation from thereonin.
The Welsh Assembly Government is also developing a ‘Families First’
strategy and Neath Port Talbot is in the process of submitting a
collaborative bid (with Swansea and Bridgend) to pioneer an approach
similar to IFSS but at earlier intervention phases, as described above.
Substance and Alcohol Misuse Strategies – a paper has been produced
(attached) which outlines the various work and range of strategies across
the local authority. There are a number of recommendations made by this
report as follows:

The main strategy has not been reported to CYPP or the SCB and there is a
general lack of awareness of this work as a coordinated strategy.

The strategy appears to be support and treatment focussed and it would be
helpful to understand more in relation to prevention.

The review needs to focus on the impact of substance misuse to children and
young people in need of protection. This would have formed part of a review
of substance misuse services for children and young people which was to be
undertaken by been PCM to inform planning. Unfortunately funding to
support this review has been turned down by WAG.

The national developments supported by a legislative measure in Wales for the
development of IFSS’s now needs close attention by NPT, but also thought
needs to be given to extending this model to prevention and not only using it
at acute levels of intervention.
The Chair of the Safeguarding Children Board has held a cross
partnership senior meeting with Health/Substance Misuse leaders, CYPP,
and SNPT senior leaders. This meeting concluded that a single model for
substance and alcohol misuse services needs to be developed which
addresses the spectrum of Prevention to Intervention. The model at
prevention stages needs to be closely aligned to identifying the links with
emotional vulnerability and resilience.
3
Agenda item 6
This group made strong statements that it is time that the community of
Neath Port Talbot experiences a sea change in a long standing problem of
substance and alcohol misuse and that any new developments are badged
with transformational messages.
The Local Service Board has already made decisions to support strategies
related to alcohol misuse and the childrens services systems review. The
following recommendation will enhance this work.
Recommendation
That the Local Service Board leads on the development of the Families
First pioneer model and the IFSS model by:
-
-
-
the lead officers for CYPP, SCB, HSCWB and SNPT to meet to
develop a terms of reference for a tiered model for local
delivery of prevention and intervention services related to
substance and alcohol misuse, domestic abuse and emotional,
health and wellbeing services.
Developing outcome measures which seek to increase the
number of individuals and families who are able to care for
themselves and their children safely.
the lead officers to report the terms of reference for approval by
the Local Service Board.
Julie Rzezniczek,
Head of Children and Young People Services.
4
Agenda item 6
Appendix 1
Progress report on the progress of inter-partnership work relating to Substance
Misuse Services and Children and Young People Services in Neath Port Talbot
Purpose of the report
To report to the Safeguarding Children Board Management Group (SCB MG) and the
Children and Young People’s Partnership (CYPP) on current substance misuse
strategies and developments which relate to children and young people in Neath Port
Talbot.
The report will outline the findings under the following headings





Substance Misuse Strategy - Neath Port Talbot
National and Local Statistics
Child and Family substance misuse services and developments.
Developments in substance misuse services 2010-2013
Summary and Recommendations
Substance Misuse Strategy - Neath Port Talbot
‘Working Together to Reduce Harm’ is the Welsh Assembly Government’s 10 year
strategy which aims to set out a clear national agenda for how we and our partners can
tackle and reduce the harms associated with substance misuse in Wales. The strategy
describes how the actions will be taken forward by local delivery agents within
community safety partnerships supported by WAG regional advisory teams, and
providing them with detailed guidance to support the development of local action
plans and the commissioning of local services.
Locally, the Safer Neath Port Talbot Partnership has the responsibility for the
implementation of a Community Safety Strategy. The strategy incorporates substance
misuse issues under aim 3 as follows;
“Tackle drug and alcohol misuse through the continuing development of a
coordinated approach to prevention, detection and treatment.”
This is progressed by the Substance Misuse Action Team (SMAT), a multi-agency
partnership of local statutory and voluntary agencies working in the substance misuse
field. Membership of the SMAT includes relevant Locality Authority Departments,
Health, Police, Probation, specialist Substance Misuse Agencies and relevant wrap
around services. The team is responsible for the development and implementation of
a Substance Misuse Action Plan which is approved by the Welsh Assembly
Government. The work of the team includes the development of projects, initiatives
and programmes to improve substance misuse treatment, prevention and education
services for adults, young people and children in Neath Port Talbot.
5
Agenda item 6
The work of the SMAT is progressed through subgroups and task and finish groups.
Local provision for specialist substance misuse services is currently in the process of
change following the recommendations of a review of substance misuse services in
Neath Port Talbot undertaken by PCM Services (Wales) and commissioned by the
SMAT. A project manager has recently been appointed to progress the
implementation plan in line with the findings and recommendations of the review.
The plan involves the development of a service model that is representative of all
substance misuse services and needs. It sets out to streamline and develop pathways
among services. Using a project management methodology the model consists of
three principal elements;
Initial Access – The establishment of a duty case management team (DCMT). Initial
information and advice services. This should provide a wider and more streamlined
access point for potential clients, families and carers.
Duty Case Management Team – Initial triage assessment will be undertaken and
services suited to the client’s needs will be identified. This may include further
detailed assessment and will include care planning.
Modular service provision – To ensure a client focused and flexible treatment model
services will be categorised into five modules. Support services, Consumption
Intervention Services, Therapeutic Services, Children and Young People Services and
Criminal Justice
The specialist providers who work with those affected by substance misuse in Neath
Port Talbot are the Community Drugs and Alcohol Team (CDAT), West Glamorgan
Council on Alcohol and Drug Abuse (WGCADA) and within the criminal justice
sphere the Drug Intervention Project provided by G4S. Within a Primary Care setting
the work of the specialist agencies is supported by Community Pharmacies who
provide Supervised Methadone/Subutex Consumption Services and Needle Exchange
facilities. The work of the projects is further supported through a range of services
offered by statutory and the third sector providers eg Communities 1st Projects,
Women’s Aid, Progress 2 Work, Barnardos, Housing, Education, YOT, Police,
Health, Social Services etc
The above outlines the local structure, however from 1st April 2010 the Welsh
Assembly Government required that Substance Misuse Area Planning Boards were
put in place, the ABM Area Planning Board is co-terminous with the re-structured
regional health boundaries. For Neath Port Talbot this means that the CSP and
SMAT are now part of a wider regional planning structure with neighbouring
authorities Bridgend and Swansea. Responsibility for some elements of substance
misuse funding have moved to the Area Planning Board, ie. Capital Funding and
Health Funding, however the Substance Misuse Action Plan Fund which is a source
of revenue funding remains the responsibility of the CSP locally at present.
National and Local Substance Misuse Statistics relating to Children and Young
People
6
Agenda item 6
All Wales figures and research outlined in the Hidden Harm report suggests that
substance misuse is an issue for over 60% of children subject to care orders, Increases
in parental substance misuse, particularly more harmful drinking by mothers, have
been identified as a key factor in the rise in the number of looked after children in
recent years. 64% of problematic drug using mothers and 37% of fathers live with
their children.
The above figures are further supported through qualitative substance misuse data
from Children and Young People’s Social Services in NPT. The following data has
been extracted from a Child in Need census which was conducted on all cases open to
Children and Young People Services on 31 March 2010. The following tables
highlight a strong link with parental substance misuse and the numbers of children
being looked after.
Children in Need/Child Protection/Looked After/Adoption Cases
Total Number of Cases on
31/3/10
1238
% Parental Substance
Misuse
34%
C & YP Substance
Misuse
7%
Looked After & Adopted Children and Young People
Type of Placement Total of C&YP
Looked After
Short Term
146
Long Term
219
Pre-Adoptive &
17
Adoptive
% Parental
Substance Misuse
63%
45%
71%
% C & YP
Substance Misuse
2.75%
4.5%
6%
The above table shows that Children and Young People in NPT who become looked
after are on average twice as likely to have come from families where parental
substance misuse has been reported as an issue and of concern.
Percentage of children and young people who are looked after or adopted and are part
of a sibling group.
Total Looked After/Adopted 0 sibling 1 sibling 2 siblings 3 siblings 4 siblings
382
31%
29%
19%
10%
11%
The above table illustrate that nearly 70% of children who are looked after have
1 or more sibling who are also looked after or adopted.
Adoption and substance misuse
The findings from a recent review of Adoption medicals undertaken by Dr Peter
Barnes for Swansea and Neath Port Talbot also demonstrates relatively high
percentages of mums who have lost their children to adoption where substance
misuse has been of concern.

36% of birth mother’s had issues around substance misuse at some point
7
Agenda item 6



32% of the children seen were exposed to drugs during pregnancy.
12% of children were born prematurely, over 2/3rds were born to substance
misusing mums
10% of children had problems around neonatal abstinence syndrome.
The NPT Adoption team report that referrals to the team relating to children under 5
are often linked to issues around parental substance misuse.
Child and Family Substance Misuse Services and developments in Neath Port
Talbot
Child and Family Initiatives
In April 2009 a Hidden Harm Substance Misuse Senior Practitioner Social Work Post
was established and funded through SMAT funding. The post is based within the
Community Drugs and Alcohol Team. The aim of the post is to ensure a safe and
effective Substance Misuse Service is delivered by Social Care and Health staff in the
project. This includes developing and maintaining strong links with staff based
within Children’s Services. The post holder spends one day a week in the social work
teams and aims to reduce the harm caused by parental substance misuse and
consequently reduce family breakdown and improve family life by;







Undertaking joint assessments with Children Services Staff
Undertake an initial substance misuse assessment
Act as a resource for social work staff by providing advice, information,
support and training specifically around parental substance misuse
Provide support to parents whose children are on the child protection register
Refer on for a substance misuse assessment and referral (SMART) or other
appropriate service
Attendance at Child Protection conferences and core assessment meetings
Refer pregnant mums onto the substance misuse nurse within CDAT whose
child is at risk
The attached flowchart outlined in Appendix 1 shows the referral and assessment
process and support services in place locally which support adults who misuse
substances,
Initial feedback from social work teams is extremely positive. Strong links and
working practices have been made and maintained and there have been positive
outcomes for families. CDAT have also reported consistently high informal feedback
from parents that have used the hidden harm services. To support and develop the
work of the project CDAT are to commission PCM to undertake a formal review of
the project and its outcomes.
The CDAT Substance Misuse Nurse who works with pregnant mums is also part of
the Hidden Harm initiative. The nurse attends an average of 32 ante natal clinics per
annum. Of those clients referred, over 50% of the children born to the women are
placed on the child protection register. The nurse works closely with children’s
services with the aim of reducing the harm to children of problematic alcohol or
8
Agenda item 6
substance misuse. Attendance at strategy meetings, child protection conferences, core
groups and Looked After Children reviews. The above figures show that 69% of
children who are looked have siblings who are also looked after. Within these figures
there will be quite a large percentage of parents where substance misuse is an issue.
Support and contraceptive advice is high on the list of priorities and a bid has been
submitted to WAG to increase the capacity of the post to incorporate support to mums
post birth for up to a year. The role would also include advice and delivery of
contraception medicines. Unfortunately, initial responses from WAG indicate that
funding may not be made available.
‘Working together to Reduce Harm’ highlights the importance of family intervention
projects in meeting the needs of children of substance misusing parents, and
describes how we need to ensure that interventions are based on evidence based
practice that it evaluated and proven to be effective. Children and Young People
services are currently piloting new ways of delivering statutory and voluntary family
intervention support services. The pilots involve the systems review team and a
recently established Family Action Support Team managed by Action for Children.
Both models support integrated ways of working and aim to deliver intensive
individual packages of support to families when they need it. . The teams will offer
consultation and advice to professionals supporting families at lower prevention levels
whilst also delivering statutory children’s social services. Both are also trialling
evidence based practice models.
The Hidden Harm role within the new Family Support Model will be critical in terms
of providing the more specialist substance misuse direct support to parents, children
and young people. To further support a holistic way of working within children and
adult social services a group has been established and led by Children and Young
People services to develop a strategy to deliver Family Orientated Service Delivery
which will feed into both pilot projects. Fulfilled lives, Supportive Communities and a
recent Inspection of Children’s Services has identified bridging the gap between adult
and children’s social services as a key target for development. Furthermore, the
Children and Families Measure 2004 places a statutory duty on partners to establish
Integrated Family Support Teams (IFST) which will require child and adult services
to work together with complex families where more specialist interventions are
required and where substance misuse is an issue. These teams are currently being
piloted in three pioneer areas across Wales.
Bridging the gap between adult and children services and the development of IFST’s
is further supported and proposed in a research paper written Dr Wendy Ball, School
of Human and Health Sciences Swansea University. The main purpose of the project
was to carry out an in depth research into the rising demand for Children’s social
services in Neath Port Talbot CBC.
The substance misuse strategy also sets out the responsibility partners have to ensure
the child’s emotional health and well being needs are being met. This is outlined in
the WAG Action Plan for Wales entitled Breaking the Barriers: Meeting the
Challenges. The plan is intended to underpin the efforts of all partners who are
working to develop and deliver safe, comprehensive, effective and efficient support
that children and young people with emotional well-being and mental health needs
9
Agenda item 6
are entitled to, including extending the remit of specialist CAMHS supportive and
treatment services being made available to 16-17 year olds.
A review of EHWB services has been undertaken by IPC consultants and progressed
through the CYPP in line with the Children and Young People’s Plan (2008-2011)
The review recommended the establishment an integrated multi disciplinary team to
which would provide a single entry service for children and young people in need of
emotional support at lower and higher level interventions. The team would not
duplicate the work of specialist CAMHS but should prevent children requiring higher
level interventions. The model would also support the prevention of self harm and
suicide amongst children and young people as a response to a recommendation from a
recent serious case review from the Neath Port Talbot Safeguarding Children Board.
Unfortunately, plans to establish a new team have not been realised due to a lack of
funding primarily from health.
Young Persons Substance Misuse Services
SWITCH is a Young Person’s service specifically targeted at young people who are at
risk of, or already engaging in risky behaviour involving the use of substances. The
SWITCH service consists of one full-time Young Persons Worker and a part-time
Young Persons Worker based within WGCADA. In line with the Youth Work
Curriculum Statement for Wales the project works in ways which are:




EDUCATIVE: through prevention, education, advice and harm reduction
intervention.
EXPRESSIVE: through activities e.g. art and poetry.
PARTICIPATIVE: all of our interventions require participation of the young
person, from their input into their care plan to engaging in activities.
EMPOWERING: by giving our young people the tools and support we are
able to open new doors for them and empower them to make positive changes.
The service works with young people up to 25 years old identified as at risk or
currently using substances. Referrals are accepted from any service working with
Children & Young people, Self referrals and Family members. Attendance is
voluntary and the young person must agree to the referral. Assessments are offered
within 5 days and an intervention provided within 10 days. Interventions include one
to one sessions, outreach, group sessions and referrals to other agencies.
During 2009 – 2010, 71 young people (66% male) aged 25 years and under were
referred to the service. 32 were aged 0-20 years and 39 were aged 21-25 years
There is a full-time Specialist Substance Misuse worker based at the Youth Offending
Service (YOS) and a part-time worker based at Hillside Secure unit. These posts
work in partnership closely with WGCADA and the Switch service. All young people
referred to the services are screened for substance use. Assessments and interventions
are provided within the timescales set by National Standards for Youth Justice.
During 2009-2010 there were 77 substance misuse referrals. This equates to
approximately 25% of all referrals to the YOT during the year (a rise of 7% on the
previous year)
10
Agenda item 6
Developments in Substance Misuse Services (2010-2013)
The Assembly Government have issued guidance on how children and young people
substance misuse services should be delivered.
In addition, guidance will be issued shortly in relation to ‘Substance Misuse Service
and System Improvement’ which will provide partners with operational guidance on
the detailed development of integrated care and treatment services for Children and
Young People up to and including the age of 18 years who have substance misuse
problems. It promotes the four tier approach to service delivery and focuses on the
issues surrounding assessment and care management across the agencies. It is likely
that residential services (Tier 4) for children and young people will be developed
nationally by WAG given the small numbers involved.
At a practical level the Assembly are to develop a compendium of direct substance
misuse services for Local Authorities which have been developed and implemented
across Wales for children and young people. The compendium will also include how
projects were developed and lessons learnt.
In line with the Hidden Harm strategy in terms of safeguarding children from
substance misusing parents/adults the Assembly will be conducting a mapping
exercise to assess how each local authority is tackling hidden harm, the lessons learnt
and the barriers to change. Community Safety Partnerships will also be asked to
report to WAG on the core standard requirements related to safeguarding.
At a local level and in line with the Assembly Government’s strategy for the
development of substance misuse services/initiatives for adults and young people
under 18 years of age. The SMAT have placed bids with WAG to develop the
following projects. Some of these initiatives are time limited and subject to continued
funding being made available.
WGCADA
A full-time Young Persons Substance Misuse Prevention worker to provide
interventions for children and young people identified as requiring education,
prevention and counselling for their own or a parent/carer’s substance misuse. The
post holder will carry out assessments, develop and review care plans and contribute
to a holistic package of care for each individual. The aim is to improve relationships
and outcomes for the young person and to help individuals to achieve their full
potential. This will be achieved by working closely with the 11 comprehensive
schools and college in Neath Port Talbot and the 14-19 Network.
A full time Hidden Harm worker to provide interventions for children and young
people affected by parental or carer substance misuse under the Hidden Harm
Agenda. The post holder will carry out assessments, develop and review care plans
and contribute to a holistic package of care for the whole family. The aim is to
improve relationships and outcomes for the family by providing individual support to
children and young people, working closely with all other organisations involved.
Women and Families worker – To provide information, advice, practical help,
education and support to women and their children (in particular those children with
11
Agenda item 6
Social Services involvement) who are significantly affected by substance misuse.
Support may be provided through advocacy, one-to-one sessions and/or working with
the family collectively. Sessions may include substance use and associated
behaviours, parenting, life skills, personal development (including accessing
education, training, volunteering and employment opportunities) and practical advice
(e.g. housing and budgeting).
Family counsellor – To provide an advice, information and counselling service to
family members/carers/significant others adversely affected by substance misuse.
This service aims to help family members understand substance misuse and
associated behaviours, and cope better with the stresses and strains that it can bring to
family life. Support is provided on a one-to-one basis and through group work. Our
programme of support is based on the 12-Step philosophy. During 2009 – 2010, 37
family members were referred for family support (68% were self referrals).
Training
Awareness training on Hidden Harm relating to parental substance misuse and the
way in which services share information regarding the children of problem drug users.
Barnardos will provide training to 100 employees from organisations providing
services to children and families.
Training for the Youth Service, schools and the third sector for substance misuse
awareness and prevention training. The training will be provided by Drugs Education
Training of Cardiff and will focus on “providing participants with the most up to date
research into drugs and young people, and the effectiveness of different approaches to
educating young people about drugs.
Summary
The report outlines some of the current range of strategies and the range of
operational initiatives relating to children, young people and adults affected by
substance misuse in NPT. The main current strategy outlined in the report is currently
about to be implemented resulting from the PCM review conducted during 20082009.
Recommendations

The main strategy has not been reported to CYPP or the SCB and there is a
general lack of awareness of this work as a coordinated strategy.

The strategy appears to be support and treatment focussed and it would be
helpful to understand more in relation to prevention.

The review needs to focus on the impact of substance misuse to children and
young people in need of protection. This would have formed part of a review
of substance misuse services for children and young people which was to be
undertaken by been PCM to inform planning. Unfortunately funding to
support this review has been turned down by WAG.
12
Agenda item 6

The national developments supported by a legislative measure in Wales for the
development of IFSS’s now needs close attention by NPT, but also thought
needs to be given to extending this model to prevention and not only using it
at acute levels of intervention.
APPENDIX 1
HIDDEN HARM SUBSTANCE MISUSE SOCIAL WORKER ROLE
IN
NPT CHILDREN AND YOUNG PEOPLE SERVICES
FLOWCHART
TO REDUCE THE HARM CAUSED BY PARENTAL SUBSTANCE MISUSE, PREVENT
FAMILY BREAKDOWN AND IMPROVE FAMILY LIFE.
BY
UNDERTAKING JOINT ASSESSMENTS WITH CHILDREN SERVICES STAFF
ACTING AS A RESOURCE FOR STAFF - PROVIDING ADVICE, INFORMATION AND SUPPORT
SPECIFICALLY AROUND PARENTAL SUBSTANCE MISUSE.
PROVIDE SUPPORT TO PARENTS WHOSE CHILDREN ARE PLACED ON THE CHILD
PROTECTION REGISTER AND SUBSTANCE MISUSE IS A FACTOR
REFERRAL FOR A SUBSTANCE MISUSE ASSESSMENT OR OTHER APPROPRIATE SERVICE
SMSW is available
in Children
JOINT ASSESSMENT UNDERTAKEN WITH SOCIAL
WORKER IN RAAT AND SUBSTANCE MISUSE SOCIAL WORKER Services teams
(RAAT), Neath on
(SMSW -CHEY JENKINS) WITHIN 7 DAYS
Tues morning and
all day Weds.
FOLLOWING INITIAL ASSESSMENT SMSW MAY;
COMPETE PARENTAL SUBSTANCE MISUSE CHECKLIST
(PSMC)
2 visits required to
complete PSMC
SIGNPOST TO OTHER AGENCIES
Eg; Barnardos,
Welfare Rights,
Mind, Young
Carers, Women’s
Aid etc
PROVIDE ADVICE AND EDUCATION
CLOSE CASE
13
Agenda item 6
CASE TRANSFERRED TO FAMILY SUPPORT TEAMS
ONGOING SMSW SUPPORT MAY INCLUDE;
IMPLEMENT ACTIONS FROM PSMC
RE; RISK AND REFERRAL FOR FURTHER
ASSESSMENT
DIRECT SUPPORT RELATED TO SUBSTANCE MISUSE
AND EFFECTS ON PARENTING
FURTHER ADVICE AND INFORMATION
ATTEND CP CONFERENCES AND MEETINGS
WHERE RELEVANT
INFORM CORE ASSESSMENT RE SUBSTANCE
MISUSE AND ASSOCIATED RISK
SMART ASSESSMENT FOR PREGNANT MUMS (20 WKS
PLUS) WHOSE CHILD IS AT RISK
Referral to Substance
Misuse Assessment
and Referral Team
(SMART).
SMART triage
assessment may
recommend referral
back to Primary Health
Care services eg GP, or
referral to drug
treatment services eg
CDAT or WGCADA.
CDAT provides a
medical / psycho /
social harm reduction
service as a multi
disciplinary team i.e.
Substitute prescribing,
Detoxification, support
to residential rehab etc.
WGCADA provides a
non medical,
abstinence and harm
reduction approach
offering holistic
support and advocacy,
via a range of services
CDAT has a specialist
. nurse who works with
pregnant mums and
works closely with the
midwifery team based
at Neath Port Talbot
Hospital
14
Agenda item 6
Appendix 2
Subject: **DIARY MARKER - SSIA/IFSS Regional Workshop**
Good afternoon
Further to my email below ...
Here is the website link referred to in the SSIA's flyer: http://www.ssiacymru.org.uk/ifss
Please note the location for the event on 18th March has changed from ECM2 Port
Talbot to The Dragons Hotel, Swansea.
If you have any queries, please contact the SSIA direct: [email protected]
Kind regards
Jen Callow
From: Callow, Jennie (HSSDG - Children's Social Services Directorate)
Sent: 07 January 2011 16:55
Subject: **DIARY MARKER - SSIA/IFSS Regional Workshop**
Importance: High
Sent on behalf of Phill Chick
Please see the event flyer attached and explanatory email below from
Cathryn Thomas, SSIA.
Jen Callow
Flexible Resource Team
Tîm Adnodd Hyblyg
Children’s Social Services
Gwasanaethau Cymdeithasol Plant
Health and Social Services Directorate General | Cyfarwyddiaeth Gyffredinol Iechyd a
Gwasanaethau Cymdeithasol
Welsh Assembly Government | Llywodraeth Cynulliad Cymru



Email | E-bost : [email protected]
Tel | Ffon : 02920 825302 Fax | Ffacs : 02920 823142
Cathays Park, Cardiff CF10 3NQ
15
THE DEMAND FOR CHILDREN AND YOUNG
PEOPLE’S SERVICES IN NEATH PORT TALBOT:
TRENDS, INFLUENCES AND RESPONSES
FINAL REPORT
Research Commissioned by Neath Port Talbot
County Borough Council Children and Young People
Services
November 2010
Dr Wendy Ball
Centre for Children and Young People’s
Health and Well-Being
College of Human and Health Sciences
Swansea University
Table Of Contents
Acknowledgements 5
Steering Group Membership
5
List of Abbreviations
6
1. Introduction
8
1.1 Background
8
1.2 Project Brief
8
1.3 Research Methodology
10
2. Context: National and Local Issues in NPT
Children and Young People Services 11
2.1 National Issues 11
2.2 Local Issues
16
3. Perspectives from Professionals in Children and Young People Partnership Services and Agencies 25
3.1 CYP Partnership Services and Agencies in Neath Port Talbot CBC
28
3.2 Partnership, Collaboration and Co-ordination in
CYP Partnership Service Provision
29
3.3 Safeguarding Matters and System Pressures
31
3.4 The Role of Education in Safeguarding
35
3.5 Supporting Parents: Early Intervention for Families
40
3.6 Fitting Services around the Child?
46
3.7 Local and National Influences on Safeguarding
Pressures in NPT
52
2
3
Tables
4. From Family Assessment to Family Support:
Analysis of Case Files
56
4.1 Introduction
56
4.2 Questions
57
4.3 Three Cases
58
4.4 Summary of Themes Arising from Case File Analysis
62
5. Discussion: Safeguarding Children and Supporting Parents
65
5.1 Introduction
66
5.2 The Delivery of Multi-Agency CYP Services
66
5.3 Parenting Support: Prevention and Early Intervention
68
5.4 Moving Towards Integrated Family Services
71
5.5 Changing Systems and Doing Things Differently
74
6. Conclusion and Proposals
76
References
80
Appendices
85
Appendix A: List of Participants in Interviews
85
Appendix B: Interview Schedule for Professionals in
CYP Partnership Services and Agencies
87
Table 1: Numbers of Looked After Children in NPT, Bridgend and Swansea Local Authorities Over the
Period 2007 to 2010
19
Table 2: A Comparison of Three Neighbouring Local Authorities (NPT, Bridgend and Swansea) on Key
Dimensions at 30/06/09
20
Table 3: Wales Index of Multiple Deprivation Child Index 2008
22
Table 4: CIN Census Factors Present in Most Recent Referral to NPT CYP Services
24
Boxes
Box 1: CYP Partnership Services and Agencies in Project Sample
28
Box 2: Parenting Support in NPT
42
Box 3: CYP Initiatives Based on Team around the Child Model
49
Box 4: Questions for Case File Analysis
57
Box 5: Analysis of Sample of Case Files
61
Box 6: Proposals for Action by NPT CYP Services
79
Graph
Children in Need in NPT 2007 to 2009
23
4
Acknowledgements
List of Abbreviations
The project was commissioned by Neath Port Talbot County Borough Council and I would like to thank the
Research Commissioners and members of the Steering Group Ms Julie Rzezniczek, Head of Children and Young
People Services, Mr Russell Ward, Head of Partnership and Community Development, and Mr Karl Napieralla,
Director of Education, Leisure and Lifelong Learning for providing the opportunity to undertake the research and
for their on-going support throughout. I am also grateful to Dr Tracey Maegusuku-Hewett and Dr Alex Morgan, in
the College of Human and Health Sciences, Swansea University for their interest in the project and their role as
members of the Steering Group.
ADHD
Attention Deficit Hyperactivity Disorder
CAMHS
Child and Adolescent Mental Health Service
CCYPHWB
Centre for Children and Young People’s Health and Well-Being
CDAT
Community Drug and Alcohol Team
The research set out to build on the wide knowledge and expertise of those delivering services in Neath Port Talbot
and I am particularly grateful to all the professionals working in Children and Young People Partnership Services
and Agencies who agreed to participate in this research despite busy timetables. Thanks are also due to Shaun
Kelly, Principal Officer and Team Leader for the Systems Review for meeting me to discuss the on-going work of
his team; Rachael Davies, Business Manager and Fiona Clay-Poole, Data Analysis and Performance Officer for
providing information as the research progressed.
CHIP Project
Children’s Inclusion Project, Barnardo’s, Neath Port Talbot
CIN
Child in Need
CP
Child Protection/ Child in Need of Protection
CSS
Children’s Social Services
CSSIW
Care and Social Services Inspectorate Wales
CYP
Children and Young People
CYPP
Children and Young People Partnership
CYPS
Children and Young People Services
DfCSF
Department for Children, Schools and Families
DfEE
Department for Education and Employment
DfES
Department for Education and Skills
ELPPEG
Early Learning Partnership Parental Engagement Group
EWO
Education Welfare Officer
FGMS
Family Group Meeting Service, Barnardo’s, NPT
FOS
Family Outreach Service, Action for Children, NPT
ICS
Integrated Children’s System
IFSS
Integrated Family Support Services
JRF
Joseph Rowntree Foundation
The request to locate the project at Swansea University was progressed quickly and I appreciate the support
offered by Dr Non Thomas, Director of the Centre for Children and Young People’s Health and Well Being
(CCYPHW) and the opportunity provided to base the project with CCYPHW. I am also thankful for the guidance
offered by Ms Helen Elton in preparing the budget for the project.
Steering Group Membership
Dr Wendy Ball, Senior Research Officer, Centre for Children and Young People’s Health and Well-Being, Swansea
University
Ms Julie Rzezniczek, Head of Children and Young People Services, Neath Port Talbot CBC
Mr Karl Napieralla, Director of Education, Leisure and Lifelong Learning
Mr Russell Ward, Head of Partnership and Community Development, Neath Port Talbot CBC
Dr Tracey Maegusuku-Hewett, Lecturer, College of Human and Health Sciences, Swansea University
Dr Alex Morgan, Lecturer, College of Human and Health Sciences, Swansea University
5
6
1. Introduction
Section Summary
LAC
Children Looked After by the Local Authority
LSCB
Local Safeguarding Children Board
NAfW
National Assembly for Wales
NPT CBC
Neath Port Talbot County Borough Council
PPD1
Notification of Children or Young Persons Coming to Notice of
Police Form
WAG
Welsh Assembly Government
WIMD
Welsh Index of Multiple Deprivation
YIP
Youth Inclusion Programme
YOT
Youth Offending Team
•
The rising demand for CYP Services in Neath Port Talbot was identified by the CYPP as an issue that would benefit from independent research and this section establishes contextual matters and the project brief.
•
The key methods of data collection and sources of information are presented alongside a synopsis of where these sources are discussed in the main sections of the report.
•
The contractual agreement and ethical matters are described.
1.1 Background
The project was commissioned in March 2010 by Ms Julie Rzezniczek, Head of Children and Young People
Services, Neath Port Talbot CBC, and Mr Russell Ward, Head of Partnership and Community Development, Neath
Port Talbot CBC. Ms Rzezniczek and Mr Ward had presented a briefing paper to the CYP Partnership to establish
a case for a research project to explore the rising demand for CYP Services in NPT. Following initial discussions
with Dr Wendy Ball, it was agreed that the project should be located within the Centre for Children and Young
People’s Health and Well-Being in the College of Human and Health Sciences, Swansea University. Dr Ball was
appointed as Principal Investigator for the project. There has been a Steering Group for the project which has met
on four occasions between April to October 2010. The Membership of the Steering Group is provided on Page 5.
The Project commenced formally on 12th April 2010 and the programme of work was conducted by Dr Ball on a
half-time basis over a period of 6 months. The final project report was submitted for comment to the Steering Group
in October 2010 and presented to NPT CYPP Programme Team in November 2010.
1.2 Project Brief
1.2.1 Context
The research project has been designed to investigate issues relating to the rise in demand for CYP Services in
NPT. More specifically, the Research Commissioners had identified certain matters in their briefing paper for further
attention and these provide background and context to the research. The issues are:
•
7
Rise in demand: A need to understand and explain the significant rise in demand for CYP Services, especially at the acute level and in meeting complex needs; this rise in demand being manifested in the substantial rise in the numbers of children Looked After by Social Services. In seeking to explain this increased level of need, there are questions regarding how far this can be related to wider local and national social trends and how far it relates to the operation of key services and interventions to support
families.
8
1.3 Research Methodology
•
•
Coping with service pressures: In view of the increased pressures on CYP Services, it is important to ensure interventions are designed and delivered so as to identify and respond to need at the earliest stage possible. There are a variety of questions in the briefing paper relating to the appropriate balance between universal and targeted services; how well various interventions have worked in the past and where limited resources can be best placed to provide appropriate support to families facing adverse circumstances.
An independent perspective: The research commissioners stated an interest in the research being conducted without preconceived assumptions about the nature of the problem and how best to address it. There was further interest in learning how far there may be issues specific to the local area and the Neath Port Talbot community that need to be understood and that are having an impact on the growing level of need.
This background information has been used to inform the research design described below.
1.2.2 Rationale and Aims
The main purpose of the project was to carry out in-depth research into the rising demand for CYP Services in
Neath Port Talbot using a variety of methods and sources of primary and secondary data. The main aims of the
study were to identify what is happening in terms of the increased demand for CYP Services; why there has been
an escalation of demand; and how the issue can be best addressed from a service delivery perspective. More
specifically the study was based on the following aims:
1.3.1 Selection of Methods
The research adopted a multi-method approach and the selection of research methods took into account the interest
expressed by the research commissioners in ensuring the study avoided pre-conceived ideas and was responsive
to local issues based in the communities of Neath Port Talbot. The Project Investigator had not previously worked in
Neath Port Talbot but had experience of conducting research in the field of childcare and family support services
in another Welsh local authority. It was, therefore, possible to offer an independent perspective on the matters of
interest within NPT.
On this basis, the research data was based on the following sources:
•
Analysis and collation of local area social statistics and existing NPT CYP Services data, CYPP materials and the Systems Review data and reports. (Section 2)
•
Qualitative interviews with local professionals in key services and agencies within the CYP Partnership in Neath Port Talbot- to draw together existing local expertise and knowledge in relation to the research questions and to ensure relevant service stakeholders were included in the research process. (Section 3)
•
Local study of the Sandfields area of Port Talbot in order to explore the provision of services to families in need in an area of significant socio-economic deprivation. (Section 3)
•
Qualitative analysis of a sample of case files held on the NPT CYP Services Integrated Children’s System (ICS) (Section 4)
•
Review of relevant literature on the themes of the research including academic and policy based sources. (Section 5)
(a)
To describe the nature of the increase in demand for CYP Services in Neath Port Talbot;
(b)
To explore why this increase is happening and set this in the context of local, regional and national socio-
economic trends;
(c)
To examine the contribution of current universal and targeted services and interventions through the collation of evidence about current service delivery, perspectives on what is working well or poorly and analysis of other available indicators that may assist service evaluation;
1.3.2 Ethical Issues
(d)
To identify potential appropriate and effective forms of service delivery to ensure early identification of need and offer preventative measures.
These are ambitious aims in relation to the timescale and available resources for the project but it was confirmed
that a broad, general overview of issues would be more helpful to the Commissioners than a narrow focus
on specific aspects of service provision. It should be emphasised that, in view of these limitations, the Project
Investigator did not conduct an evaluation of any of the services and agencies referred to in this report. The aim
instead was to examine how the different services and agencies embraced by the CYP Partnership fitted together,
the location of CYP Services within this wider picture and where there were potential gaps and system pressures to
be addressed.
9
The Project Investigator was subject to a CRB Enhanced Disclosure. All participants were advised that the project
had been commissioned by NPT CBC Children and Young People Services and was being conducted by an
independent Investigator reporting to a Steering Group. Confidentiality has been respected throughout the research
with an agreement that participants would be listed in an Appendix to the Report (Appendix A) but would not
be identifiable in the selection of quotations or presentation of material. In addition, the analysis of CYP Services
case files in Section 4 has protected the anonymity of service users. The Economic and Social Research Council
guidance contained in the Framework for Research Ethics also provided a reference point for questions arising over
ethical matters1.
1
http://www.esrc.ac.uk/ESRCInfoCentre/opportunities/research_ethics_framework/index.aspx
10
2. Context: National and Local Issues in NPT Children and Young
People Services
Section Summary
2.1.1 Placing Children and Young People at the Heart of Social Policy
•
This Section sets the matter of Safeguarding Children and Young People in a broader social policy context with reference to UK Government, Welsh Assembly Government and local agendas within NPT.
•
The principle of a ‘shared responsibility’ in Safeguarding is highlighted as this was explored in the current research.
The Labour Government that was in power between 1997 to May 2010 developed a social policy agenda
that claimed to place children’s needs and interests at the heart of its concerns (F.Williams, 2004: 406). Specific
policy measures that emerged during this period that focused on children and young people have been wideranging. Some relate to the UK as a whole whilst others have followed different routes in Wales, England,
Scotland and Northern Ireland.
•
The other actions being progressed by NPT CYP Services to address the problem of system pressures including the internal systems review are acknowledged as an important point of comparison with this commissioned research.
•
Key statistics relating to children and young people in NPT and measures of socio-economic deprivation are presented.
•
Current statistical data reveals that the pressures facing CYP Services in NPT are present in other Local Authorities but there is evidence of deep socio-economic deprivation in the locality which will make NPT vulnerable to a sizeable number of families facing adversity and consequent demands on services.
•
The secondary sources reviewed in this Section provide an early indication that the needs of adults within the families referred to CYP Services can be complex and their resolution will benefit from a holistic model of family support.
2.1 National Issues
The Safeguarding Agenda in Wales can best be explored through placing it within a wider context in relation to
social policy and legislation relating to children and young people at the UK level and in relation to the trajectory
of policy in Wales following devolution and the establishment of the Assembly2. Safeguarding policy in Wales
can be assessed in relation to the Assembly’s strong commitment to inclusion, social justice and children’s rights
agendas (WAG, 2004a; 2004b; 2005a). The key elements of policy relating to children and young people at
the national level are described next.
The National Assembly for Wales has 60 elected members and has legislative powers in devolved areas. The National Assembly has delegated its
executive powers to the Welsh Assembly Government made up of nine Cabinet Ministers and led by the First Minister. Reference will be made simply to “the
Assembly” in this report unless the distinction between the legislature and the executive is relevant.
2
11
2.1.2 The Commissioner for Children for Wales
The agenda for children and young people in Wales has not simply been responsive to developments at the
UK level but in many ways has been groundbreaking. Wales was the first of the four countries, for example, to
appoint an independent Children’s Commissioner in 2001 (Clarke, 2002; J.Williams, 2005). According to
Lynda Bransbury, the Assembly’s decision ‘was therefore an immediate demonstration of the possibilities created
by devolution. It was also tangible evidence of a rights-based approach and the promise of new and more
collaborative governance in Wales’ (2004: 178).
The establishment of the Office of the Children’s Commissioner was an example of the commitment of the Assembly
to affirming the welfare and rights of children and young people and also an indication of the intention of the
Assembly to adopt a style of governance that is open, inclusive and accessible (Catriona Williams, 2003).
2.1.3 Children and Young People’s Partnerships
The emergence of policies for children and young people in Wales following devolution had implications for
service delivery locally; this background is, therefore, relevant for understanding arrangements at the local Authority
area level today. The publication of Extending Entitlement: supporting young people in Wales (NAfW, 2000a)
and Children and Young People: a Framework for Partnership (NAfW, 2000b) started a process directed towards
improving services for children and young people and ensuring their participation in developments.
In July 2002 the Assembly issued a guidance set entitled Framework for Partnership (WAG, 2002a) comprising
various documents resulting from earlier consultations and containing proposals designed to integrate policies
and services for children and young people and to secure their involvement in service delivery at the local level.
The priority was ‘to make the planning and delivery of services for children and young people by local agencies
more coherent and cross cutting’ (WAG, 2002b: 1, Para 1.1). The guidance proposed the establishment of
local Children and Young People’s Partnerships charged with the task of developing a strategic Framework for
all services for children and young people aged from birth to 25 years. The Framework would take the form of
a 5- year strategy for children and young people that would also link to the local authority’s Community Strategy.
It also proposed that there should be two sub-groups. One sub-group would be a Children’s Partnership for
children aged from birth to 10 years with a role to improve services in the context of guidance issued in Early
Entitlement: Supporting Children and Families in Wales (WAG, 2002c). The Children’s Partnership was to produce
a Children’s Plan for the local authority area. The other sub-group would be a Young People’s Partnership which
would have a comparable role for the 11 to 25 years age group in the context of the Extending Entitlement
(WAG, 2002d) guidance. This Partnership would be expected to develop a Young People’s Strategy for the area.
12
2.1.4 The Cymorth Fund
2.1.6 The Children Act 2004
Alongside these new arrangements for service planning, the Assembly introduced a new funding stream called
Cymorth, the Children and Youth Support Fund (WAG, 2002e; WAG, 2003) beginning in 2003. This was a
replacement for 5 funding streams that had previously been separate (Sure Start, Children and Youth Partnership
Fund, National Childcare Strategy, Youth Access Initiative, Play Grant) and responsibility for administering the
fund was placed with the local CYP Partnerships. It was stated that the key aim of Cymorth was ‘to make targeted
services more effective in breaking the cycle of deprivation that affects children and young people’s life chances’
(WAG, 2004c: 6). Significantly, in the context of this research project, family and parenting support was identified
within the areas of priority for Cymorth funding.
Whilst it will be clear that the Assembly was providing a strong lead in matters relating to the well-being of children
and young people in Wales, there were also developments at UK level with significant implications for the matter
of Safeguarding children. The Green Paper Every Child Matters (Chief Secretary to the Treasury, 2003) called ‘for
the biggest shake up of statutory children’s services since the Seebohm Report of the 1960s’ (F.Williams, 2004:
406). This Green Paper included proposals that would ensure services would focus around the needs of children
and young people and would be more effective in safeguarding their interests. The Every Child Matters: Change
for Children (DfES, 2004) became an ongoing programme of action designed to transform children’s services and
the Children Act 2004 provided the legal framework that underpins this programme.
2.1.5 Core Aims for Children and Young People
Whilst the Every Child Matters Green Paper contained proposals mainly for England, the Children Act 2004 had
implications for both England and Wales3. The Act introduced similar provisions for England and Wales although
specific measures were detailed separately because of differences between children’s services in each country. The
overall goals of improving the well being of children and young people, and securing partnership and integration
in children’s services, are common to legislation and policies in England and Wales. Part Three of The Children
Act 2004 being specific to Wales:
In placing children and young people at the heart of its policy agendas the Assembly also adopted its Core
Aims for Children and Young People (WAG, 2004b). These are informed by the principles of the United Nations
Convention on the Rights of the Child and the core aims are intended to underpin all services for children and
young people. Policy in Wales has evolved within this framework of concern for meeting children and young
people’s needs and rights and ensuring policies are integrated. The Assembly’s Core Aims for Children and Young
People are to ensure children and young people:
•
have a flying start in life and the best possible basis for their future growth and development
•
have access to a comprehensive range of education, training and learning opportunities, including acquisition of essential personal and social skills
•
enjoy the best possible physical and mental, social and emotional health, including freedom from abuse, victimisation and exploitation
•
have access to play, leisure, sporting and cultural activities
•
are listened to, treated with respect, and are able to have their race and cultural identity recognised
•
have a safe home and a community that supports physical and emotional wellbeing
•
are not disadvantaged by child poverty
(WAG, 2004b: 1)
•
Section 25 of the Act introduced a duty for each children’s services authority (the local authority) in Wales to make arrangements to ensure co-operation between the authority, relevant partners and other relevant bodies to improve the well-being of children in the area;
•
Section 26 of the Act gave the Assembly the power to require local authorities to develop a plan for services to children and young people.
•
Section 27 of the Act concerns the requirement that local authorities each appoint a lead director for children and young people’s services and designate an elected member as the lead member for those services.
•
Section 28 of the Act concerns arrangements to safeguard and promote the welfare of children and applies to key organisations that have contact with children and young people.4
The Every Child Matters Green Paper (Chief Secretary to the Treasury, 2003) introduced policies and proposals for England only with the exception of
certain proposals relating to non-devolved responsibilities. The Welsh Assembly Government was able to determine which proposals they wished to adopt but
within the legislative framework subsequently introduced by the Children Act 2004, Part Three, Children’s Services in Wales.
3
4
13
Details summarised from www.opsi.gov.uk/acts/acts2004/40031-d.htm
14
The Act has thus enabled the Assembly to build on the original Framework arrangements by putting them on a
statutory footing. It is important to note that each Children’s Services Authority is required under the Act to ‘have
regard to the importance of parents and other persons caring for children in improving the well-being of children’
(Children Act 2004, Section 25 (3)). In this sense parents are taken into account in the planning process but
only in relation to the needs of the child. This is a significant point in relation to the local arrangements that have
evolved to safeguard children and support parents. The focus is on the child or young person first rather than the
family as a whole and this may not always be helpful in relation to addressing the needs of any adults with caring
responsibilities for the child. This is a matter to be illustrated later with reference to the research data.
2.1.7 Safeguarding
Responsibility for safeguarding and the key principles that inform responsibility have a statutory basis in the
Children Act 1989 and the Children Act 2004. According to Nick Frost and Nigel Parton:
The key theme of the Children Act 2004 was to encourage partnership
and sharpen accountability between a wide range of health, welfare,
education and criminal justice agencies. (2009: 41)
The statutory duty for these key agencies to co-operate in discharging their joint responsibilities to improve the
well-being of children and young people and to safeguard and promote their welfare would require approaches
to joint working and integrated forms of service delivery at every level. The Children Act 2004 introduced the
statutory requirement for all Local Authorities in England and Wales to establish a Local Safeguarding Children
Board (LSCB) that would co-ordinate multi-agency work to safeguard children and promote their welfare. In Wales,
the LSCBs replaced the former Area Child Protection Committees in October 2006. The Assembly introduced
guidance relating to the Children Act 2004, Safeguarding Children: Working Together under the Children Act
2004 (WAG, 2007) and in 2008 the All Wales Child Protection Procedures (AWCPP Review Group, 2008)
were produced for all LSCBs in Wales. The All Wales Child Protection Procedures emphasise the principle of a
‘shared responsibility’:
The protection of individual children from significant harm, as well as the
broader requirement for safeguarding and promoting children’s welfare,
depends fundamentally upon effective sharing of information, collaboration
and understanding between agencies and professionals. (2008: para 1.3.2: 36)
The matter of this shared responsibility was addressed in the current research and will be discussed with regard to
the empirical data in Section 3 and Section 4.
2.1.8 CCSIW Review
In October 2009 the Care and Social Services Inspectorate Wales (CSSIW) published a review of the role of
Local Authority Social Services and the LSCBs in safeguarding children in Wales (CSSIW, 2009a). The review
was undertaken in the aftermath of the death of Peter Connelly and the serious case review carried out by
Haringey Safeguarding Children Board 5. This tragic case placed the matter of safeguarding centre-stage and led
to further action by the Assembly including the CSSIW review. This report is relevant with regard to the question
raised by the Research Commissioners as to whether the rise in demand facing CYP Services was a local matter or
part of a wider trend. Some of the findings of the CSSIW report reveal this trend is not specific to NPT. The report
reveals that Local Authorities across Wales were reporting an increase in the volume of referrals to children’s social
services and in the complexity of cases coming forward. This was having an impact in their capacity to address
cases at a lower level assessed as children in need. In addition the report suggests that the message of shared
responsibility has yet to be realised in practice:
A recurring theme emerging from this review is that there is imbalance in
how organisations and professionals discharge their responsibilities in relation
to safeguarding and promoting the welfare of children, with too much reliance
being placed on local authority social services. (CSSIW, 2009a, para 1.3: 1)
This is an issue to be considered with regard to the current pressures in NPT. It is now appropriate to move to a
consideration of the local context.
2.2 Local Issues
In this section the arrangements for safeguarding and promoting the welfare of children and young people in NPT
will be described followed by a discussion of some of the key features of the locality.
2.2.1 NPT Children and Young People’s Partnership
The current project was commissioned on behalf of NPT CYPP and funded through the Cymorth Grant. The CYPP
in NPT produced the current CYP Plan for 2008 to 2011 Putting Our Children and Young People First (NPT CYPP,
2008). The plan refers to the basis for its work in the Assembly’s Core Aims that were identified in Section 2.1.
The plan also states that the focus will be on vulnerable children, young people and their families (NPT CYPP,
2008:9). Building on this focus, the CYPP has identified 5 cross cutting themes that relate to the 7 Core Aims:
5
Peter Connelly died at the age of 17 months in August 2007 as a result of injuries received while in the care of his mother, her partner and a lodger. He
had been subject to a child protection plan on account of concerns of neglect and abuse.
15
16
(1)
(2)
(3)
(4)
(5)
Identification and Support for Vulnerable Children and Young People;
Integrated Early Intervention Services;
Enhance Information Sharing;
Partnership Communication;
Joint Commissioning.
The current research has collected material of relevance to all 5 of the themes.
The CYPP Service Profile provides information on how specific services and agencies play a role in relation to the
Core Aims at each Tier and within the specific localities that make up the County Borough. In this sense the CYPP
had already carried out a mapping exercise that would be helpful in identifying gaps and areas of need. The
current research has tried to add to this through an exploration of the views of professionals on how this map of
services is working in practice.
2.2.3 Systems Review
The project was conducted during the same period as the CYP Services Systems Review Team were considering
service demands in CYPS with regard to assessment and case management processes. The Project Investigator
met with the Team Leader on two occasions and was provided with access to some of the data collected by the
Systems Review Team. In addition ongoing reports provided further background information (Kelly, 2010; Head of
CYPS, 2010). The Systems Review was launched in October 2009 and the Review Team had progressed to the
small-scale trial phase during the period of fieldwork.
The participants in the interview strand were all aware of the Systems Review and were anticipating change in
the organisation and delivery of CYP Services in due course. In this context the Project Investigator was aware that
actions from the Review could have implications for many of the matters arising in the interviews. Nevertheless, the
research was distinct from and independent of the Systems Review providing opportunity to compare and contrast
themes of mutual interest.
2.2.2 The NPT Local Safeguarding Children Board
2.2.4 Children’s Social Care Consultants Ltd Report
The CSSIW Review of children’s safeguarding arrangements in NPT (CSSIW, 2009b) was conducted 12 months
before the current research was commissioned. The report published in October 2009 provides helpful context
with regard to issues arising at the local level. The report identifies strengths and areas for improvement with regard
to ‘corporate responsibilities’, ‘policy, procedures, protocols and systems’, ‘assessment and case management’,
‘monitoring, quality assurance and management information systems’ and ‘workforce- induction training and
professional development’ (CSSIW, 2009b). As part of the process of review the Local Authority prepared a self
audit on the effectiveness of local arrangements to safeguard and promote the welfare of children. In addition
there was a separate self-evaluation on the effectiveness of the NPT LSCB prepared by the Chair of the LSCB (NPT
LSCB, 2009). Among the variety of issues arising from these reports, the Project Investigator identified the following
points as being particularly relevant to the current research:
The sharp rise in the numbers of Looked After Children in NPT had been the subject of a consultancy undertaken
by Children’s Social Care Consultants Ltd and their report, completed in January 2010, was made available to
the Project Investigator. While the rationale for the current research was also based on a concern to explore why
there had been an increase in demand for CYP services including the rise in Looked After Children, it was sensible
to avoid duplication. The research design for the current project focused more on the role of the various CYP
services and agencies beyond Children’s Social Services and on preventative and early intervention activities. The
experience and needs of Looked After Children and their families had been addressed by the Consultants and
this was not a focus in the current research. Nevertheless, there is some consistency in the main recommendations
offered by the Consultants and some of the proposals reached on the basis of this research.
(1)
The NPT LSCB has identified a gap in that the focus of efforts to improve safeguarding has been
“disproportionately on social services” (NPT LSCB 2009). There is a need to ensure practice in safeguarding in other services including police, health and education is improved so that all are meeting their statutory responsibilities;
(2)
There is a problem within children’s social services of “unmanageably high caseloads in some teams” (CSSIWb, 2009, para 2.4: 1). It was noted this difficulty had been identified by the Local Authority and there was a plan to conduct a review to address the matter further.
(3)
One area for improvement related to a need to formalise “the links between referral criteria for children and adult services and an agreed policy in social services about supporting adults who are parents in need” (CSSIWb, 2009, para 4.3: 3).
These 3 matters were present as ongoing matters of concern in the current research. This claim will be supported
with evidence drawn from interviews and case file analysis in subsequent sections.
17
18
2.2.5 The County Borough of Neath Port Talbot
Comparing Local Authorities
Looked After Children
If differences between these 3 Local Authorities are considered on the dimensions of population size, population
density and age profile, information was available from the Local Government Data Unit, Wales 7 as reported in
Table 2:
The pressures facing NPT CYP Services are not unique and there has been reports of recent increased volume and
complexity of referrals to children’s social services in other Local Authorities in Wales (CSSIWa, 2009). In addition
there is a growing body of research revealing comparable safeguarding pressures within Local Authorities in
England (ADCS, 2010; Clarke, 2010; Macleod et al, 2010).
TABLE 2: A Comparison of Three Neighbouring Local Authorities (NPT, Bridgend and Swansea) on Key
Dimensions at 30/06/098
Analysis of the available statistical data on the numbers of Children Looked After (LAC) by each Local Authority
can provide some indication of trends. However, this data is provided in absolute numbers so it makes little sense
to compare those figures across Local Authorities that vary in population size and other dimensions. In order to
explore whether the rise of LAC in NPT is unusual in comparison to other Local Authorities it would be necessary to
have access to more sophisticated data that would control for different variables. The following limited information
should be read with this caveat in mind. Numbers of LAC in NPT have been compared with those in neighbouring
Local Authorities, Swansea and Bridgend, over a period of 4 years:
TABLE 1: Numbers of Looked After Children in NPT, Bridgend and Swansea Local Authorities
Over the Period 2007 to 2010 6
No of LAC by Local
Authority
By Year Ending 31st
March
Neath Port Talbot
Bridgend
Swansea
2010
390
290
560
2009
290
255
430
2008
285
275
395
2007
275
290
390
Key Variables
Neath Port Talbot
Bridgend
Swansea
Population Size
(Total Number of People)
137425
134197
231307
Population Density
(Population Count/ Area in Sq Km)
311
535
612
% of Population Aged 0 to 15 Years
18.1%
18.9%
17.2%
If Table 1 and Table 2 are compared it is possible to draw out trends that are not immediately apparent when
only the absolute figures for LAC are considered. Table 1 reveals that NPT had experienced a significant rise in
LAC between 2007 and 2010 and especially between 2009 and 2010 that was not experienced by Bridgend,
a neighbouring Local Authority, with a comparable size of population and percentage of the population aged 0
to 15 years. The two authorities are different in terms of population density as NPT has a higher prevalence of
geographically dispersed communities scattered across the County. Table 1 also revealed that NPT and Swansea
have experienced comparable percentage increases in the number of LAC over this period; although they are
different in both population size and population density. The bigger population size of Swansea explains why
Swansea has higher absolute numbers of LAC overall. In this context, the data suggests that NPT is closer to
Swansea than Bridgend in the pressures currently being faced as measured by rises in LAC. Nevertheless it is
a much smaller Authority in terms of population size and population density with implications for the solutions in
service delivery that might be possible.
If the observation above regarding the need to control for variables such as population size, population density
and age profile in each Local Authority is put to one side, initially, these figures reveal that NPT has experienced
an increase in the numbers of LAC between 2007 to 2010 of 41.8%; compared to 0% for Bridgend and 43.6%
for Swansea. The rise between 2009 and 2010 is 34.5% for NPT; 13.7% for Bridgend and 30.2% for Swansea.
7
8
6
19
These figures were obtained with reference to the statistical data collected by the Welsh Assembly Government, www.wales.gov.uk/statistics/
http://www.infobasecymru.net/IAS/dataviews/ (www.dataunitwales.gov.uk)
The project investigator acknowledges that there is a difference in the date to which statistics provided in Table 1 (31st March for each year) and Table 2
(30th June 2009) refer. However, this was the closest point of comparison that was found for data sets available from different sources.
20
If the 3 Local Authorities are compared on Economy and Labour market data (statswales.wales.gov.uk) with
regard to trends over time: in 2001 the economic inactivity rate (excluding students) was 34.1% in NPT; 24.4%
in Swansea and 26.5% in Bridgend. By March 2010 the figures were 31.1% for NPT; 23.7% for Swansea
and 26.3% for Bridgend. Hence, NPT has had a markedly higher rate of economic inactivity than the two
neighbouring Authorities during this period. With regard to the unemployment rate, this has risen from 6.1% in
2001 to 10.2% in 2010 for NPT; from 6.2% in 2001 to 9.2% in 2010 in Swansea; and from 4.6% in 2001 to
8.5% in 2010 in Bridgend.
The ten most deprived Lower Super Output areas in Neath Port Talbot are presented in the table 3 alongside their
Welsh Index of Multiple Deprivation Child Index Rank:
Table 3: Welsh Index of Multiple Deprivation Child Index 200810
While the preceding figures point to a higher level of economic need in NPT than Bridgend or Swansea, there are
other figures that suggest NPT does better as measured through certain indicators. The percentage of children living
in workless households, for example, went down from 23.3% in 2004 to 18.6% in 2008 in NPT; while the figures
went up from 21.1% in 2004 to 24.8% in 2008 in Swansea; and from 13.7% in 2004 to 18.9% in 2008 in
Bridgend.9 Nevertheless, these figures remain high for all 3 Local Authorities.
The data above has been presented to illustrate two points. First, there is a paucity of statistical evidence to enable
comparisons between Local Authorities in Wales with regard to reported pressures on CYP services and their
relationship to family needs as measured by indicators of socio-economic deprivation. Second, even where there is
an attempt to cross-check different statistical sources, it can be difficult to discern obvious patterns that would help
explain why some Local Authorities have experienced a sharp increase in demand for CYP Services while others
have not. There is also a problem of time lag and different dates for recording information in the key statistics that
might help in an exploration of trends and comparison of Local Authorities. At best it is possible to say that NPT
is not the only Local Authority in Wales to be facing these pressures but national statistics currently available may
not offer either explanation or solution. It seems likely that a number of different factors combining together may
make some Local Authorities more vulnerable to the rise in demand than others. In addition the current absence
of measures to identify discernable patterns points to the value of developing solutions that are locality specific
tailored to each Authority’s particular circumstances.
The Public Consultation Paper launched in January 2010 for the NPT Community Plan 2010 to 2020 (NPT CBC,
2010) provides further contextual information: the Welsh Index of Multiple Deprivation (WIMD) 2008 reveals that
17 of the 91 small areas in the County Borough are classified as in the most 10% deprived in Wales. The WIMD
2008 shows that the three most deprived Lower Super Output (LSOA) areas in NPT are Cymmer (Neath Port
Talbot) 2 with a score of 65.2, which ranked 29 out of 1896 in Wales; Sandfields East 2 with a score of 59.7,
which ranked 52 out of 1896 in Wales; Neath North 2 with a score of 57.3, which ranked 60 out of 1896 in
Wales.
The statistics are drawn from stats.wales.gov.uk folders for economy and labour and social inclusion - the folders vary with regard to the most recent dates
available for specific indicators.
9
21
Welsh Index of
Multiple Deprivation
Child Index
Lower Super Output
Area Name
47
Aberavon 4
53
Cymmer 2
57
Briton Ferry West 1
76
Sandfields West 2
78
Sandfields East 2
99
Gwynfi
113
Sandfields West 3
122
Aberavon 3
155
Neath East 3
161
Neath East 1
These high levels of socio-economic deprivation concentrated in many geographic areas in NPT provide context to
issues of service delivery for CYP services.
The CYPP Plan Needs Assessment 2010 (NPT CYPP, 2010a) provides further information on levels of need for
children and young people mapped against the core aims identified in the CYPP plan. A further indicator of child
poverty is available through the numbers of school age children claiming free school meals. The Needs Assessment
reports that for Primary School Pupils the percentage has risen from 22.5% in January 2006 to 24.9% in January
2010. For Secondary School pupils the figure was 19.8% claiming free school meals in January 2006 and
20.1% in January 2010. These figures are higher than for Wales as a whole over this period although the All
Wales figures for January 2010 were still to be confirmed.
10
The Needs Assessment 2010 Version 2 provided by NPT CYPP (2010a) was the source for this data relating to the Wales Index of Multiple Deprivation.
22
Children in Need in NPT
The Needs Assessment also presents data on Children in Need in NPT by ward of residence and the graph below
offers this information for the period 2007 to 2009. It is, therefore, possible to compare the wards with the highest
numbers of CIN against the Welsh Index of Multiple Deprivation Child Index. The graph indicates that numbers
rose from 2007 to 2008 but then dropped in 2009. According to the Needs Assessment there were 985 cases
of CIN in 2007, 1158 cases in 2008 and a drop to 734 cases in 2009. However, the CIN Census for NPT
for 2010 covers a total of 1268 children meaning the dip in 2009 was not maintained. This pattern would be
compatible with claims from professionals presented later in the report that some cases that are referred as CIN
are not assessed as meeting the thresholds and are not progressed, leading to re-referral later. It is possible that
thresholds for progressing a referral within CYP Services could have risen in 2009 following the pressures evident
in 2008 leading to the relatively low number of CIN cases for 2009 but only to lead to another sharp rise in
cases in 2010.
GRAPH11:
Children in Need, Neath Port Talbot 2007 - 2009
The Child in Need Census Analysis for NPT for 2010 (NPT CYPP, 2010b) covered a total of 1268 children.
With regard to the factors present in the most recent referral, the following breakdown was reported:
TABLE 4: CIN Census Factors Present in Most Recent Referral to NPT CYP Services12
NUMBER OF
CHILDREN
% of CIN Children
Child had been on CPR in 12 months prior to referral
37
2.9%
Child had been LAC in the 12 months prior to referral
14
1.1%
Parental substance/alcohol misuse present in referral
448
35.3%
Parental learning disabilities present in referral
166
13.1%
Parental mental health present in referral
505
39.8%
Parental physical health present in referral
278
21.9%
Domestic Abuse present in referral
278
20.8%
FACTOR PRESENT
These figures provide indication that families are facing complex problems where preventative and early
intervention strategies might not be sufficient and where specialist support is required. The figures also offer useful
background information in relation to the perspectives of professionals involved in offering parenting support.
They would suggest that parenting programmes need to be designed to address complex adult needs that require
support and resolution prior to or alongside any focus on styles of parenting and advice on appropriate care. The
extent to which current parenting support is able to achieve this will be considered in Section Three. In addition the
case file analysis presented in Section Four will explore the extent to which the current management of a referral to
CYP Services addresses the needs of the adult involved.
In the next section the report turns to the interviews with professionals within CYP Partnership Services and Agencies
in NPT.
Reproduced from NPT CYPP (2010a) Needs Assessment 2010 V2
11
Source of data, NPT CYPP, 2010b
12
23
24
3. Perspectives from Professionals in Children and Young People
Partnership Services And Agencies
Section Summary
•
This Section presents material from qualitative interviews with professionals in CYP Partnership Services and Agencies in NPT.
•
Multi-agency approaches are evident in a wide variety of projects in the field of education, parenting
support and “team around the child” models. Specific examples are presented.
•
There is a need for clarity in terminology and in understanding the challenges and benefits of different
approaches to collaboration across agencies and professional disciplines.
•
With regard to joint responsibility for Safeguarding, there are competing views between professionals in different agencies as to appropriate thresholds for referral to CYP Services as well as different perspectives on who has the expertise to provide family support and the power to intervene where necessary.
•
There is evidence that system pressures have rippled out across the entirety of CYP Partnership Services and Agencies eroding the principles of preventative and early intervention approaches.
•
The Education Service has a key role to play in Safeguarding and schools provided many examples of creative approaches to supporting the well-being of children and young people. However, it is felt that there is too much variability across the Education sector as a whole in understanding the Safeguarding role.
•
Professionals in schools conveyed a wish for more opportunities for regular contact with social workers through school-based or cluster-based initiatives. It was felt that this would establish access to professional expertise and would enhance current multi-agency projects that do not include a social work presence.
•
Professionals in agencies providing parenting support described a variety of complex adult needs that cannot be addressed through a parenting programme alone. In this context the term ‘parenting capacity’
may be unhelpful, obscuring a host of difficulties that require timely signposting to other forms of
intervention for the adult.
•
The experience of a service user whose two children are currently in foster care is presented to illustrate the value of providing holistic family support.
•
The rise in demand for CYP Services was not felt to be specific to the locality but due to a combination of increased safeguarding awareness and the impact of early intervention, meaning that more families would be identified as in need of specialist and targeted support.
•
Local and national socio-economic and family changes combine to make life hard for many families meaning there are structural problems beyond the responsibilities of CYP Services that need to be addressed at local, Assembly and UK Government levels.
25
The report now turns to the views of professionals based within statutory and voluntary CYP Partnership Services
and Agencies in NPT. The aim of this strand of the research was to ensure that the knowledge and experience
of professionals working within CYP Partnership Services and Agencies would inform the assessment of what is
happening and what could be done differently in this climate of rising demand.
The sample was selected in order to include perspectives from statutory children’s social services, education,
health, police, youth services and voluntary agencies. The Project Investigator made reference to the Tier of CYP
Services represented in the CYP Plan for NPT (2008: 10) and the sample included services and agencies included
in Tier 1 (Universal), Tier 2 (Targeted) and Tier 3 (Specialist) provision. The agreed focus on parenting support and
early intervention and preventative initiatives also influenced the selection process. The inclusion of the Sandfields
area for in-depth research also informed sample selection so, where possible, professionals with working
knowledge of the area were included.13
In total, face-to-face in-depth qualitative interviews were conducted with 35 professionals of which 26 were
conducted with individuals and 4 were conducted in small groups of 2 or 3 participants. The contributors within
this strand of the project are listed in Appendix A. Interviews were tape-recorded and transcribed by the Project
Investigator prior to thematic analysis.
Participation in interviews was agreed on the understanding that individuals would be named in the list of
contributors to the research but they would not be identifiable in the reporting of issues and opinions arising from
interviews. The need to protect anonymity has been taken into account in the selection of quotations from the
interviews and each professional or small group of professionals has been assigned a random number (PR1 to
PR30) so the reader can confirm that a wide range of views are presented. Where specific services or agencies
are identified, this is on the basis of information that is available in the public realm.
The Project Investigator did not conduct an evaluation of any specific agency or service; this would require indepth, longitudinal research. The aim of the interviews was to gain a picture of how the different CYP Partnership
services map onto the whole and to ensure a wide variety of stakeholders were included in the process of
reflection on the key areas of concern.
The interviews were designed to address a common set of themes but with flexibility to respond to relevant issues
associated with the specific role and CYP service affiliation of each participant. The interview schedule is located
in Appendix B. The key areas for discussion included:
13
The project investigator acknowledges that the sample did not include the entire range of CYP services and there is a gap with regard to Tier 4 services and
with regard to capturing insights from the different local communities that make up NPT. However, the research was limited in terms of time and resources and
effort was made to achieve a sensible balance.
26
(3.1) CYP Partnership Services and Agencies in Neath Port Talbot CBC
(1)
CYP Partnership Services in Neath Port Talbot CBC: the contribution of the agency or service in relation to the themes of the research.
(2)
Partnership, Collaboration and Co-ordination in CYP Partnership Service Provision.
(3)
Safeguarding Matters and System Pressures: a Vicious Circle?
(4)
The Role of Education in Safeguarding.
CHILDREN AND YOUNG PEOPLE SERVICES
ACTION FOR CHILDREN
(5)
Supporting Parents: early intervention for families.
(6)
Fitting Services around the Child?
•
•
•
•
(7)
Local and National Influences on Safeguarding Pressures in Neath Port Talbot.
• Family Outreach Service including specialist outreach
provision for parents with a learning disability
• Flexible Home Support
• Sponsored daycare
• NPT Family Support Project
• Playgroup provision
• Counselling for children and young people who have
been sexually abused or suffered from domestic abuse
The services and agencies that contributed to the research are presented briefly in 3(1). This is followed by
a presentation of the thematic analysis in 3(2) to 3(7) with further reference to the place of CYP services and
agencies in relation to specific themes.
Participants were drawn from the following CYP Partnership Services and Agencies:
Box 1: CYP Partnership Services and Agencies in Project Sample
Service / Agency / Team
Referral and Assessment Team (RAAT)
Family Support Team 1 (FST1)
Child Care (Disability) Team (CCDT)
Fairway Team
EDUCATION
YOUTH OFFENDING TEAM
•
•
•
•
• Parenting Support work
Schools
Education Inclusion
Education Welfare
Children and Vulnerable Adults Safeguarding
INTEGRATED CHILDREN’S CENTRE
SCHOOLS COMMUNITY POLICE LIAISON
Day care provision including childcare, playgroup, After
School Club and Holiday Club
Includes places funded through Flying Start
• Core programme of lessons to Primary and Secondary
Schools
• School Beat
• Pupil Support Teams
FLYING START
SURE START STARTWELL
Childcare, health visiting, basic skills, parenting, family support, ante-natal care, education psychology service
• Early years advisors provide parenting support
through home visits
YOUTH AND COMMUNITY SERVICE
BARNARDO’S NPT PARTNERSHIP
• Youth Clubs
• Detached youth work
• Youth Counsellor
•
•
•
•
WOMEN’S AID
WEST GLAMORGAN COUNCIL ON ALCOHOL AND DRUG
ABUSE
CYP Workers, refuge provision, delivery of educational
programmes including work in schools
27
Parenting Matters
CHiP and Mentoring Service
Family Group Meeting Service
Parent Network
Advice and information, abstinence and harm reduction
programmes, counselling for individuals and their families.
28
(3.2) Partnership, Collaboration and Co-ordination in CYP Partnership
Service Provision
•
The relationship between CYP Services and the Education Service will be discussed in Part 4 of this Section where the role of education in safeguarding is considered.
•
The contribution of those services that provide support to parents will be considered in Part 5 of this Section where the theme of parenting support as a form of early intervention is discussed.
•
The role of all the services in providing support that fits around the needs of the child and their family will be addressed in Part 6 of this Section.
(3.2) Partnership, Collaboration and Co-ordination in CYP Partnership
Service Provision
I think there is a real spirit of partnership in NPT that is genuine and people are
committed to working with their colleagues from whichever agency and that is
reflected at all levels. Relations are good. It is about how we work together to
provide a service for children in context of limited resources. (PR8)
As the participant quoted above indicates, there is considerable support, in principle, for collaboration across
services and agencies working within CYP provision. Participants were able to provide many examples of
valuable collaboration between service providers to support children, young people and their families. Some of the
examples that were offered included:
•
•
•
•
•
Multi-Agency Pupil Support Teams for Year 7 and Year 8.
Flying Start Team.
The ‘Team around the Child’ Pilot Project.
The Family Group Meeting Service, Barnardo’s NPT Partnership.
CHiP and Mentoring Service, Barnardo’s NPT Partnership.
These interventions14 draw several agencies and professional disciplines together for sustained joint working to
address a specific area of need and this is valued by those professionals involved as one participant explained
“the underlying way of working is good because it is multi-disciplinary and it is getting people talking about
families and trying to support families” (PR11). In addition, there were various examples of collaboration in
relation to the process of commissioning that may stop short of sustained joint working but where one agency
may co-ordinate activities with another to ensure a piece of work is completed or a service provided. Some
participants described more informal arrangements for information sharing and signposting between agencies that
were designed to offer support to children and young people, as one participant observed “So there is a lot of
information exchanging that is going on to the advantage of the client. It is more holistic, I suppose” (PR28). Other
participants referred to the value of opportunities to network with colleagues across professional boundaries at
local events and training days.
It was evident from these discussions that there is a wide variety of approaches to collaborative and cross-agency
work and terms such as “multi-agency working” or “integrated service provision” can be used by different people
to refer to different models of co-operative work. As Sarah Galvani and Donald Forrester observe, the terminology
can be confusing:
The increased focus on greater integration of services in recent years has led to a proliferation of different terms to capture various types of integration. Many terms are used interchangeably in the literature and in practice, and agencies and individuals are likely to interpret them differently. Some of the most common terms include: integrated, inter-agency, multi-agency, inter-professional, inter-disciplinary, multi-disciplinary, trans-disciplinary. (2010: 5)
The different understandings of collaboration across CYP Partnership services that were referred to in the interviews
suggest that it might be helpful to understand this in terms of a continuum where there will be various approaches
in operation to achieve partnership, joint working and integration ranging from informal, ad hoc, voluntary
arrangements that are fostered by fellow professionals over time through to specific co-ordinated multi-agency
interventions to achieve an agreed goal.
Looking beyond support for the principle of joint working, comments were offered about some of the challenges to
making this work effectively across professional boundaries:
I get that feeling of a clash of cultures as you are getting different
organisational beasts to come together. It is a bigger issue than
information flow… There has been a need to learn about other
organisations and their agendas. (PR25)
There was some concern expressed that multi-disciplinary teamwork did not always achieve representation from all
relevant CYP services and agencies and, in particular, there were some initiatives based on the ‘team around the
child’ concept where there was no social worker from CYP Services, where this could be a vital and valued link:
Social services do not come to these meetings. I think they were asked
but they don’t come. If they were there I think it would be easier and
more personal and direct but they don’t, but the way they get involved
is through a referral from around that table. (PR16)
This observation needs to be set in the context of the pressures facing staff in CYP Services that has been reported
in the Systems Review (Kelly, 2010) and in this research and presented next in Part 3 on Safeguarding Matters. As
one professional working in CYP Services put it: “I am so much dealing with the day-to-day needs, I think my role
should involve building links but the reality is that I do not have the time” (PR21).
14
Further information about the role and contribution of these interventions is provided in the later sections on parenting support and on the team around the
child model.
29
30
(3.3)Safeguarding matters and System Pressures
Participants were asked to reflect on their role in relation to Safeguarding and to offer their views on what worked
well and what was challenging in meeting those responsibilities. This also provided an opportunity for further
reflection on principles of partnership and collaboration with specific focus on the Safeguarding agenda. This
was a theme that attracted some strong opinions from across the range of CYP Partnership services. In this context
Safeguarding helps to illuminate some of the real challenges of joint working in practice where there are statutory
procedures to be followed, rising demand and budgets under pressure.
There were several key areas of interest with regard to Safeguarding that will be addressed below and these relate
to matters of thresholds, communication and information flow in a context of the escalation of demands on CYP
Services.
The issue that was identified most frequently by participants located in agencies outside of CYP Services
concerned thresholds for referring a child to CYP Services as a Child in Need (CIN) or Child in Need of Protection
(CP). Many professionals drawn from across the range of agencies stated that there was a lack of consistent
interpretation of thresholds for referral and differences of view between staff in key agencies on when referral
would be appropriate.
Some participants argued that their own service thresholds for referral had not changed and remained appropriate
but thresholds within CYP Services had had to rise because of system pressures:
Having a clear understanding of what the thresholds are would be useful.
Social Services need to be honest about what they can deal with in terms
of capacity, because stresses are high and there is high staff turnover. Because
the thresholds are moving up, you have got kids who are Child in Need cases
now who would have been Child Protection years ago. And what are the other
agencies dealing with now as a result of that? (PR25)
There is an issue over what we see the threshold as being and what they see
the threshold as being- there is a grey area even with Child Protection caseswhat is the term? Significant harm? What is meant by significant? It is in my
eyes, no it is not in their eyes. (PR11)
I do feel there are children who should be on the at-risk (sic) but at these
meetings the social workers will say that they don’t meet the thresholds and
you do get concerned about what is the threshold? So I haven’t got a clear
criteria of what the threshold is. (PR16)
This was sometimes expressed as a concern that referrals made for solid reasons would not progress to further
action leaving the referrer worried for the welfare of the child:
31
Sometimes I make a referral and it is not picked up because the threshold for
intervention is different from ourselves. We may go in with relatively low
level concerns but enough to refer and nothing happens. (PR22)
These comments can be compared with the observation from some of the social workers who were interviewed
that the information provided from some of the agencies making referrals could be more comprehensive.
Some participants acknowledged that the decision over whether to refer could cause anxiety and uncertainty.
Those in leadership roles might have to support their staff in this regard as one participant explained: “sometimes
you have to say to staff, well meaning and experienced staff, no, no, that is not a case for social services but keep
me advised” (PR24).
Participants with experience of making referrals to CYP Services also commented that subsequent communication
could be limited so that they did not receive information back:
I don’t want to appear critical but yesterday I put in a referral and I have had
no feedback. …You just don’t know what is going on in the background. Also
if you phone to speak to a social worker because you have concerns, you just
don’t get a phone back. I think there are children getting lost in the system
because of their workload, because of their lack of social workers and,
therefore, the lack of continuity. (PR16)
What I find frustrating is that we are looking to support families and our whole
aim is to reduce the number of children going in to accommodation or on to
the CP register, so if we refer it is not done lightly. So it is frustrating when it
comes back with no further action. We are not always given feedback on why
a specific decision has been reached. (PR1)
With social services the turnover of staff is so high and I don’t know who is
who myself. It is very confusing. What would be really useful is a Who’s Who
updated with names of team managers and who is on their team. (PR29)
A further perspective was that referrers felt that their initial decision to refer could be proved to be correct later on
where a case that had not led to further action would escalate in complexity, leading to a further referral to CYP
Services:
Six months to two years down the line we find ourselves sitting round a case
conference discussing the very issues we had highlighted; that is a huge
frustration and concern. (PR22)
There is that gut instinct when you feel something is not right and you put the
referral in and on paper it does not seem like anything but from your contact
you feel there is an issue and we feel sometimes it is not taken seriously
enough. (PR3)
32
Where participants raised these concerns, they would emphasise that there was no intention to criticise individual
social workers and there was wide appreciation that the difficulties were of a systemic nature and must be set in
the context of the rise in numbers of families needing support and issues of capacity to meet that demand:
I appreciate that social workers work under massive caseloads and as a
service we have to be quite tenacious in ensuring we get the information
that we need and I think we just accept that as part of our role. (PR30)
I have been in the Authority for many years now and I have never seen it as
manic as it is now as far as social work staff are concerned. There has been
nothing like the pressure they are under now. This is as bad as it has got. (PR1)
These perspectives were compared with those of staff working within CYP Services who described current
pressures and the impact on day-to-day processes:
We are very much fire-fighting….. There is always a backlog of cases
requiring allocation which prevents us from becoming proactive and
becoming involved with families at an early stage. It tends to be very much
about responding to crisis because we don’t have the capacity to respond at
an earlier level. (PR21)
The volume of cases coming over is a stress on all teams. Systems Review
are looking at how to streamline….. and we don’t know what is going to
happen and I have workers saying are they going to be cutting posts? (PR23)
Staff within CYP Services thus described a situation where they lack time for front-line work and for building
relationships with families at an early stage of need; rather they have become case managers for a system under
relentless pressure. In this context a case may be assessed as not meeting thresholds for action and Child in Need
cases may not have a social worker allocated to them. This can mean that needs escalate and relationships of trust
between families, CYP Partnership agencies and CYP Services are fractured. In turn, professionals within the key
agencies that refer cases in to CYP Services observed they are not always sufficiently informed about the progress
of a case and may not know who is working with a particular family. Opportunities for vital communication and
sharing of information may be lost. Agencies with valuable information to share, including at the case conference
and other key meetings, may not always be involved.
A further view expressed from within CYP Services was that there was a tendency for some external agencies to
make referrals where the agency could be more creative and proactive in addressing a problem directly:
33
I do feel the onus is on Social Services when it does not need to be. With CIN
cases and where mum needs a bit of support at parenting classes or it is mum’s
2nd or 3rd child and she could do with some childminding, social services do
not need to be involved in those cases….. so it is about being creative in their
own roles and not covering their back and passing the buck. (PR23)
With CIN cases there are sometimes other agencies that agencies could look at
first. (PR21)
Conversely, some examples were offered regarding cases where an agency should have referred at an earlier
stage and vital information had not been disclosed quickly enough. The uncertainties over thresholds for referral
expressed by various participants in CYP agencies, in addition to these observations from social workers, points to
a potential role for further multi-agency training in relation to establishing shared understanding of thresholds across
agencies with joint statutory responsibility for safeguarding.
If there is scope for agencies to make greater use of other options prior to referring a case to CYP Services, this
could be assisted through a review of the referral routes into those agencies that work with families to ensure clarity
over what is available and who has the authority to refer:
There are systems as well where only social workers can refer to different
agencies, whereas if we were all able to refer to different agencies we
wouldn’t have to go through their door to get through the back door. You
have to go in through social services to get the service that you want. If these
routes were more direct then this would reduce their workload. (PR28)
The agencies available vary considerably in their own referral criteria ranging from those that will take referrals
from all including self-referrals from parents through to those where referral must come through Social Services.
Some participants suggested that their agency limited the range of eligible referrers and service publicity in order
to manage demand: “We won’t take self-referrals as we are struggling to meet the needs of referred people”
(PR29). Another participant explained how limits on capacity had impacted on training stating “We used to do
referral training… but we haven’t done this for 2 years because we are so hugely oversubscribed” (PR30). This
suggests that a vicious circle will continue, even with more efficient management of referrals across the board,
there remains a problem of capacity in a climate of budgetary pressures and loss of staff. Service delivery is
organised to manage increasing demand rather than in relation to meeting need and improving access to the
service.
This escalation of demand for services and workload intensification was reported as an issue beyond CYP Services
suggesting that a vicious cycle has developed that has rippled across the entirety of CYP Partnership services and
agencies. Various agencies offering family support have to prioritise the most urgent cases and were working with
cases at a higher level of need than in the past:
Initially our work was with CIN cases and now we have children who are on
CP Register and we are more involved in that kind of monitoring and this is a
bit of a shift for us. (PR19)
I think we are in a situation where we are not able to do as much preventative
work as we possibly can in NPT. It all seems to be crisis stuff at the moment
and a lot of families are not getting support unless they are in dire straits. (PR29)
Because of our waiting list we are finding that by time we can offer the service
it is not a viable referral. (PR30)
34
Those professionals working in universal services including schools and health visiting also described an increase
in need as one participant explained: “I have tended to attend more case conferences, more social services
meetings about families than I had to when I started” (PR24)
These are challenges that NPT CYP Services were addressing through the Systems Review and other measures
during the progress of this research. So far, the situation as it is seen by professionals has been described and
responses reveal that this is widely perceived as a systemic problem. In addition participants did not view the
situation as one specific to the locality but one facing colleagues in neighbouring Authorities and nationally.
Having set the scene with regard to the pressures facing professionals working within CYP Services and across the
Partnership, participants were invited to identify specific ways of addressing some of the issues. Some participants
argued that there was a role for more multi-agency training on matters such as safeguarding and family support.
However, it was also noted that this could often be difficult to achieve in practice as:
each agency has competing priorities, so I am not sure how multi-agency training is taken forward. For each protocol that is agreed there is generally a training package delivered alongside but if there is no multi-agency sign-up to the training then impact is diluted. (PR10)
A similar problem was reported with regard to multi-agency attendance at case conferences. Once again there
is a message in these responses that work intensification and relentless demands on services are preventing the
obvious means of resolving matters from being effective. There is a vicious circle here to be discussed further in the
conclusion.
Having presented some of the general issues regarding the impact of the demand for CYP Services, the report
now turns to the matter of preventative and early intervention to support families. What could be done and is being
done to support families before their needs reach crisis point? This will be considered with regard to three themes
to be addressed in the remainder of this Section: first, the role played by the Education Service in supporting
children and families; second, the contribution of the various agencies offering packages of parent support; third,
efforts by CYP Services and Partners to fit provision around the needs of the child or young person as enshrined as
a key principle in the NPT CYP Plan 2008-2011.
(3.4)The Role of Education in Safeguarding
The role of Education in Safeguarding was raised during some of the early interviews for this project and it was
agreed that this was worth further consideration. The sample included an Assistant Secondary Headteacher
and four Primary Headteachers for schools in Sandfields. In addition professionals working in the Education
Welfare and Education Inclusion Services were interviewed. Other participants had an opportunity to discuss their
collaborative work with schools.
The schools serve catchment areas with high levels of socio-economic deprivation and with significant levels of
need as measured by the uptake of free school meals as an indicator of family income15. Schools described
a range of measures within their responsibilities for pastoral care and for personal and social education that
were designed to provide support for all children so that any problems could be identified early. Other targeted
measures related to support for specific learning needs and issues relating to education inclusion. Specific
initiatives included:
•
•
•
•
•
•
•
Pupil Inclusion Project to address attendance issues.
•
•
•
•
•
•
•
Pupil Support Teams for pupils in Year 7 and Year 8 identified as in need of multi-agency support.
The SEAL (Social and Emotional Aspects of Learning) pilot programme for primary schools.
Anti-bullying measures.
Nurture group for children with delayed development.
Language and Play sessions for parents of young children.
Collaboration with Barnardo’s NPT Partnership CHiP project.
Contact with the School Police Community Liaison Officer to deliver lessons within Personal and Social Education.
Use of a School Counsellor shared within the cluster.
YIP Officer based in Sandfields comprehensive school.
Open Access Play.
Initiatives to support parents and engage parents in school activities.
Free breakfast club and After-School Club.
Support for children with disabilities.
The more agencies working in a multi-faceted organisation and
talking to each other, the better. Schools have a wealth of knowledge
and they have a captive audience…and often parents will talk to
schools where they don’t feel comfortable talking to social services..
so agencies need to use schools more pro-actively with someone
working in the cluster to pull all these different agencies together. (PR17)
15
It is noted this is an imprecise indicator that may underplay levels of financial need with regard to eligible families that do not claim free school meals and
those on low income above the threshold for eligibility.
35
36
Positive comments were offered by school staff with regard to the contribution of the Education Welfare Officer
role attached to a secondary school and serving a cluster of schools within a geographic area. One member of
staff explained: “We currently do not have an Education Welfare Officer16 but we used to have one and he was
a useful source of information and link to Social Services… So your EWO can be a powerful tool” (PR24). There
was similar support for the function of school counsellor shared between schools in the cluster as exemplified by
this observation:
This is helpful as children will open up to a counsellor where they won’t
open up to their family or the teacher and she (the counsellor )is good. It is an
initiative that I welcome. It is very helpful for heads to have someone from outside to
come in and give you an untainted view of the situation that perhaps you can’t
resolve in the classroom or with the child. (PR24)
School staff also referred to the role of the Safeguarding Officer for Children and Vulnerable Adults as one offering
a valuable source of guidance and a link between Education and CYP Services: “There is a sort of link between
Schools and Social Services…. Very useful and she arranges CP training and going over issues - so a nice link”
(PR9). These interviews took place at a point where there had been a long gap in appointing someone to this role
but a new appointment was imminent. It was evident from these observations that school leaders value the support
and opportunity for joint working with other services that these appointments offer.
Having asked staff working in the Education Service to comment on the wide range of measures intended
to support children and their families, there was an opportunity to discuss the role of schools in those cases
where collaboration with CYP Services over safeguarding matters would be necessary. Some of the issues
already identified as of more general concern such as clarity over thresholds, communication and information
sharing were expressed by staff based in education. In addition, the pressures facing staff in schools in meeting
their responsibilities for safeguarding alongside their day-to-day duties in relation to the curriculum or school
management was identified as a challenge:
For me as a Head, it is taking a lot of time over what should be managing a
curriculum but the children have got a lot of needs. Our budget is allocated
in terms of special needs but not our social service needs. (PR20)
I know how much pressure Social Services is under, it is not an easy job
but it works both ways and schools could help but with an awareness that
our first remit is to educate. (PR17)
16
One of the particular difficulties in this regard concerned arranging cover to attend meetings with CYP Services
including Case Conferences:
We in Education come prepared and turn up on time but the parents do not
turn up in time and the meeting is delayed and it takes up time; and I don’t
feel people take on board that when someone attends, they are out of school
and school has to provide someone to take the class. So time is an issue. (PR9)
Staff also identified the high levels of need facing them as a consequence of serving an area with substantial
levels of deprivation. The participants had many years of experience in working in schools in Sandfields and were
witness to changes in the local area over the years:
There are significant levels of deprivation and youth unemployment and the
loss of Freeman Cigar Factory and BP Chemicals and the retraction of what
is now Corus has had a significant impact in that parents have lost work and
we have noticed that. (PR24)
Private landlords have bought properties and that has changed the make-up
of the area and these landlords have brought families in who have lots of
problems. It isn’t the old established community that it was. I have seen a big
change in the type of children who are coming in to the school. (PR20)
Changes in employment opportunities and access to housing have had an impact on the circumstances of families
with implications for the role of schools. The wide variety of measures designed to address specific needs and
the interest expressed by school staff in improving systems relating to safeguarding indicate local schools in
Sandfields are doing their best to respond to changes. However, both time and funding are under pressure, as one
participant put it:
In areas where there are issues of poverty and deprivation, these areas need
more services and those schools need more funding. Because we are having
to fund things on a shoestring budget or look for additional outside funding.
The initiatives from WAG are great but it is only 3 year funding or one year
funding and you can’t plan on that. (PR2)
Having considered perspectives from professionals working within education, the interviews with professionals
in other CYP Partnership services and agencies invited comment on the role of schools and any collaborative
work with schools. There were many examples of positive links and some projects such as, for example, the
Barnardo’s NPT Partnership CHIP Project, the Pupil Support teams and inputs to the curriculum from the Police
Community Liaison team and from Women’s Aid CYP Workers include different kinds of joint work. However,
many participants observed that the role of the Education Service in service delivery for children in need/ at
risk is variable between schools across the County. There was a view that there are some examples of excellent
work with schools but this is not consistent across the various schools within NPT. In addition some professionals
suggested that, at times, schools could actually exacerbate a difficult situation:
The vacancy for the EWO for this school cluster was filled during the period of fieldwork for the project and the appointee was included in the sample for
interview.
37
38
There are a great deal of issues within education. We see many families where
a child’s schooling situation is affecting how a family is functioning, with a
huge impact on the home. (PR7)
Turning to views within CYP Services, it was agreed that relations with schools were variable: “Some schools are
better than others and we know which ones they are” (PR23). As another professional explained:
39
Participants advised that this is an issue that has been raised by the Education Service in communication with CYP
Services. The information that this has been discussed among education professionals working within the cluster
indicates mutual identification of a gap in joint working that they wish to be resolved. Whether that resolution could
be through the attachment of a social worker to a cluster of schools may be debateable in the context of budgetary
pressures and issues of recruitment within the workforce of CYP Services. However, the matter could be considered
and a resolution reached.
It depends very much on the ethos of the school because some schools take
a view that they are there to educate children and beyond that is not their role;
and there are other schools that take a far more holistic view of their role.
(PR21)
Following on from this observation, it was suggested that some CP Officers in schools could be more proactive
in their role. Concerns were expressed that some schools would have a minimising approach with regard to
attendance at CP case conferences and subsequent reviews. Examples were provided where schools did not pass
on information quickly and other examples where schools were perceived as tending to elaborate on concerns
in order to improve the likelihood of reaching thresholds for further action. This indicates some gaps in trust and
understanding where there will be value in finding ways to extend joint working between Education and CYP
Services.
In concluding this section, attention is due to the positive message embedded in this desire within the Education
Service for further joint working with CYP Services. The Project Investigator encountered a strong interest among
education professionals in improving their safeguarding role in collaboration with social workers. Equally, as noted
in an earlier section, social workers seem frustrated that they lack the time to build those valued relationships. As
one participant observed in summing up the current situation:
School participants and other educational professionals were invited to reflect on how joint working with regard
to safeguarding could be developed. All participants expressed a wish for more direct and regular contact with
social workers to improve understanding, communication and the progress of specific cases. There was very strong
support within the Education Service for having a named social worker attached to a group of schools to build
ongoing relationships and provide support and a link in to the system:
This claim does seem justified in relation to evidence gathered during this research project.
There is a need to have a Social Worker attached to a cluster and working
within a cluster and who gets to know the families on the estate and who you
can access immediately. There is a place for that role within schools. As a
cluster we have mulled over this. (PR9)
Ideally, what should happen, and I feel strongly about this- there should be
a social worker based in a catchment area of schools, and if that were to
happen, I think that you would have a bit more continuity. That would be my
only reflection to improve things. We have Flying Start and they have a Health
Visitor and an Education Psychologist in the team, well a natural progression
surely is to put in a social worker in the Flying Start areas. It’s the same
principle, isn’t it? (PR20)
What schools would like to see are social workers located in school premises
and that is true across primary and secondary sectors. They would like to see
more of social workers through an office similar to the Education Welfare
Service. (PR8)
I don’t feel we have different purposes- we have the same purpose which is to
improve children’s lives whether to keep them safe or to ensure they can
achieve - if there are tensions between services these are minor in comparison
to that spirit of partnership that schools are saying give us more partnership.
If schools didn’t value social workers, they wouldn’t be saying come and live
with us. (PR8)
(3.5) Supporting Parents: Early Intervention for Families
Participants in services and agencies outside of CYP Services were invited to comment on reasons why they might
make a referral relating to CIN or CP concerns and one of the most common factors related to the conduct of
parenting:
There are a lot of poor parenting issues, almost as though the grandparents
have not trained the children right. They just haven’t got the skills or tricks
of the trade of how to parent. (PR11)
Obviously managing children’s behaviour is very difficult for some of the
parents because they give them no boundaries. The children are allowed to do
what they like and speak disrespectfully to adults. I have a group of parents
who are not caring for their children as they should. They don’t put the
children first. Some of them really do not know how to parent. (PR20)
It was thus suggested by some participants that problems of neglect and associated social, emotional and behavioural difficulties could link back to parenting issues. It was also recommended that this was one area where early intervention approaches were desirable to prevent problems escalating. One participant argued that this could be provided early on in schools: “We need early intervention at the nursery and reception level for parenting classes” (PR2).
40
Box 2: Parenting Support in Neath Port Talbot17
AGENCY
Action for Children:
It was also evident that the term “difficulties in parenting” was used by many professionals as a broad category for
a host of problems that could lead to a chaotic or neglectful home environment for children deemed to be in need
or at risk of significant harm. This tendency to collapse complex problems together under the umbrella label of
‘parenting capacity’ may not be helpful in the identification of solutions or in seeking to engage parents. There is a
case for disentangling the issues and for establishing greater clarity as to whether reference is being made to day
to day low level problems, such as setting boundaries for a toddler or, at the other end of a continuum, to dealing
with hugely complex areas of family distress. When asked to comment in depth on the issues for which parents
may need support, a picture emerges of a whole jigsaw of life challenges. The social workers within CYP Services
and within the various agencies that offer parenting support illustrate this point:
The families we have, women are having poor experiences themselves of
being parented, poor levels of education, they haven’t got any money, they
are either in no relationship or some crappy relationship, they have their kids
young, before they are able to manage, and they love their kids and do their
best for them, but it is chaotic and many are depressed and have low selfesteem and they deal with that by becoming involved in violent relationships
or by self-harming or take drugs, and there isn’t the services out there for
them. (PR21)
I think it is parenting more than anything, their lack of experience, lack
of self-confidence, all of the issues that they have got before parenting
comes into play such as social issues, housing, drink, drugs, it all comes
out…it is all about self-esteem and building up their confidence to enable
them to parent, and putting it in to practice alongside all the other issues
that they have. (PR14)
As these responses reveal, parents may need support in connection with a wide variety of complex, serious
problems that impact on their capacity to parent well and which also erode their own well-being. These are
matters that may be the responsibility of adult health and social services and may also have their roots in problems
of poverty and social exclusion. Those professionals offering support for parents are clearly well aware of the
complexity of needs that may be presented but there is a possibility that the simplistic and sometimes pejorative
terminology of ‘poor parenting’ or ‘parenting capacity’ gets in the way of addressing matters directly and quickly.
Serious problems may be masked or issues that have their roots in poverty and deprivation can be individualised,
presented as the responsibility of the individual parent struggling to cope. Having raised this issue it will be
addressed further in relation to the various parenting support initiatives that were considered during the research.
• Family Outreach
Service
AGE RANGE
Parents from
pregnancy to
children of primary
age
• Specialist Outreach
DESCRIPTION OF PARENT SUPPORT INTERVENTION18
The aim of the Family Outreach Service is “to keep families together and reduce risks to children
by helping parents reach acceptable standards within their home” (NPT FOS Leaflet)
Visit parents in the home in relation to agreed plan and package of support in relation to targets
agreed with the family social worker
Specialist outreach work to support parents who have a recognised learning difficulty
• Flexible Home
Support
The referral is accepted only from a social worker or social work support worker for Outreach
including Specialist Outreach
• Sponsored Day
Care Services
Flexible Home Support provides “practical help and support to families during times of temporary
difficulty” (NPT FOS Leaflet).
Referral will be accepted from a key worker who is working with the family
Sponsored Day Care Services to offer respite for families facing stress which is impacting on the
children. Referral will be accepted from a professional who is working with the family
Action for Children
Sandfields Family
Centre19
Parents with children
aged from Birth to
8 Years
This “provides help for parents who are struggling with their children’s behaviour”
(www.barnardos.org.uk/neathporttalbot.htm)
Offer both group work and home visits through outreach strand
Groups run on a term-time basis day-time and evening options; different groups for parents of
teenagers and pre-teens
4 week taster courses
Referrals accepted from all professionals and through self-referral
Access to outreach based on initial assessment
Parent support group run by volunteers and open to parents who have attended a parenting
programme
Barnardo’s NPT
Partnership Parenting
Matters20
Parents whose
children
are aged 4 to 18
years
This “provides help for parents who are struggling with their children’s behaviour”
(www.barnardos.org.uk/neathporttalbot.htm)
Offer both group work and home visits through outreach strand
Groups run on a term-time basis day-time and evening options; different groups for parents of
teenagers and pre-teens.
4 week taster courses
Referrals accepted from all professionals and through self-referral
Access to outreach based on initial assessment
Parent support group run by volunteers and open to parents who have attended a parenting
programme
The sample of agencies included some that were involved in parenting support and these are described in Box 2:
Fairway Centre,
Children’s Social
Services
Age range open to
all in contact with
CYP Services
Intensive, time limited support for family including a parenting programme
Support for basic parenting skills within the home
Resource for CYP Services and all referrals made from within CYP Services
17
The project Investigator does not claim to have included all forms of parent support available in the locality; but has covered a variety of different
interventions.
18
Some of the agencies listed in Box 2 may offer other projects or services in addition to parent support. These are not considered here.
19
Action for Children also has a Family Centre in Briton Ferry and runs playgroup and drop-in sessions in various locations in the County Borough.
20
There is also a Parent Network which is a voluntary organisation housed in the same premises as Parenting Matters and provides a resource for all
parents and carers in NPT.
41
42
AGENCY
Flying Start team
AGE RANGE
From ante-natal care
to 4th birthday
DESCRIPTION OF PARENT SUPPORT INTERVENTION
The aim of Flying Start overall is to ensure the early identification of needs to improve child
outcomes and to provide preventative interventions where this is desirable21
Support for parenting offered by midwives and health visitors through home visits and clinic;
through drop-in facilities and parent and toddler groups and delivery of parenting programmes
Delivered by multi-professional health team and family support team and further partnership with
other agencies as required to meet needs of child and family
Parents identified by health visitors or members of team and offered option to join parenting
programme
Confined to designated Flying Start areas but, within those areas, services are universally
available to families with children aged from birth up to 4th birthday
Sure Start Startwell
Health Development
Scheme
Parents from
pregnancy up to
child’s 4th birthday
Young mothers under
17 years
Support provided by outreach team of early years advisors through home visits usually over 12
week period
Health focus and with aim “to improve social and emotional development of young families
and their children” (Service leaflet)
Women and
children who are
experiencing, or who
have experienced,
domestic abuse
Women’s Aid offers various practical and emotional support including emergency
accommodation. There are also Outreach services and a Floating Support Scheme
(see www.ptwa.org.uk)
Support for mothers experiencing domestic abuse in issues relating to their children
Freedom Programme includes material on impact of domestic abuse on children
Referral available to relevant agencies for specific parenting education
Sure Start Startwell
Health Development
Scheme
Parents from
pregnancy up to
child’s 4th birthday
Young mothers under
17 years
Support provided by outreach team of early years advisors through home visits usually over 12
week period
Health focus and with aim “to improve social and emotional development of young families
and their children” (Service leaflet)
County wide service and open to all families with children in age range
Referrals mainly from Health Visitors but will take referrals from all sources including self-referral
Youth Offending Team
Young people aged
10 to 18 years in
contact with Criminal
Justice System and
their parents
In reviewing the provision in Box 2, it would appear that some of these services operate as a form of early
intervention once problems are identified, yet none are really operating as a preventative service to provide
support before problems occur. It does seem that there is a gap here for a wider programme of parent education
open to all and based on the principle of prevention. Those services that accept self-referrals or provide drop-in
facilities do, however, offer parents the opportunity to seek guidance early.
A further point with regard to the principles of prevention and early intervention is that, for some agencies, their
role in this regard had been eroded because of the trend towards taking on more high need cases and as one
professional observed: “We go in at crisis and some of those problems could have been prevented if we had got
in earlier” (PR1)
County wide service and open to all families with children in age range
Referrals mainly from Health Visitors but will take referrals from all sources including self-referral
Women’s Aid
There are many different forms of parenting support available in Neath Port Talbot that vary according to age
range, referral criteria, mode of delivery and whether area based or County wide. Some initiatives may be
designed to cater for the more low level need for guidance on how to parent well whilst others may target families
with more complex needs including where there is a possibility that children will become Looked After if the
intervention is not successful. In the case of the latter, other forms of support will need to be offered alongside a
parenting package.
Designated YOT worker for parents of the young person
Works closely with Parenting Matters to access parenting programmes
Parenting intervention is voluntary although the young person’s co-operation with the YOT
worker can be required by the Magistrates Court
The professionals involved in the delivery of parent support programmes were asked to comment on their
experience of working with parents. Many referred to low self-esteem among parents as an issue to be addressed
first:
Taking in mind that we are working with the most vulnerable families, we
have found it very difficult for them to take on board a behaviour management
programme until we have done some self-esteem work with them…..
Sometimes these parents are in a state where they cannot see anything positive
and there is a lot of depression, alcohol and drug misuse. (PR29)
We found one session was upsetting as they had to say what was good about
themselves and (session leader) said they were crying as they couldn’t find
anything good. I think a lot of our parents feel that. (PR14)
Programme leaders pointed out that where further underlying issues were identified they would signpost parents to
relevant services. Referral to parenting support may open up avenues to other services:
We may find that what we agreed in the plan cannot be achieved because of
mum’s mental health and so we will support mum in accessing mental health
services. Or they may be moving house or there is a risk of eviction or there
may be correspondence that is not answered so the first part of your visit is
dealing with those other issues. So the beauty of the project is that we can look
at the whole. (PR1)
Worker provides one-to-one sessions in home where attendance at a group is not appropriate
For further information see http://wales.gov.uk/topics/childrenyoungpeople/parenting/help/flyingstart
21
43
44
However, delays and barriers may occur in accessing services operating at a higher tier to address more complex
areas of need: “At the end of the process we may find issues that need addressing and waiting lists for counsellors
are long, so some interventions that we request may not happen until later” (PR7). One example concerned access
to the parent support programme offered by CAMHS for children and young people with a diagnosis of Attention
Deficit Hyperactivity Disorder (ADHD). One professional felt that there was a gap for families here where CAMHS
is viewed by providers of parenting support as the appropriate referral route for a child or young person who had
been diagnosed with ADHD but where those families were not engaged with CAMHS and where “they have
fallen out with CAMHS for one reason or another” (PR5). This case points to a wider issue as to whether there
could be further co-ordination of the various forms of parenting support to ensure gaps of this kind are addressed
and there are clear pathways through to the most appropriate form of support and signposting to other services so
that the purpose of early intervention is not eroded.
A further issue was raised with regard to addressing the needs of adults for support for problems that impacted on
their parenting but would be the responsibility of adult health and social services and voluntary sector agencies that
work with adults. Adult social services had distinct statutory responsibilities, referral criteria and ways of working
that could impact on the capacity of CYP Services and partners to effect family change in the interests of the child:
There is an issue around Children’s Services, Adult Services and Children’s
Disability services not really working together and we are caught in the middle
as we try to work with the whole family. (PR1)
There are lots of issues around parental mental health and parental learning
difficulty, parental substance misuse. It is rare to have a case where you are
dealing with a single issue. There is not necessarily the services for adults
available to provide parents with the levels of support and intervention that
they need. (PR21)
The different statutory basis to service delivery in CYP Services and Adult Social Services may obstruct efforts to
provide holistic support to a family. The agencies that work with adults in relation to drug and alcohol misuse,
mental health and domestic abuse rely on the willingness of the adult to engage with the service. In addition,
services may vary with regard to whether their focus is the adult as their client or whether they address the needs
of the whole family including the children. This lack of integration between CYP Services and Adult Social Services
is significant and parent support agencies may be playing a role of mediator in addressing this gap and helping
parents engage with adult services. This matter will be addressed further in the analysis of case files in Section
Four.
Providers of parenting support were asked to reflect on how far their programmes worked for parents so that issues
were addressed successfully. Providers referred to their efforts to provide a service that was responsive to individual
needs so that specific problems relating to parenting could be addressed. The case for offering parenting support
both through outreach and through group work was made by relevant agencies and referrers also played a role in
deciding which approach might work best for a particular family. The programmes are focused on achieving both
attitudinal change and behavioural change:
45
We achieve an attitudinal shift with parents- relationship repair with children
and young people so they are ready to take up the strategies we promote. We
help them understand why children are behaving in a particular way and offer
strategies to manage difficult situations. (PR7)
There was a view among providers that the parenting programmes could work effectively in providing relevant
skills. In addition some of the other agencies that refer to these programmes stated that, they had received positive
feedback from parents who had attended courses. However, it was also suggested that for a proportion of the
families, there was a likelihood of them having to be referred again:
We have got good success rates, but what we have found and what research
shows is that they are not the sort of parents where we can say, off you go,
we have fixed you, they’ll come back… There are going to be many factors
in their lives that are going to disable life being smooth for them. They will
have slumps, they may split from a partner, and need to come back again. (PR29)
This experience was shared by those making referrals to access support for parents:
There are some success stories, of parents turning their lives around, but
they may get lots of support from Social Services and once that support has
gone, they regress, a lot of the families that find it difficult to manage,
managing their finances, managing their chaotic lifestyles. (PR20)
This is an issue to be addressed with regard to the assessment of rising demands on the system. Is there any
way that the problem of regression once support is withdrawn can be addressed? Some families may benefit
from continued support or fast access to services if new challenges arise. While parenting programmes based
on attitudinal and behaviour change may address some family problems, they are not sufficient. The problems
facing the families go deeper and may have their roots in socio-economic deprivation or of family breakdown. As
one provider of parenting programmes commented: “I am teaching them to cope with poverty, not step out of it”
(PR29). The links between family support, safeguarding and poverty will be discussed further in the Conclusion.
(3.6) Fitting Services around the Child?
Services should fit around the child or young person, rather than
the other way around.(NPT CYP Plan 2008-2011:10)
In order to provide further opportunity for reflection on CYP service delivery in NPT, professionals were asked
to comment on how the principle of fitting services around the child was realised in practice. All participants
supported the principle and were aware that there is an intention to achieve this. Some responded by offering
examples of how their own agency or service tried to achieve this by identifying the individual needs of a child
and their family and tailoring any support on this basis:
46
When we first set this project up the aim was to centre it round the child
and family so it is a needs led service. …. They are continually involved
in the review of the process. The service is there for the family and the child
rather than us saying this is what we are doing. (PR27)
It was also pointed out that the commitment to encouraging participation by family members, including the child,
requires skill and time and there will be occasions where there will be conflicting perspectives:
Where it was difficult to achieve this principle, this related to the barriers raised as a consequence of statutory
requirements to work in a particular way or to the pressure to meet service targets:
These responses reveal that there may be different interpretations among professionals as to what the principle of
fitting services around the child means in practice and how this can be implemented. It is not surprising that this
broad intention might be understood in different ways and will be perceived as difficult to achieve in practice
because it will require a shift in systems and styles of working. However, this does suggest that there is a case for
establishing further clarity with regard to specific models and with how to resolve practical difficulties. This is a
further area where multi-agency training could be beneficial to support that process.
I have been thinking about this quite a lot. I have just done our business plan
for the service and this does keep me focused, but it is quite targeted- so many
people must do this and so on… we seem to be constantly putting young
people into boxes and I feel that I have to fit people into a box to get a
particular source of funding…. So you have to get a balance to meet your
targets but also do other stuff. (PR18)
In addition, participants felt that where their work required them to collaborate with other agencies to achieve this
goal, the system pressures and service gaps identified in earlier sections of this report got in the way:
You cannot refer children on to services that don’t exist or they do exist but
are too full (PR25).
When a young person comes to you with an issue, it is important to them so
it is important to you, but when you go to a service that deals with very
important issues for everybody, it is hard. I have only got one but they have
got 25 really important issues to deal with. (PR18)
The child gets asked what they think. However, what the child thinks is
needed is not necessarily always what is needed and I know that sounds a bit
top down but the child’s perception of what should happen is not always in
their best interests in the long term. (PR25)
The agencies in the sample included some where there had been a concerted effort to develop joint working
based on the principle of the team around the child. This included the following examples presented in Box 3.
Whilst there is agreement, in principle, to work on the basis of what a child and family need, and to fit services
around them, this can require negotiation where the family does not perceive there is a problem or is not willing to
co-operate with a service provider. Those professionals working in CYP Services or in agencies that offer support
for higher tier concerns suggested that the challenges of working with families that find it difficult to engage with
services could make it hard to realise the principle:
47
I think we should be fitting services around the child but in many situations
it does not happen because the service needed is not out there or the service
depends on the parent being proactive and the parent is not going to be
proactive. (PR21)
The Systems Review team are saying you need to be listening to families and
what matters to a family. But that is in an ideal world because what matters
to a family might not address what concerns social workers and health visitors
have in relation to a family and it is about getting the family on board and
signing up to an agenda- there could be CP issues involved. (PR23)
48
Box 3: CYP Initiatives Based on Team around the Child Model22
INITIATIVE
DESCRIPTION
Barnardo’s NPT Partnership Described as “an early intervention service for children who are at risk of offending
CHIP (Children’s Inclusion
behaviour”.
Project) and Mentoring
(www.barnardos.org.uk/neathporttalbot.htm)
Service
2 strands: (a) Support for children aged 8 to 12 years; (b) Mentoring service for
young people aged 8 to 18 years.
Strand (a) will take referrals from schools and other professionals but not parents
directly
Strand (b) has closed referral process for 12 to 18 year olds from specific agencies
and as ongoing support for children aged 8 to 12 years referred by CHiP project
worker.
Cannot work with child where case is open with CYP Services
Assessment and action plan may include outreach work in schools, brokering out to
other services and referral for counselling.
Barnardo’s NPT Partnership The FGMS “aims to co-ordinate meetings for families who need to reach a decision
Family Group Meeting
about their children’s welfare” (www.barnardos.org.uk/neathporttalbot.htm)
Service23
Team leader, co-ordinator and team of advocates are all based within Barnardo’s
but process involves joint working with CYP Services and other agencies providing
family support
Focus on needs of the child within context of family mediation working towards a
family group conference that is organised by the independent co-ordinator for the
NPT FGMS and with an advocate for the child where this is desirable
Referrals possible from any professional working with families in the County
Multi-Agency
Pupil Support Teams
Work with Year 8 and Year 9 children presenting behaviour and attendance issues
Wide range of agencies attend including schools, Education Welfare, Youth
Worker, Schools Community Police Officer, Neighbourhood Policing Team, Estate
Rangers and other agencies as required to address issues.
22
This is a selection and not an exhaustive list of projects that share interest in drawing multi-agency teams around the child and family. Projects not already
addressed in the section on parenting support have been selected.
The Project Investigator was able to meet one parent currently using the FGMS and this is offered as a case study in this section.
23
49
The three examples offered in Box 3 indicate that there are many ways in which agencies may work in partnership
to fit their service around the child. In each case these are initiatives that are in heavy demand and working at
full capacity and where the work is of an intensive nature. They illustrate the point that initiatives designed to meet
the goal of early intervention may find that this is eroded as they have to give priority to the most urgent cases.
In addition, the intensive nature of the support in a climate of budgetary pressures increases this drift from early
intervention to specialist guidance at the higher level of need.
The Project Investigator was invited to meet one parent who had been provided with access to the FGMS and a
meeting took place at Barnardo’s NPT Partnership during the summer in 201024. This example provides further
insight into the potential of a service that, as far as possible, offers a holistic approach to family support.
Laura’s Personal Account
Laura has experienced two Family Group meetings during the year. Her two children are currently in foster care in
separate placements.
Laura was very positive about the service that she has been offered by Barnardo’s FGMS and she began by
saying how much she valued the support of the FGMS Co-ordinator. This support has made a big difference during
a period of difficulty. Laura is also receiving support from Barnardo’s Parenting Matters Outreach Programme and
from the Community Drug and Alcohol Team (CDAT). Together, these services are helping Laura to make the steps
that will be needed to improve her personal situation with the hope that her children return to her care.
Laura said that she could see how she had grown in confidence between the first and second Family Group
Meetings. She remembered that while she had found it difficult, due to her emotional distress, to speak at the first
meeting, she was able to take the role of Chair in the second meeting. She felt she was more in control of the
process.
The involvement with Barnardo’s came about initially as a result of Laura’s social worker proposing a referral to the
FGMS and to Parenting Matters Outreach programme. Laura felt that her relationship with her social worker had
improved during the process and she was appreciative of the mediating role of FGMS as an agency providing an
input in addition to Social Services.
The FGMS draws together relevant family members as well as professional workers and helped Laura heal some
broken relationships in the interests of her children. Laura and her children had each been able to suggest who
should participate in the meetings and, therefore, who would be included in the process of negotiating plans for
the future. This was important to ensure Laura and her children had trusted support and so that the children would
retain valued relationships.
24
The FGMS Co-ordinator introduced the parent and project researcher to each other and then withdrew to enable a private discussion to take place. In order
to protect confidentiality, the personal story that was shared by the parent with the project researcher has been presented in generalised terms in the case
study that is presented. The parent will be referred to through a pseudonym as Laura.
The written account has been discussed with Laura who has agreed this can be included in the project report.
50
Laura described some difficult issues that she had to face both before and after her children were taken into foster
care. These related to issues such as previous family breakdown, drug misuse and housing difficulties, suggesting
a complex set of circumstances came together that made life hard. The FGMS has been helpful in supporting Laura
so that she can address those different life challenges while Parenting Matters Outreach service and CDAT have
offered practical support. The availability of Parenting Matters Outreach workers to visit the parent at home was
mentioned as a positive element of this service. Laura was also pleased that she had the opportunity to gain an
Open College certificate as a result of her involvement with Parenting Matters.
The discussion with Laura revealed that the FGMS can be an empowering model for a service user whereby they
can feel they have a role in decision-making with support for areas of difficulty and where the children involved in
the process also have access to advocacy. It is a model that also accesses relevant services for family members to
address complex needs.
Laura’s story was illuminating in relation to the matter of current gaps in family support services. Laura suggested
that she needed support for her adult needs and would like Social Services to address the needs of the parent as
well as the children. She felt this should include continued support for an adult in a situation where children are
taken into foster care. While Laura was able to access support from CDAT so that she could address her drug
dependency, she found it more difficult to access help for her housing difficulties because she did not meet the
criteria for support. A further concern was that she believed supervised contact with her children could be limited
because of resources being stretched whereas further contact could be beneficial to the family. These concerns
link with wider matters identified during the research concerning (a) the potential lack of integration between CYP
Services and Adult Social Services and (b) resource pressures that are impacting on all family services facing rising
demand and budgetary constraints.
In addition to the information above, Laura shared further personal information and observations which have been
invaluable for the project researcher in learning about what is important from the perspective of a parent seeking
support from services in NPT during a period of difficulty.
This example also revealed that the social worker had a key role to play in ensuring Laura was put in contact with
the FGMS and other relevant services. In this context some professionals expressed concern that there may not be
equality of access into services for families in need of support. Referral to a service may depend on the degree
to which there is wide knowledge of that service and what it can offer. In addition referrals may be dependent
on personal connections built up over time and differences of view among professionals over which models can
be most effective. It was also suggested that the current pressures in CYP Services could operate in tension with
offering equitable access to various services. The use of agency social workers, the problems of staff retention and
the constraints on time could all mean that there was a lack of knowledge regarding service availability:
So new social workers are hitting the ground running with new cases. So,
for example, they are going out on cases and they don’t know we have a
service that will offer support… They are chasing their tails and there is
no settling in period and opportunity for networking. (PR29)
It seems possible that an approach that builds a multi-agency team around the needs of a child and their family at
the earliest opportunity could be one way of addressing this matter. Among other things, new social workers would
be supported by fellow professionals with knowledge of services to be accessed.
51
(3.7) Local and National Influences on Safeguarding Pressures in NPT
The research sought to explore the reasons why the demand for CYP Services has increased significantly especially
at the acute level of need and with regard to the increased number of children who are Looked After by the Local
Authority. There was further interest expressed by the Research Commissioners in whether this related to specific
local issues within the County Borough or whether this was common to other Local Authorities and part of a
national trend.
Participants were invited to consider the possible combination of local and national factors that might impact on
the current situation. Many participants argued that the position in NPT was not confined to the locality and that
there has been an escalation of demand generally, including a rise in the number of Looked After Children in
other areas. This is a position supported by available statistical data (see Section 2.2), research on safeguarding
pressures (ADCS, 2010; Clarke, 2010; Macleod et al, 2010) and current reports in the media25. Some pointed
out that they were aware of this through their participation in professional networks outside the County Borough.
Some participants felt this general escalation of pressures was due to greater public and agency awareness
following high profile cases such as that of Baby Peter and media reporting of how this case was handled by
Haringey Social Services:
I don’t feel we are in a unique position at all. There is a general rise in
referrals because the public are more aware and people are more averse to
taking risks than ever before. (PR10)
If it is the case that greater awareness has impacted on referral rates then an assessment of the following would be
required to determine an appropriate response:
(a) The proportion of referrals to CYP Services that are unjustified and are due to over-reaction and, therefore,
divert precious resources away from cases of real concern;
(b) The proportion of referrals that are justified at the lower levels of need but could be worked by other agencies
in order to reduce pressure on CYP Services;
(c) The proportion of referrals that are based on sound reasons that do need to be addressed by qualified social
workers within CYP Services and do continue to further action.
The question, therefore, to be addressed with regard to increased safeguarding awareness, is whether that
improved awareness leads to appropriate action and identification of cases of genuine concern. If it does, then
this heightened awareness is to be welcomed but will need to be managed in a fresh way ensuring that the
unnecessary referrals under (a) and (b) above are addressed. However, this will not be straightforward in a context
of competing perspectives regarding which cases justify referral and who should be responsible.
See, for example, the daily news bulletin produced by Children and Young People Now, www.cypnow.co.uk
25
52
The response to the 3 questions identified above leads directly back to the matter of conflicting views between
agencies regarding appropriate thresholds for referral and where accountability ultimately lies within their shared
responsibility for safeguarding. In this sense, it is difficult to measure the proportion of unjustified versus sound
referrals and whether appropriate action, to address directly at agency level or to make a referral, has been taken.
The interview data reveals multiple standpoints. This issue will be addressed further with regard to the analysis of
case files.
The view was expressed that if there had been a rise in awareness leading to more referrals this was positive:
Whether people are picking things up and passing things on, just in case,
because of all these high profile investigations. …. Not that that is a bad
thing as these families need to be in. (PR1)
I don’t know, perhaps we are all now more aware, it has always been there
but we are all now more aware. Because it is real- it is not as though these
are cases that we would not have put into care years ago. I can’t see how we
could do it any different. (PR29)
The fact that the rise in demand in NPT has been evident not only at the point of referral but also in the rise in
cases that do need to be progressed within CYP Services and a rise in the numbers of Looked After Children
would support the claim that heightened awareness is a positive development overall.
A further view was expressed that more cases of genuine need were coming to the attention of CYP Services
because of the expansion of multi-agency working based on principles of early intervention. Whilst the assumed
view could be that early intervention initiatives would reduce the number of cases to be referred to CYP Services,
it seems possible that they sometimes have the opposite impact of identifying more families requiring support that
may have previously not come to the attention of CYP professionals:
We are digging deeper and because of that we are finding out more issues
that are bubbling to the surface where ten years ago we didn’t have those
workers going out there and finding out those bits of information. (PR5)
Staff are visiting the families who previously were not picked up and so
are identifying more issues by the nature of the visits. (PR14)
I think there is much earlier identification of children’s issues so there is
a lot of pressure in our (service) because of early identification. (PR17)
The argument that is emerging so far is that in a climate of increased safeguarding awareness and efforts to
identify problems through early intervention, the number of cases brought to the attention of CYP Services has
increased considerably. This is a positive outcome in the sense that more families who need help are being
identified but the system has not had the capacity to cope with this rise. In turn a proportion of referrals within the
CIN category are not taken further and the needs of those families sometimes escalate requiring intervention later
on. These are systemic problems not confined to this locality but where local solutions will be required to address
those problems.
With regard to the matter of the balance between local and national factors impacting on demand, questions
remain over the kinds of problems being faced by families in need and how both local and national social change
relates to those problems. The County Borough has many areas of high socio-economic deprivation as highlighted
in Part Two. The associated problems of poverty, unemployment and housing need connect with life challenges for
some families that impact on the health and well-being of all:
There are more problems generally in society, a lot more unemployment, a
decline in pride in NPT, not as many services out there, a decline in accessible
entertainment, transport is an issue, money is an issue, a massive increase in
substance misuse and this has a big impact as there is no structure to the day
or appropriate management of funds; also a lot of disengaged families who
just seem to be drifting aimlessly from partner to partner and house to house;
there is family breakdown every couple of years and older children who are
depressed and mixed up. (PR22)
The observations presented in the quotation above point to the interaction between structural problems being
beyond the control of individual families, family breakdown and, with regard to the issues of drug and alcohol
misuse, unhealthy coping strategies. Whilst services may be directed towards attitudinal and behaviour change
towards more healthy coping strategies, the question remains as to how the structural problems that lie underneath
can be addressed. How can the Borough Council address those matters relating to employment opportunities,
provision of decent, affordable housing and so on and what are the constraining factors in resolving those
problems?
Participants pointed out that there were some features of the County Borough that impacted on service delivery
for families. Services have to cater for many dispersed communities and service availability in NPT can vary
significantly between different areas. One professional provided an example of a family that was moving between
areas and this would reduce their access to childcare provided through Flying Start with implications for pressures
they were facing. Issues of transport and capacity of service users to travel out of their area can impact on access
to support26. In addition, some professionals suggested that some of the more remote communities had strong
social ties and networks that could sometimes be an obstacle to effective work with families facing problems.
Conversely, those ties and networks could be critical in offering informal social support in times of adversity. With
regard to families living in Sandfields, it was argued that some parents faced problems with regard to housing,
where they were renting from private landlords.
26
It is acknowledged that the current research has focused on service delivery in central services and in Sandfields and will not have captured the full range of
issues relating to the need for family support in NPT.
53
54
4. From Family Assessment to Family Support: Analysis of Case Files
These socio-economic issues are longstanding and link with the pattern of industrial change and employment
opportunity in the area. Those issues mean that CYP Services has been under pressure for many years but in
a context of constrained budgets and staffing there was little capacity to cope with a rise in referrals. They are
also the issues that ultimately must be addressed through agendas beyond the remit of CYP Services. This will be
difficult to achieve in the current climate where it is a certainty that socio-economic pressures and cuts to services
are about to increase further:
Unemployment is an issue and it is going to get worse jobs wise and there
will be no money and if they are on drugs, then they will turn to crime to get
the money and everyone is going to be looking at massive cutbacks, people are
going to lose jobs, and as young people want things, petty crime is likely to
increase. (PR16)
The problems of drug and alcohol misuse and domestic abuse were identified by many participants as of pressing
concern and this is consistent with statistical data collected in the recent Child in Need census (NPT CYPP,
2010b). The cohort of 1268 children included in the census included 264 (20.8%) where domestic abuse was a
factor and 448 (35.33%) where substance/alcohol misuse was a factor. The concerns expressed earlier regarding
access to adult social and health services and interaction between Adult Services and CYP services are relevant
here. This will be addressed further in the analysis of case files in the next section of this Report.
Section Summary
•
This Section presents the qualitative analysis of all referrals to NPT CYP Services on a single day in March 2010.
•
The case files were examined in relation to the 4 questions presented in Box 4. These had been formulated on the basis of issues emerging from the interview material.
•
Three cases are presented for detailed examination followed by a summary of key themes emerging from analysis of the whole sample of 14 families.
•
The analysis lends support to the views of professionals that:
(a) children and young people may not access support quickly enough following a referral to CYP Services;
(b) the adults involved in the care of the child or young person may not get support for their needs where their problems are impacting on the well-being of the whole family;
(c) there can be differences of view between various CYP partner agencies that make a referral and CYP Services over thresholds and over who has the professional skills and authority to resolve issues of concern;
(d) in a small proportion of cases, referral to CYP Services could be avoided through signposting directly to other agencies that provide family support.
•
The analysis points to the potential for developing integrated approaches to family support across the boundaries of CYP Services and Adult Social Services.
4.1 Introduction
The files for all referrals to CYP Services on a randomly selected date in March 2010 were requested. There were
26 referrals on this date and 25 case files were available for qualitative analysis. These related to children and
young people within 14 families currently recorded on the Integrated Children’s System (ICS).
The analysis provided opportunity to explore and cross-check some of the themes arising from the interviews with
professionals. In addition the statement in NPT Children and Young People’s Plan 2008-2011 that “Services should
fit around the child or young person, rather than the other way around” (2008:10) acted as a reference point
against which the information contained in the files could be explored.
55
56
4.2 Questions
4.3 Three Cases
The case files were analysed in relation to the questions in the box below:
Case 1: The source of referral was a school teacher with designated responsibility for CP stating the source of
concern was emotional well-being, including issues of self-harm and eating disorder. The teacher had made a
previous referral for the same reasons.
Box 4: Questions for Case File Analysis
(1) Does the evidence show that the child/young person received the support that is required and at the earliest opportunity?
(2) Do the adults involved in the care of the child/young person receive the support that they need?
(3) Is there evidence of a difference of opinion between the referrer and CYP Services regarding the needs of the child/young person?
(4) Could the referral to CYP Services have been avoided through direct sign-posting to other agencies?
This analysis has been conducted on the basis of information available in the case files only. In some cases
information was incomplete or actions were still in progress. In addition, conclusions drawn must be provisional in
view of sample size.
The questions in the box have been considered in relation to each case in the sample and the approach to
analysis is illustrated below through reference to three specific cases. In each instance certain details including the
age and gender of the child or young person have been omitted in order to protect the anonymity of service users.
The details of the case are described followed by the Project Investigator’s analysis.
57
The Initial Assessment for the first referral records the social worker had advised the young person to talk with
another family member; it was noted that support was being provided through a school nurse and a referral had
been made to CAMHS. The decision at that point was for the case to close and the young person signposted to
other agencies
The current re-referral notes that the situation had not improved and was being exacerbated by a lack of
understanding by other members of the family. The case log confirms case should close because there were no
new concerns or information and an Initial Assessment had been recently undertaken; it was also agreed that the
school would monitor and an opt-in form for CAMHS would be signed and returned.
(1) Does the evidence show that the child/young person received the support that is required and at the earliest opportunity?
No. There is a delay in the young person receiving support although the school is dealing with the case in a pro-active manner. There is a delay in referral to CAMHS that is complicated by poor relationships within the family and a lack of trust between family members.
(2) Do the adults involved in the care of the child/young person receive the support that they need?
In this case the young person withholds consent for family members to be consulted. The fact that the school teacher makes two referrals suggests that s/he feels this is a case where support beyond school and health service is required.
(3)
Is there evidence of a difference of opinion between the referrer and CYP Services regarding the needs
of the child/young person?
Yes. While the school teacher emphasises a need for support, this is assessed by the social worker in a milder tone as a case where there is upset due to family breakdown. How does the young person feel with regard to these statements? This is not recorded.
(4) Could the referral to CYP Services have been avoided through direct sign-posting to other agencies?
There was a direct signposting via School Nurse to GP to CAMHS but further intervention is required because of difficult family relationships preventing this being straightforward.
It seems possible this problem could be addressed through either of the following approaches (a) A package of school based support offered in confidence so that any obstacles within the family are bypassed; (b) Family mediation such as that offered by Barnardo’s Family Group Meeting Service to support family through this communication breakdown.
58
Case 2: The referral was made by the Police following call from a friend reporting an incident attended by police.
Both parents were on drugs and the child was removed to extended family. The father was arrested. There was a
history of contact with CYP Services since the mother’s pregnancy and initial referral from her Health Visitor. The
mother was recorded as on drugs and in an abusive, on-off relationship with the child’s father including a previous
serious domestic incident.
There is a history of referrals and Initial Assessments conducted prior to current referral- including a CP Conference
when child was not placed on CP Register and returned to mother’s care.
Current referral led to Strategy Discussion and S47 Enquiries. The child was in care of extended family pending
assessment. The case was referred to CP Conference on grounds of domestic violence, substance misuse and
parenting capacity.
59
Case 3: The case had been referred by a student Social Worker noting the mother needed extra support in looking
after the children who were currently taking on a caring role and with a lot of responsibility in the home. The
mother was seeing her General Practitioner for depression.
There was previous contact via a PPD1 from the Police where mother had been victim of domestic abuse and
partner had been arrested.
Prior to current referral there was report of domestic abuse and mother had been contacted for signposting to
support services- two calls were made to mother followed by a letter requesting she contact CYP Services. There
was no response and so case was closed with note of first report domestic incident but not assessed as CP.
There have been referrals from several sources since before child was born prior to this point.
Current referral was dealt with by making contact with mother- notes mother wanted counselling and advised to
return to her General Practitioner for referral. Referrer was advised no role for CYP Services but mother to request
counselling for self- case to close.
The father has faced problems of family breakdown during his childhood and case note suggests father needs
support for mental health issues.
(1) Does the evidence show that the child/young person received the support that is required and at the earliest opportunity?
(1) Does the evidence show that the child/ young person received the support that is required and at the earliest opportunity?
Immediate action with child removed to extended family in response to current referral. However, there is a history of CYP Services involvement due to domestic abuse and drug abuse.
No. The report is that the children are taking on a caring role and this does not seem to have been resolved on case closure. In addition, the mother did not respond to requests to get in touch with CYP Services following earlier referral relating to domestic abuse. The case was closed at that point without further investigation.
(2) Do the adults involved in the care of the child or young person receive the support that they need?
(2) Do the adults involved in the care of the child or young person receive the support that they need?
No or not yet. The child is unlikely to be safe until the adult problems are addressed and these have been known since before the birth. This case was still ongoing and this may involve referral to adult services. Both parents are young and the father has experienced adversity during his own childhood.
The case has been assessed as one where it is the adult rather than the children who has a need for support. The mother is advised to seek help from her GP. It is not possible, from information on file, to know the outcome with regard to the position of the children as carers.
(3) Is there evidence of a difference of opinion between the referrer and CYP Services regarding
the needs of the child/ young person?
(3) Is there evidence of a difference of opinion between the referrer and CYP Services regarding the needs of the child/young person?
No. Immediate action was taken by police to the phone call.
Yes. The student Social Worker judged this to be a case for attention of CYP Services but was advised there was no role for CYP Services.
(4) Could the referral to CYP Services have been avoided through direct sign-posting to other agencies?
(4) Could the referral to CYP Services have been avoided through direct sign-posting to other agencies?
The situation is one that would require Social Services action and co-ordination but both parents need help for their problems from appropriate agencies. The records do not state whether either parent had been referred to adult services so it is not possible to say whether those needs were met on basis of evidence in the file.
It is not clear because the mother has needs which are impacting on her children. A model of family support based on integration between children’s and adult social services would help address this type of case.
60
Each of the three cases above highlights some of the challenges in meeting the needs of a child and their wider
family. The cases also provide illustration of some of the concerns expressed by professionals in relation to the
following matters:
(a)
(b)
(c)
(d)
Delays in providing support to the child or young person who is the subject of the referral;
The need to provide integrated family support through addressing any adult needs that are impacting on the care of the child;
Differences of perspective between the referrer and staff in CYP Services regarding the need for CYP
Services to take responsibility for the case;
Situations where referral could be avoided through referring the case to another agency immediately.
This approach to qualitative analysis was adopted for all of the 25 files that were made available and an overall
assessment of the evidence for each case with regard to these 4 matters is offered next. The 25 case files related
to children within 14 families so the total figures add up to 14 across each row:
Box 5: Analysis of Sample of Case Files
QUESTION
61
Yes
No
Mixed
Insufficient
Information
Does the evidence show
that the child/young
person received the
support that is required
and at the earliest
opportunity?
2
6
3
3
Do the adults involved
in the care of the child/
young person receive the
support that they need?
2
5
2
5
Is there evidence of a
difference of opinion
between the referrer and
CYP Services regarding
the needs of the child/
young person?
6
4
1
3
Could the referral to
CYP Services have been
avoided through direct
sign-posting to other
agencies?
2
7
2
3
This is a small sample of cases handled by CYP Services on a single date and any conclusions are, therefore,
tentative. Nevertheless, it is notable that the figures in the Box lend strong support to the observations made by
professionals. The mapping of a case against these questions is at one point in a process that for many families
links back to a history of referrals and where actions were still ongoing. Nevertheless, it is encouraging that there is
a marked consistency between the perspectives of professionals presented in the previous section of the Report and
the case file evidence. This is summarised below:
4.4 Summary of Themes Arising from Case File Analysis
(1) Does the evidence show that the child/young person received the support that is required and at the
earliest opportunity?
The professionals who were interviewed had expressed concern over the extent to which children who they viewed
as being in need received appropriate support at an early stage. The case file analysis supports these concerns.
Some cases point to a delay in the child being provided with support quickly; although where there is a CP issue,
action is taken swiftly. This confirms views offered in interviews that pressures on CYP Services have led to a
situation where the focus must be on the most urgent cases. Children in Need may be caught in a cycle of referrals
before their needs become pressing and are then addressed.
Only 2 of the 14 families clearly had the needs of the children met in the current referral. In 6 cases it was
apparent that children’s needs had not been met, either because they did not meet the threshold for support,
or because there was a refusal to engage with CYP Services or because the concern related to the parent’s
own problems and these were not the responsibility of CYP Services. In 3 cases the outcome was mixed in that
immediate action was taken at this point because the cases were assessed as CP issues but where evidence on the
file revealed earlier referrals had not resolved matters and problems had escalated. In the remaining 3 cases the
files contained insufficient information for the Project Investigator to make an assessment.
(2) Do the adults involved in the care of the child/young person receive the support that they need?
There appears to be a significant gap created by the division of functions between CYP Services and Adult
Services. Some of the professionals had identified this as a concern that made a holistic approach to family
support difficult. Here too, this is illustrated further in the analysis of the case files. Some of the cases point to the
need for swift action to support the needs of the adults within the family. The assessment process focuses on the
child/ young person and questions relating to parenting capacity. The problems that the adults face seem to be
treated as a sideshow rather than the central problem. In some cases an assessment that the issue relates to adult
problems is used as a reason for closing a case. The need for an integrated and holistic model of family support
has a clear evidence base in the case files. An integrated model would ensure more joint working between
CYP Services and Adult services. The model would also ensure all family members are included in systems of
assessment and support. There are some examples in this small sample where fathers are involved in the child’s
care but do not appear to have been fully included in meetings and ongoing actions.
62
In only 2 cases did the evidence indicate that the adults in the family received a referral for support for their own
needs which, in turn, could benefit their child. In 5 cases it was clear that the adult(s) had problems that would
require resolution in order to address the matters facing the child but these were not addressed. In two cases the
assessment is mixed in that support had been offered but the adults had not consented to the service. There were 5
cases where it was unclear whether the adults had been offered support or not and this points to a potential gap in
the recording of information relating to any adult needs.
(3) Is there evidence of a difference of opinion between the referrer and CYP Services regarding the needs of
the child/young person?
The interviews revealed that there are differences of view between agencies/ services about (a) thresholds for
referral and (b) who has the authority and skills to resolve a problem and (c) who is able to signpost a family to
appropriate services. There are examples in the case file analysis where a referrer from another service has a
different view of the need for support to CYP Services and will be proactive and persistent in referring in.
The case file data supports the view of professionals that there is lack of agreement on appropriate thresholds for
referral between referring agencies and CYP Services. In 6 cases there was a clear difference of view between
the referrer and CYP Services regarding the need for action by CYP Services. In 4 cases there was agreement that
the case met the criteria for further action. In one case there was a shared view at this point that further action was
required but there had been a history of previous referrals to reach this agreement. In 3 cases there was insufficient
information to make a judgement.
(4) Could the referral to CYP Services have been avoided through direct sign-posting to other agencies?
There was a view within CYP Services that pressure on CYP Services could potentially be eased through direct
signposting of a case to other agencies. This would be possible, for example, for those cases where either
Startwell, Action for Children Family Outreach Services or the Flying Start Health Visitors could provide support
around care and home conditions. The case file analysis indicated that this may be correct for a small number of
cases but does not support any claim that a significant proportion of cases could be addressed through alternative
routes.
In 7 cases the matters were of sufficient complexity to warrant immediate referral to CYP Services. In these cases
there were various reasons why alternative signposting would not be an option. In one case the family was not
willing to consent to any service, in 2 cases the referral came from a family member rather than a professional,
and in the remaining 4 cases there had been a history of referrals and unsuccessful interventions prior to the current
referral. In 2 cases the evidence was mixed in that the cases were largely concerning problems facing the adults
in the family and they were not progressed by CYP Services. However, signposting to other agencies including the
Family Group Meeting Service would have been helpful to resolve matters and this was not offered in either case.
In 3 cases there was not enough information on file to assess them on this criterion.
Is the CYPP Plan vision that “Services should fit around the child or young person, rather than the other way
around” achieved?
This data analysis would suggest that, at present, this vision is not realised and children and young people are
especially vulnerable at points where they are either waiting for a service (e.g CAMHS) or a service has just
been completed but there is no ongoing support to bridge gaps. The case file analysis identified some instances
where professionals were referring in to CYP Services where they anticipate service gaps will create a position
of vulnerability for the child or young person but CYP Services cannot fulfil that role of bridging gaps. There were
examples where this was the position for both the YOT service and the probation service.
In addition, the focus of this vision is on the child or young person where the research has revealed that it
would be helpful to include the support needs of the adult, with the aim that services should fit around the whole
family. Services for children and for adults need to be considered together if complex family problems are to be
addressed. These case files and other secondary sources suggest that the key risk factors where adults need swift
support include drug and alcohol abuse, domestic abuse and mental health problems. The pathways into services
that provide appropriate support appear to be fragmented and complex potentially leading to delays and gaps in
the support adults need for problems that impact on the children. In order to understand pressures on CYP Services,
there is a need to understand the organisational culture and pressures facing Adult Social Services and the
partner agencies that provide support to adults. This goes beyond the brief of the current research but is clearly
an issue for further attention.
The case file analysis revealed only 2 cases where, at this stage, the family could have been sign-posted
elsewhere by the referrer without any involvement for CYP Services. In one case a referral from an Education
Welfare Officer for poor home conditions could have been addressed by an agency such as Startwell or Action
for Children Outreach Service. However, it should be noted that, under current agreements, a referral would have
to go in to CYP Services in order to access Action for Children support. In the second case, which is presented
as Case One earlier in this section, the referral from the school teacher could have been avoided through coordinated support in school to respect the confidentiality that this young person was requesting. The further
suggestion offered by the Project Investigator that the Family Group Meeting Service could be used to address the
breakdown of trust within the family could only be progressed with family consent. In this sense, the expertise within
CYP Services could be required to reach a point where that would be possible.
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5. Discussion: Safeguarding Children and Supporting Parents
Section Summary
5.1 Introduction
•
In this section the key themes of the research are discussed in relation to wider literature. This literature is helpful for placing the challenges that NPT CYP Services are facing in wider context.
In this section some of the key themes arising from the research will be identified and placed in wider context with
reference to academic and policy literature. The four themes that will be addressed are:
•
There are many examples of multi-agency family support services and parenting intervention programmes in the literature, but it is more helpful to draw out key principles of good practice rather than to recommend a specific approach that may have developed to meet needs in a specific locality elsewhere but may not be transferable to the County Borough of NPT.
The delivery of multi-agency children and young people’s services;
(b)
Parenting support: prevention and early intervention;
(c)
Moving towards integrated family services;
Changing systems and doing things differently.
•
Multi-agency working comes in various forms that can all contribute to service delivery. Clarity is required in selecting specific models with regard to their potential benefits and weaknesses.
(d)
•
The impact of joint working has been seen to be beneficial from a service delivery perspective but less is known about the impact on service users.
•
5.2 The Delivery of Multi-Agency Children and Young People’s
Services
The introduction of the pilot schemes for the IFSS in Wales demonstrate that the challenges in meeting the needs of families with complex problems are not confined to NPT.
•
If there are elements of the IFSS approach that can be adopted in NPT in the short-term and prior to the All Wales roll-out, this would be beneficial to address current system pressures.
•
Parenting interventions can take many different forms and should be placed within the context of wider policy changes and packages of support to families; there should be efforts to maintain the balance
between universal, targeted and specialist support even in this climate of budgetary pressures.
•
The many positive developments in multi-agency working, parent support and integrated family services can be undermined by wider systemic problems within the child social work service described by the
professionals in Section 3 and in the wider literature in Section 5.5.
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(a)
In Section 2.1 the overview of national policy for children and young people’s services within Wales and at
UK Government level highlighted the emphasis on partnership and joint working between professionals and the
various agencies and services in which they are located. The report by Lord Laming into the death of Victoria
Climbiè (Laming Report, 2003) had included recommendations for changes to the organisation and management
of services for children and young people and had highlighted the importance of effective joint working between
professionals. The themes of partnership and the joining up of services is, nevertheless, not a new policy direction
but, with regard to child welfare, was also enshrined in the Children Act 1989 and has been a regular focus of
debate within many policy arenas. Integrated service provision and multi-disciplinary working have also been
themes within area based initiatives to tackle poverty and deprivation including Sure Start (Bagley et al, 2004;
Glass, 1999) and Flying Start.
In their review of integrated service provision in the early years, Iram Siraj-Blatchford and John Siraj-Blatchford
(2009) argue that there is a need to reach a clearer understanding of what is meant by ‘integration’ as the term is
ambiguous and complex. In practice, integrated working may be implemented through different models of interprofessional and inter-agency collaboration. The interviews with professionals in NPT supported the observation
that there are different understandings of what is meant by integrated working and different terms (inter-agency,
multi-agency, partnerships, multi-disciplinary, multi-professional) may be used to refer to this and may be deployed
interchangeably.
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There were a variety of different models based on joint working in NPT described in Section 3 and all may have
a useful role to play in bringing services to children, young people and their families. Nevertheless, it may be
helpful to achieve greater clarity about the different models available and their relative strengths and weaknesses.
A distinction is made in on-line guidance from the Department for Children, Schools and Families between the
following three approaches:
• A multi-agency panel: where practitioners remain employed by their home agencies, agreeing to meet as a panel on a regular basis to discuss children and young people with additional needs who would benefit from multi-agency input.
• A multi-agency team: where practitioners are seconded or recruited into the team, making it a more formal arrangement than a multi-agency panel.
• Integrated service: that acts as a service hub for the community by bringing together a range of services, usually under one roof, whose practitioners then work in a multi-agency way to deliver integrated support to children and families.27
Each of these models is described further in the guidance in terms of key characteristics, benefits and opportunities,
and challenges. There are examples of each model in operation in NPT as described in Section 3.
In choosing between the different possible models of joint working, it will be useful to know more about their
impact on securing positive outcomes for children. Here Siraj-Blatchford and Siraj-Blatchford conclude that: “Very
little hard evidence is currently available on the impact that inter-agency working is having on children’s outcomes”
(2009: 8). This was a concern raised by practitioners in NPT with regard to their belief that what they were doing
was making a difference but was difficult to measure and there was an associated worry that this could make
certain initiatives vulnerable in a period of cuts.
There is an abundant literature providing examples of integrated working in CYP Services and there have been
efforts to evaluate, for example, the National Evaluation of Sure Start (NESS, 2004)28 and the evaluation of
Cymorth and Flying Start29 have addressed the impact on service users of these programmes based on partnership
and joint working. The Flying Start Evaluation Case Study Overview Report, for example, highlights the centrality of
multi-agency working to the programme and its positive impact:
Multi-agency working underpins Flying Start. It is clear through the case studies that it has significantly aided effectiveness and assisted in the progress towards achieving the programme’s overall aims. The multi-agency approach was seen not only to improve access to services through co-location and joint delivery but also to bring together and coordinate the necessary range of skills, knowledge and perspectives to enable the programme to identify and meet needs – providing tailored interventions and responses to ensure that the most appropriate services and support are in place.
(SQWconsulting, 2010, para 4.23: 31)
www.dcsf.gov.uk/everychildmatters/strategy/delivering services/multiagencyworking/ Accessed on 30/09/10
www.ness.bbk.ac.uk
29
www.cymorthandflyingstartevaluation.co.uk/
27
The authors acknowledge that this assessment is largely in terms of service evaluation rather than the measurement
of progress towards outcomes for children and families involved with Flying Start.
The challenge of measuring outcome was also identified in research by Kay Tisdall and her colleagues (2005;
JRF Findings, 2005) in Scotland on the provision of integrated services by Family Centres and New Community
Schools. Whilst many of the families were able to identify positive impacts of these services “most are not regularly
quantified in official statistics nor captured by certain standardised evaluation measures.” (JRF Findings, 2005:
3). Where the families did identify positive impacts, such as faster access to services, these were seen to be an
outcome of integrated service delivery. Conversely, where families reported a negative experience this tended to
be where there were complex needs that went beyond the boundaries of the particular integrated service team
and this did lead “to certain families having overlapping, fragmented or gaps in support services, with significant
difficulties unresolved” (JRF Findings, 2005: 3). A comparable difficulty was reported in the current research with
regard to the operation of multi-agency teams operating at the lower tiers of service delivery working with children
and families requiring access to higher tier support or a form of support beyond the boundaries of the team.
Patricia Moran and her colleagues (2007) carried out a study of an early-intervention family support team based in
a Local Authority social services department. The study focused on the social workers’ perspectives on multi-agency
working and gathered evidence through interviews and focus groups. The study revealed differences in ways of
working between the social workers and partner agencies that impacted on multi-agency working. The difficulties
faced by the team related to differences in service protocols between social services and other agencies and the
need to develop new performance indicators capable of capturing the new approach to multi-agency work. In
addition, the social workers feared the loss of their professional identity within the context of an early intervention
service. The benefits reported included improved understanding of different roles and improved communication.
One further benefit of relevance to the NPT research was that staff in partner agencies reported an improved understanding of CP thresholds and faster referrals where children were identified as in need of support. In this sense,
the fact that the multi-agency team included professional social workers with specific expertise was valued by all.
5.3 Parenting Support: Prevention and Early Intervention
In Section 3 the variety of approaches to parent support offered within NPT were discussed. It was also reported
that some practitioners argued that “poor parenting” was the basis for many of the concerns that could lead to
a referral to CYP Services and, in turn, interventions might be based on addressing attitudes and behaviour in
parenting. These perspectives can be addressed with reference to some of the literature on parenting support.
The matter of parent support has received attention within the political sphere and has been the focus of new
policies and legislation during the thirteen year term of the previous Labour Government. The publication of the
Green Paper Supporting Families (Home Office, 1998) and the launch of the National Childcare Strategy (DfEE,
1998) can be viewed as part of a package of support for families (Rahilly and Johnston, 2002). Most recently,
and prior to the change of UK Government, the Families and Relationships Green Paper, Support for All (DfCSF,
2010) was published. In the context of devolution, the Assembly has pursued its powers to determine its own
policies in family support, parenting and childcare but within limits imposed by reserved areas such as those
relating to welfare benefits and parental employment rights. In 2005 the Flying Start programme was launched for
28
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consultation (WAG, 2005b) allied to the Assembly’s Child Poverty Strategy and targeted towards disadvantaged
areas. WAG also published the Parenting Action Plan (WAG, 2005c) in 2005. Most recently the Assembly
passed the Children and Family (Wales) Measure 2010 and this addresses matters of child poverty, childcare
and the Integrated Family Support Service plans to be discussed in Section 5.4. It also establishes powers for
Local Authorities in the provision of parent support. These policy developments are referred to here because it
is important to be aware that the forms of parenting support described in Section 3.5 are part of a much wider
package of initiatives for parents. The need for parenting support in the context of family crisis underlines the point
that some family challenges are not reached through the universal forms of provision.
There are inequalities between parents with regard to their access to resources that can assist them in the day to
day challenges of caring for children. Those resources may be economic or social, for example, in terms of access
to family support or friends and neighbours who can help in times of stress. Indeed, some of the professionals in
NPT who work with parents observed that wider family and community change may mean those sources of social
support are absent:
Families do not tend to have family support they had years back and a lot of people
have moved in and so do not have the support- so children have to be accommodated
when a parent goes into hospital because there is no-one, the family and community
support networks are not the same. There has been an influx of people from other
areas. (PR1)
Conversely, the case file analysis revealed some occasions where members of extended family did provide support
in caring for children who otherwise might have become Looked After by the Local Authority.
Research by Peter Seaman and colleagues (2006, JRF Findings, 2006) explored the challenges of parenting
for families living in areas of disadvantage. Their focus was on hearing directly from parents and children about
how they coped with living in an adverse environment. Parents and children reported concern about risks of
violence, including the presence of gangs and threats of drug and drink related crime. The problems of being
isolated from safe play and leisure opportunities and the exclusion that can result from being identified as living in
an “undesirable” area were also identified. The parents and children described strategies to keep safe that were
seen to be helpful in this environment. Research along these lines can be important for challenging any simplistic
interpretations of the relationship between parenthood and poverty that tend only to blame parents for situations of
adversity.
The relationship between parenthood and poverty is addressed in an edited overview of the Joseph Rowntree
Foundation programme of research into parenting (Utting, 2007). The strand of research into the impact of poverty
on parenting by Ilan Katz and colleagues reported that the relationship was not clear-cut:
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it is likely that different individuals respond in different ways to financial hardship. Factors such as family structure, neighbourhood and social support interact with parents’ temperaments, beliefs, and their own experiences of parenting. (in Utting, 2007: 12)
Nevertheless, it is reported that poverty can have an impact in terms of parental stress or depression that in turn
erodes their capacity to care for their children and their style of parenting. As the quotation above suggests,
there can be protective factors with regard to access to social support that can mitigate the impact of poverty on
parenting.
Ilan Katz and colleagues (2007) also conducted a parallel study into the barriers to including parents in
mainstream services. They identify 3 main kinds of barriers: (a) physical and practical - for example, geographical
location; (b) social - for example, institutional cultures and structures that fail to engage certain parents such as
disabled parents, parents living in poverty, and fathers; and (c) suspicion and stigma, for example, where parents
believe they will be judged if they seek help in parenting. The authors proceed to consider strategies for the
effective engagement of parents including sensitive service delivery and community development approaches. The
latter includes approaches where parents are involved in service delivery in various ways and it is argued this can
help in community capacity building and empowerment. There are examples of this approach within NPT including
the Parenting Matters programme at Barnardo’s NPT Partnership which encourages parents to become volunteers
and has a Parent Support Group run by volunteers. In addition the Parent Network acts as a forum for parents and
ensures they are able to contribute to processes of consultation.
Another study that examined the effectiveness of parenting programmes in areas of disadvantage by Scott,
O’Connor and Futh (2006) claims that these programmes can be effective. They refer specifically to the WebsterStratton Incredible Years programme as one that has been shown to work:
The underlying notion is that parents cannot think freely about solutions
until feelings that are overwhelming are processed – indeed this
represents the practical application of what research on parenting has
demonstrated for many years. Thus the approach is to offer both
emotional support and skills with which to improve the relationship with
the child. With this approach, not only do child outcomes show a large effect size,
but also there is high consumer satisfaction and low drop-out rates.
(Scott et al, 2006: 9)
The Webster-Stratton Incredible Years programme is used by providers in NPT. Scott et al (2006) point out that,
aside from offering specific interventions, where parenting is affected adversely by poverty there will be a need
for political intervention in terms of factors such as improved community facilities, housing and financial support.
In addition, certain specific conditions affecting a family, such as parental depression, will also require attention.
Patricia Moran and Deborah Ghate (2005) make a comparable observation in their review of evidence regarding
the effectiveness of parenting support. They argue that the wider social context to parenting should be considered
and recognition of “the limited impact that any parent support intervention can have if broader social inequalities
affecting families are not addressed” (2005: 332). These arguments highlight the value of locating parenting
programmes within a wider package of interventions for family support and a broader set of policy goals that
target poverty and inequality. The matter of integrated family support is the subject of the next section.
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5.4 Moving Towards Integrated Family Services
In Sections 3 and 4 of this report some of the problems evident in supporting the needs of adults struggling to
care for their children as a consequence of complex needs of their own were highlighted. It was also found that
agencies seeking to offer a holistic service for the whole family could find the division of responsibilities between
CYP Services and Adult Services to be a barrier. This is an issue that was identified previously in the report of the
Children’s Social Care Consultants Ltd where it was advised that developing a holistic “Think Family” approach30
would be beneficial where collaboration across CYP and Adult Services could be fostered.
In October 2008 the Welsh Assembly Government launched a consultation Stronger Families: Supporting
Vulnerable Children and Families through a new approach to Integrated Family Support Services (WAG, 2008).
This was announced as a response to evidence that service delivery for children within families with complex
problems was failing to meet their needs. This included problems such as mental health, domestic abuse, substance
misuse and learning difficulties. The consultation document proposed the piloting of an Integrated Family Support
Service (IFSS) that would include a multi-disciplinary team of professionals with a view to earlier intervention and
improving support. This would potentially address some of the problems raised by professionals and in the case
study analysis in the current research. This new initiative also indicates that NPT is not alone in the barriers to
effective service delivery that have been identified.
Following the consultation, the Assembly has introduced the IFSS model in 3 pioneer areas in Wales and this is
intended to improve links between adult and children services. The 3 pioneer areas will also be subject to a new
statutory framework. Among other things this will involve changes in the thresholds for access to adult services.
Whilst this is an exciting development, the model will not be rolled in across Wales until 2013 to 2015. Yet, the
present research suggests that some of the rising demands experienced in NPT could be addressed through the
reconfiguration of social services along these lines. If there is any potential in NPT to borrow from some of the
features of this model more immediately, this could be beneficial.
The Early Learning Partnership Parental Engagement Group (ELPPEG) also proposed a framework for good practice
by suggesting a set of principles for engaging with families. They propose 10 key principles:
Successful and sustained engagement with families is maintained when
practitioners work alongside families in a valued working relationship
Successful and sustained engagement with families involves practitioners
and parents being willing to listen to and learn from each other
Successful and sustained engagement with families happens when
practitioners respect what families know and already do
Successful and sustained engagement with families needs practitioners to
find ways to actively engage those who do not traditionally access services
Successful and sustained engagement with families happens when parents
are decision-makers in organisations and services
Successful and sustained engagement with families happens when families’
views, opinions and expectations of services are raised and their confidence
increases as service users
Successful and sustained engagement with families happens where there is
support for the whole family
Successful and sustained engagement with families is through universal
services but with opportunities for more intensive support where
most needed
Successful and sustained engagement with families requires effective
support and supervision for staff, encouraging evaluation and self-reflection
Successful and sustained engagement with families requires an
understanding and honest sharing of issues around safeguarding
(ELPPEG, 2010: 3)
30
The Think Family Toolkit published in September 2009 as part of Every Child Matters encourages ways of ensuring co-ordination between Children’s, Adult
and Family Services. The programme of action also provides targeted support for parents and families. The Toolkit is promoted for delivery in England but
there have also been promising developments in Wales as reported in this section.
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It is also argued by ELPPEG that parenting programmes that rely simply on teaching parents certain skills through
a time limited intervention are lacking and that how professionals work with families is as important as what kind
of support is offered. The quality of the relationship between professionals and parents and the importance of
exploring what parents expect from a parenting programme is highlighted by Sue Miller and Kay Sambell (2003).
In NPT those professionals working with parents also expressed this view that they were seeking to build effective,
trusting relationships, not simply deliver a programme. They were keen to discuss the values and processes that
underpin their programmes as well as the content of the programmes.
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A further theme that has attracted a growing literature (Clarke and Roberts, 2001; Clarke and Roberts, 2002) and
relates to the matter of working with the whole family concerns ways of engaging fathers (Lewis and Lamb, 2007).
It was noted in Section 4 that the case file analysis revealed some cases where fathers who did have caring
responsibilities did not appear to have been included in some of the ongoing discussions about such matters as
the improvement of home conditions. It was also noted in interviews that some professionals would naturally refer
to the role of mothers when questioned about their work with parents. On the other hand, some of the providers
of parenting support commented on the need to run classes at a time that would be accessible to both parents.
Jonathan Scourfield (2006) reflects on how fathers may be engaged in the child protection process and how
the organisational culture of social work child protection teams may reflect assumptions about gender that may
marginalise fathers with implications for mothers and the children also31.
The Scottish Government has commissioned research into the impact of intensive family support projects (Pawson et
al, 2009) relating to families where there was a concern about anti-social behaviour and where the families were
either at risk of eviction or had already been barred from social housing following eviction. Their data reveal that
the projects were successful in achieving positive outcomes for families and that the projects were cost-effective in
that they reduced the need for other services. The study concludes:
5.5 Changing Systems and Doing Things Differently.
It can…be stated with confidence that the Projects have engaged – and in most cases achieved immediate positive impacts – with some of the country’s most vulnerable and troubled families. And, although the evidence as yet available is limited, it also appears that in the majority of cases, improved lifestyles and behaviour achieved with Project support have tended to be maintained at least in the months immediately following case closure. The extent to which such gains are sustained and built on over the longer term is a matter for further research.(Pawson et al, 2009: 132)
This is encouraging in relation to the plans in Wales to introduce intensive family support through the IFSS initiative.
Trevor Spratt and John Devaney (2009) conducted comparative research into how social work teams identify
families with multiple problems. Their focus was, therefore, on families facing the kind of acute problems to be
targeted through the IFSS. It is observed that their interest is in exploring whether “these families share similar
characteristics and to ascertain what responses may need to be developed by agencies to meet their particular
needs” (2009: 419). They observe that in the three countries included in the research- Australia, the USA and
Northern Ireland- the structure and mode of delivery of each child welfare system was focused on the management
of the risk of child protection. This entailed a narrowing of service functions towards investigation and away from a
broader role in family support. There was also concern expressed that teams were aware of families with multiple
problems whose needs were not really addressed through the deployment of labels such as ‘child in need’ or ‘child
at risk’ meaning that current systems were perceived as obstructive to the recognition of those needs and early
provision of support.
Spratt and Devaney argue that there will be a political and economic imperative to invest in services that will
prevent the children in families with multiple problems from becoming long-term dependents on the state:
31
Jonathan Scourfield is currently running a research project at Cardiff University that takes these concerns further through the development of an evidencebased training package for social workers that is designed to improve the engagement of fathers.
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Families with multiple needs may therefore benefit from a shift in policy
which sees investment in them- although initially costly, still justified when
measured against projected lifetime costs to the state. (2009:432)
They proceed to argue that one approach may be for current welfare agencies to retain their role in the
identification of those families “but such families would quickly be re-routed to other services provided by
government, community and voluntary agencies” (2009: 433). It does appear that the new models of Integrated
Family Support described earlier in this section could be set within the context of this shift in approach. These are
not only Nation specific initiatives but are evident across different countries. This point leads in to the final section
on the matter of systemic change.
The research was conducted during an ongoing period of change and service review within NPT revealing
an intention to change the way things are done in the delivery of services to children, young people and their
families. Many of the professionals who were interviewed raised this as an issue; stating that they knew change
was imminent and that they anticipated the possibility of having to make changes to the way they provided their
service: “I would like to stay in this (service) for ever but maybe I am clinging to something that needs to grow…
If change means we are more effective then that is the appropriate way” (PR19). Moreover, nearly all of the
professionals raised issues of budgetary cuts and expressed anxiety over what this might mean for the future of their
service making it difficult to plan in a positive and pro-active way.
There is a significant body of academic literature that identifies challenges in the contemporary social work role
and within the system of child welfare within the UK and in other advanced industrial societies. This also throws
light on the question of how far the pressures in NPT are locality specific. There is strong evidence that they are
not.
Brian Corby (2006) provides a historical account of child care social work from 1948 onwards. Turning to the
current period and changes that followed the Laming Report in 2003, Corby raises the following concern:
Many of the Climbié recommendations relate to pooling of information,
careful recording and closer managerial oversight of assessments
and interventions. No-one could sensibly question the risk-reducing
intentions of such arrangements. However, there is an issue about how
practical and, therefore, effective they are likely to prove. There is a danger
that such measures could become so complex, so systematized and so reliant on
management control that they prove unworkable. (2006: 175)
The interviews in NPT did uncover frustrations among social workers regarding current systems that framed the
way social work can be done. The emphasis on meeting the required timescales and transfer protocols in a
context of rising demand was a feature of discussion in the interviews and the high levels of stress involved were
palpable. There is a sense of having to manage the demands of the system that may inhibit capacity to make
sound decisions based on the needs of the family. Nevertheless, social workers would describe how they tried
to manage this pressure as best as possible: “personally I would rather do a quality piece of work and that may
mean foregoing the timescale” (PR21).
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6. Conclusion and Proposals
Karen Broadhurst et al (2010) also explore the theme of child care social work organisational procedures and their
potential for creating rather than avoiding risk. They argue that children’s local authority services are characterised
by a “faulty design element” so that “current attempts to increase safety, through the formalization of organizational
procedures and their enactment by IT systems, may have had the contrary effect” (2010: 352). They carried out
ethnographic fieldwork in 5 Local Authority areas in England and Wales to explore child welfare practices. They
argue that safeguarding practices were actually compromised by performance management systems and new
forms of e-governance. They describe the Initial Assessment System as a “system under pressure” (2010: 356) and
where high referral rates have forced child protection cases to take priority. The strategies that teams have had to
develop to manage this demand and the requirements of the system can lead to error rather than protect from error:
This research project set out to explore reasons for the rising demand for CYP Services in the County Borough of
NPT which had manifested in the sharp rise in the numbers of Looked After Children over the last twelve months.
The focus of the research remained broad, at the request of the Research Commissioners, with a view to gaining
an overall picture of what was happening.
On the basis of the evidence presented in the previous sections of this report, the following conclusions and
proposals for consideration are offered:
Meeting performance targets, especially when the volume of incoming work threatens to exceed capacity, workers must make quick categorizations based on limited information; this will inevitably mean that some cases are filtered out that may require intervention. (Broadhurst et al, 2010: 365)
Given that this is unarguably a systemic problem rather than a weakness of particular teams, it is likely to be
widespread across Local Authorities. The authors locate their work within a systems approach (Munro, 2005) and
argue a case for ensuring systems are designed in order to meet the needs of their users, in this case, social work
teams and the families that they are seeking to support.
The current pressures facing child care social work have also been addressed in relation to matters relating to
the management of risk. Eileen Munro (2009) explores this theme offering a distinction between societal and
institutional risks. Those agencies that have a statutory role in safeguarding children, in addressing societal risks,
cannot avoid failure, argues Munro, because uncertainties are inherent and include institutional risks of various
kinds. Nevertheless, there is enormous pressure to manage the institutional risks of failure within the context of
increased transparency and accountability. Munro argues that the proceduralization of social work practices
has reduced the capacity for social workers to use their professional expertise and judgement. Nigel Parton
(2009) explores a comparable theme on the matter of child care social work systems in relation to the impact of
technology and the expansion of ICT. He observes that there is a focus on the ‘informational’ at the expense of the
‘social’ and this is transforming what counts as social work knowledge and the nature of social work itself.
Thus far, the introduction of ICT has acted primarily to institutionalize even further the highly managerialist and proceduralist culture that has come to dominate child welfare agencies, and which is so closely associated with a narrow and prescribed child protection orientation. (2009: 720)
Parton’s observations do resonate with some of the comments made by staff in CYP Services in NPT regarding
the introduction of the ICS and the demands this could place on their time. Parton’s argument is not to suggest
technology has no useful role to play but rather that it could be approached more creatively and in a way that
serves the needs of the users, social work staff and the families with whom they work. The message from this
research is that systems must be created that are flexible and are there to enhance the needs of professionals and
families.
This section has linked some of the themes arising from the research in NPT to issues emerging in policy-related
and academic literature. It is evident that wider social policy and socio-economic trends impact on local systemic
pressures and attention to that context must form part of any resolution. In the next section some conclusions and
proposals are offered.
75
The research questions have been addressed primarily through the qualitative interviews with professionals from
a wide range of CYP Partnership Services and through the analysis of a sample of case files held on ICS. In
addition, insights gained from secondary data and the wider literature have enabled some of the issues facing
CYP Services in NPT to be placed in a wider context.
(1) National or Local Matter?
It can be concluded with some confidence that the system pressures experienced in NPT are not a consequence
of purely local problems or the configuration of service delivery in NPT. These pressures are being experienced
across Wales and elsewhere (ADCS, 2010; Clarke, 2010; Macleod et al, 2010). The trends within child care
social work discussed in Section 5.5 have created systemic problems that have been bubbling away and, in a
climate of increased safeguarding awareness, alongside cutbacks in public services, it is possible to understand
the combination of forces that has resulted in the crisis. In addition, the argument offered by some professionals that
improved early intervention could draw in families whose needs for targeted support would have previously gone
unnoticed, is plausible.
Having concluded that this is a national issue, there are features of the NPT locality that could make it more
vulnerable than others to a rise in need and a rise in the number of families with multiple, complex problems in
the context of high levels of socio-economic deprivation in many wards. There are issues relating to the industrial
history of the area, changing employment opportunities and the geographic dispersal of communities that will
impact on family experiences, the aspirations of children and young people and on service delivery.
(2) Parenting and Family Support
There are many positive examples of parenting and family support provided by a variety of CYP partner agencies
in NPT. It was beyond the brief of the commissioned research for any of these to be formally evaluated with regard
to quality of service delivery or impact on service users. Nevertheless, the commitment of staff to supporting parents
and families and in providing a service that could make a difference for parents, children and young people was
clear. The trend towards early intervention services becoming more crisis based services was also a matter for
significant concern. The principle of early intervention is being undermined by systemic pressures.
Given the dispersal of parenting and family support across various agencies, there is potential for firmer coordination and streamlining of those services. It would be helpful to refine pathways into services so as to
simplify the existing complex jigsaw of provision that exists. This could include the overview and simplification of
referral routes in to those services. In addition the development of a handbook for all professionals and parents
that provides details of parent and family services so that all know what is available and how provision can be
accessed might be helpful with regard to concern to provide equitable access to services.
76
The review of literature underpinned the importance of retaining universal, targeted and specialist services for
parents so as to ensure preventative, early intervention and specialist provision is available. If there was scope to
expand universal and preventative forms of provision then the potential of offering parenting support in schools and
childcare facilities could be explored.
(3) Educational Matters
There was a strong view expressed within the Education Service and local schools that professionals in those
services would welcome a link social worker attached to a cluster of schools and with expertise to contribute to
school based family support services. This was compared with current provision that was widely perceived to be
helpful with regard to school-based Education Welfare Officers, School Counselling and the post of Child and
Vulnerable Adult Officer.
The Project Investigator is aware that there is a view that this is not a practical option in the current climate.
Nevertheless, the proposal should be discussed between Education and Children’s Social Services with a view to
debating any potential alternatives that would secure multi-agency school based provision with social work input.
(5) Meeting the Needs of Adults who Are Parents
The research revealed that the focus of CYP Services on the child or young person can mean that the needs of the
adults who care for them are not addressed directly or quickly. The focus on ‘parenting capacity’ may fail to fully
capture adult needs that are impacting on family life. In addition, even where adult needs are identified, and they
are signposted to adult services, there may be obstacles to their receiving support because of referral protocols,
waiting lists and styles of service delivery within adult services.32 When the adult does receive support from adult
services, this may focus on them as an individual, leaving out attention to parenting issues.
The proposals put forward earlier this year by the Children’s Social Care Consultants Ltd will be important for
addressing this concern and there are current actions in progress.
The assessment process once a case comes through the front-door of CYP Services should ensure adult needs that
impact on the family are addressed as early as possible. The fact that an assessment uncovers needs that primarily
relate to an adult should not be a justification for closing a case with no further action.
The variability of school support for vulnerable children and their families and differences between schools in their
understanding of their role in safeguarding was raised as a concern. The importance of all schools adopting a proactive approach needs to be communicated through appropriate measures such as training events.
In addition the model of the Integrated Family Support Service currently at the pilot stage (WAG, 2008) should
be considered for further ideas that might be adapted for the NPT locality33. Given the on-going changes resulting
from the Systems Review, the possibility of linking new departures in integrated family support to the Review could
be a way forward.
(4) Thresholds for Referral to CYP Services and Joint Responsibilities for Safeguarding
(6) The Social Context to Family Support
The research evidence, both in terms of interviews and case file analysis, revealed significant differences of view
between the various agencies and services that work with children and young people as to appropriate thresholds
for referral as a Child in Need or Child in Need of Protection. There are related questions regarding how different
professionals discharge their joint responsibilities in safeguarding, where accountability lies and who has the
professional expertise to make a judgement and take a decision. These matters are contested at present and are
exacerbated where multi-agency teams do not have social work staff among their members because of the system
pressures that curtail their capacity to contribute.
The high level of socio-economic deprivation evident in many areas of the County Borough was referred to in
Section 2.2. The interaction between family poverty and the needs of children, young people and their parents has
also been highlighted in the literature review and was a theme in the interviews with professionals. This means that
any strategies and services designed to deliver effective safeguarding and integrated family support will need to
be placed in this wider context of measures to address poverty (WAG, 2005a) and strengthen local communities.
The Assembly has launched a new Child Poverty Strategy and Delivery Plan for Wales (WAG, 2010). This
proposes that efforts to work in a holistic way with families through ‘team around the child’ or ‘team around the
family’ approaches would be a way forward for working around the problem of family poverty. There is a need to
consider at local level what an integrated, multi-agency approach to tackling family poverty will include and how it
will connect with multi-agency approaches to safeguarding in NPT.
A shared understanding of thresholds for referral, acceptance of joint responsibilities for safeguarding and
confidence in child welfare and child protection processes are likely to be fostered in multi-agency teams that
include social work staff. There is strong evidence that professionals within CYP Partnership services and agencies
value the professional expertise of social workers and are seeking solutions where joint working includes social
worker involvement. This could break the current impasse that was evident in relation to the different standpoints on
how system pressures could be resolved. There is a vicious cycle that does need to be addressed.
This Section will end with a summary of the key proposals for action by NPT CYP Services in collaboration with
relevant partners:
Further multi-agency training to foster understanding of thresholds and increase confidence in decision-making is
also recommended. This could be delivered within the context of the multi-agency teams as described above as
well as dedicated training events.
32
The Project Investigator acknowledges that the research did not extend to interviews with staff in adult social services. This point is not intended as a
criticism of individual staff or of management in adult services. The intention is to point to a systemic weakness that was identified by many of the participants
in the interviews.
33
It is also recommended that the comparable model of “Think Family” (DfCSF, 2009) could be explored for ideas and insights, although it is recognised this
is an initiative being progressed in England.
77
78
References
Box 6: Proposals for Action by NPT CYP Services
1. Address ways in which family support and parenting advice can be streamlined, co-ordinated and publicised
to ensure any service gaps are addressed, to achieve clarity regarding the tiers of need at which each agency is
offering a service and to secure equitable access to available services.
ADCS (Association of Directors of Children’s Services Ltd.) Safeguarding Pressures Project: Results of Data
Collection, Version 4, Manchester: ADCS.
AWCPP Review Group (2008) All Wales Child Protection Procedures, Access via web-site, www.awcpp.org.uk
2. Discuss potential ways to protect those agencies offering family support and parenting education from the drift
away from early intervention towards the current focus on higher tier, specialist intervention; so as to ensure families
are able to access help at the earliest stage possible.
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3. Consider ways in which to deliver integrated family support services for those families with complex needs at
the acute level and co-ordinate existing expertise in various agencies in this regard.
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4. Review the referral routes and access criteria for family support services so that key professionals with joint
responsibilities for safeguarding can refer accordingly and families with lower level needs do not have to pass
through CYP Services to access the service.
5. Ensure the balance between universal, targeted and specialist support for children, young people and their
families is protected as far as possible in a context of budgetary pressures.
6. Communication between Education and CYP Services regarding possible ways of achieving multi-agency
school based provision with social work input. In turn, this could address the related matter of securing a pro-active
approach for all schools in their safeguarding role.
7. Explore ways in which the sustained contribution of social workers to multi-agency CYP teams can be
secured with a view to achieving a shared understanding of thresholds, recognition that safeguarding is a joint
responsibility and building confidence in the role.
8. Build on current actions to secure integrated working between CYP Services and Adult Social Services to
achieve a holistic approach to family support.
9. Consider how an integrated, multi-agency approach to tackling family poverty will connect with multi-agency
approaches to safeguarding in NPT.
Broadhurst, K., Wastell, D., White, S., Hall, C., Peckover, S., Thompson, K., Pithouse, A. and Davey, D. (2010)
‘Performing ‘Initial Assessment’: Identifying the Latent Conditions for Error at the Front-Door of Local Authority
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numbers of looked after children/ budget pressures, Confidential Report to NPT CBC.
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Sage.
Munro, E. (2005) ‘A systems approach to investigating child abuse deaths’, British Journal of Social Work, 25:
531-46.
Munro, E. (2009) ‘Managing Societal and Institutional Risk in Child Protection’, Risk Analysis, 29(7): 1015-1023.
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Goldberg Centre for Social Work and Social Care: University of Bedfordshire.
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by the Policy Unit, Cardiff, National Assembly for Wales.
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Kingdom’, Children and Society, 13(4): 257-264.
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National Assembly for Wales.
Head of NPT CYP Services (2010) NPT CYPS Recommendations for Change, Confidential Report on Systems
Review, Neath Port Talbot: NPT CYPS.
NESS (National Evaluation of Sure Start) Research Team (2004) ‘The National Evaluation of Sure Start Local
Programmes in England’ Child and Adolescent Mental Health, 9(1): 2-8.
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NPT CYPP (2008) Putting our Children and Young People First. Neath Port Talbot Children and Young People’s
Plan 2008-2011, NPT: CYPP.
Joseph Rowntree Foundation (2005) The provision of integrated services by family centres and New Community
Schools, Paper Ref: 0235, York: JRF.
Joseph Rowntree Foundation (2006) Findings: Parenting and children’s resilience in disadvantaged communities,
Paper Ref: 0096, York: JRF.
Katz, I., Corlyon, J., La Placa, V. and Hunter, S. (2007) ‘The relationship between parenting and poverty’ in
D.Utting (ed) Parenting and the different ways it can affect children’s lives: research evidence, Paper ref: 2132,
York: Joseph Rowntree Foundation.
NPT CYPP (2010a) CYPP Plan. Needs Assessment 2010, Version 2, NPT: CYPP.
NPY CYPP (2010b) Child in Need Census Analysis, NPT: CYPP.
NPT CBC (2010) NPT Community Plan 2010-2020. Public Consultation Paper, Neath Port Talbot: NPT CBC.
NPT LSCB (2009) Safeguarding Children Board Inspection Report, 7th October 2009, Self-Evaluation by Chair of
NPT LSCB, Neath Port Talbot: NPT LSCB.
Katz, I., La Placa, V. and Hunter, S. (2007) Barriers to inclusion and successful engagement of parents in
mainstream services, York: JRF.
Parton, N. (2009) ‘Challenges to practice and knowledge in child welfare social work: From the ‘social’ to the
‘informational’?’, Children and Youth Services Review, 31: 715-721.
Kelly, S. (2010) CYP Services Systems Review. Report on Completion of Check Phase and Commencement of Trial
Phase, 4th May, Confidential, Neath Port Talbot: NPT CYPS.
Pawson, H., Davidson, E., Sosenko, F., Flint, J., Nixon, J., Casey, R. and Sanderson, D. (2009) Evaluation of
Intensive Family Support Projects in Scotland, Edinburgh: The Scottish Government.
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Stationery Office.
Rahilly, S. and Johnston, E. (2002) ‘Opportunity for Childcare: the Impact of Government Initiatives in England
upon Childcare Provision’, Social Policy and Administration, 36(5): 482-495.
Lewis, C. and Lamb, M.E. (2007) Understanding fatherhood. A review of recent research, York: JRF.
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Scott, S., O’Connor,T. and Futh, A. (2006) What makes parenting programmes work in disadvantaged areas?
The PALS trial, York: Joseph Rowntree Foundation.
WAG (Welsh Assembly Government) (2004b) Children and Young People: Rights to Action. Cardiff: National
Assembly for Wales.
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26(2): 440-449.
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Wales. A Review of the inaugural year of the Cymorth Fund 2003-04. Cardiff: National Assembly for Wales.
Seaman, P., Turner, K., Hill, M., Stafford, A. and Walker, M. (2006) Parenting and children’s resilience in
disadvantaged communities, London: National Children’s Bureau.
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Government for Tackling Child Poverty. Cardiff: National Assembly for Wales.
Siraj-Blatchford, I. and Siraj-Blatchford, J. (2009) Improving Development Outcomes for Children through Effective
Practice in Integrating Early Years Services, London: Centre for Excellence and Outcomes in Children and Young
People’s Services.
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Wales.
Spratt, T. and Devaney, J. (2009) ‘Identifying Families with Multiple Problems: Perspectives of Practitioners and
Managers in Three Nations, British Journal of Social Work, 39: 418-434.
SQW Consulting (2010) National Evaluation of Flying Start Baseline Update report, March, Cambridge: SQW
Consulting.
Tisdall, K., Wallace, J., McGregor, E., Millen, D. and Bell, A. (2005) Seamless services, smoother lives,
Edinburgh: Children in Scotland.
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2132, York: Joseph Rowntree Foundation.
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Cardiff: National Assembly for Wales.
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Cardiff: National Assembly for Wales.
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Appendices
Appendix A: List of Participants in Interviews
•
Sue Bater, Manager, Aberavon Integrated Children’s Centre
•
Jeanette Harrison, Flying Start Co-ordinator
•
Tina Frances-Reed and Maggie Davies, Flying Start midwives- joint meeting
•
Kath Rees, Flying Start Health Visitor
•
Flying Start group meeting with Kath Rees (Health Visitor), Cath Bowley (Flying Start Nursery Nurse) and Jane Maine (Flying Start Education Psychologist)
85
•
Allan Doyle, Headteacher, Traethmelyn Primary School
•
Graham Merriman, Head Teacher, Glan Y Mor Primary School
•
Rhodri Phillips, Head Teacher, Ty Wyn Primary School
•
John Gould, Principal EWO and Lesley Matthews, recent appointment as EWO for Sandfields, Education Welfare Service
•
Ian Wolzencroft, Schools Community Police Liaison Officer for Sandfields Schools
•
Heather Reid, Manager, Education Inclusion Service, Education Development and Inclusion Service.
•
Lottie Bruce Lloyd, Team Manager, RAAT, CYP Services
•
Tina Wilcox, Team Manager, Fairway Family Intervention Team
•
Claire O’Flynn, Manager, Action for Children, Sandfields Family Centre
•
Myfanwy Bater (Service Manager), Jo Cole (Senior Outreach Worker) and Julie Lewis (Outreach Worker), Action for Children, NPT Family Outreach Services, Group Interview
•
Karen Rees, Team Leader, Family Group Meeting Service Barnardo’s Cymru, NPT Partnership.
•
Amanda Hinton, Children and Vulnerable Adult Safeguarding Officer
•
Rhiann Evans, Children’s Services Manager, Barnardos Cymru, NPT Partnership
•
Helen Sinclair, Team Manager, FST1, CYP Services
•
Norma Good, Team Leader, Parenting Matters, Barnardo’s Cymru, NPT Partnership
•
Graeme Williams, Acting Head, Children’s Disability Team
•
Gareth Powell, Team Leader, CHiP and Mentoring Service, Barnardo’s Cymru, NPT Partnership
•
Rachel Magee, Social Worker, FST1, CYP Services
•
Rachel Gageshidze, Children’s Services Co-ordinator, Port Talbot Women’s Aid
•
Shelley Winter, Youth and Community Worker, Eastern Cluster, NPT Youth Service
•
Dominic Howells, YOT, Parenting Support
•
Julie Howells, Co-ordinator, Startwell, Port Talbot Resource Centre
•
Rachel Kavanagh, Women and Family Worker, West Glamorgan CADA
•
Shirley Davies, Headteacher, Sandfields Primary School
•
Sue Flavel, Assistant Headteacher, Sandfields Comprehensive School
86
Appendix B: Interview Schedule for Professionals in CYP Partnership
Services and Agencies
Supporting Children and Young People in Need/Looked After Children
Background
•
Provide project information; ethical matters and questions arising
General Questions about the Agency
•
Details of how Agency is organised, the service it delivers and about the interviewee’s role within the service
Integrated Children and Young People’s Services
•
•
How does the service link to the range of services? Which tiers?
•
Integrated/multi-agency delivery- what has worked well? What has been difficult?
•
The CYP Plan for NPT states “Services should fit around the child or young person, rather than the other way around” - how far is this achieved?
•
On basis of your experience, what may have changed in NPT in the last couple of years to help us understand the sharp rise in demand for children and young people’s services and, in particular, the numbers of Looked After Children?
•
What changes could be made to improve early intervention/preventative services to help reduce demand for social work involvement?
Further Research in Sandfields
•
Any further specific information on (a) issues facing families living in the Sandfields area and (b) contacts to follow up?
Which agencies and professional groups do you work with?
Safeguarding Issues
•
Role of service in safeguarding and promoting welfare of children and young people?
•
Experience in relation to Section 47 investigations for children and young people at risk of significant harm and subsequent processes relating to child protection and care proceedings?
•
How do you assess when to refer a child or young person deemed to be at risk? Are the thresholds clear?
•
What happens next? How are you informed?
Early Intervention/Preventive Services
87
•
Which services are most effective in preventing the need for specialist intervention for young people and their families, incl. social work referrals?
•
Examples of support- what has worked well? What has been difficult?
•
What are the main issues facing those children and young people that need the support of your service?
88
Agenda item 7
CHILDREN AND YOUNG PEOPLE SERVICES
SYSTEMS REVIEW REPORT- JANUARY 2011
Purpose of Report
The purpose of this report is to set out proposals for implementing the findings of
the Children and Young Peoples Services Systems Review.
Executive Summary
The learning from this review leads to a requirement for a service redesign which is
community focussed, breaks down thresholds for services and operates on a multiagency basis at the frontline of service provision.
The two main approaches for this ‘new way of working’ are firstly,that social work
teams should be based in schools around communities where there is the greatest
demand on services for children and young people. These teams should operate
as integrated multi-agency teams who can offer consultation and advice to each
other, develop professional teams around individual family’s needs and in doing
so, intervene early so that childrens needs do not escalate to the point that their
needs require intensive and expensive service support.
Secondly that the bureaucracy attached to social services processes is reduced
and that outcome measures are produced which can better measure the impact
upon children and families, of agency interventions, than the current set of
performance indicators.
Whilst it is too soon to analyse on a statistical basis, the success of the review,
over time it is anticipated that this early intervention approach will reduce the
numbers looked after children and that the improved and more rewarding new way
of working will stabilise the social work workforce. This in turn will lead to
economies and it is these two areas which should determine the economic
success of the new approach.
Two Community Childrens Teams have been established, through the process of
the trial period and it is now proposed that a further three teams are established in
the areas of greatest need, across the authority. One of these additional three
teams will have a disability focus.
Partner agencies, that is Education Welfare Services and Health Visiting Services
are currently being consulted as to the future of integrated services so as to enable
the next stage of roll-in on a multi-agency basis.
Work will now progress on consulting key schools on how the new Community
Childrens Teams can be accommodated.
Full Report
The content of the report is:
1. The Scope and Intention of the Systems Review
1
Agenda item 7
2. Learning to Date
3. Measures
4. Model for roll-in
5. Roll-in process
6. Data
7. Training needs
8. Business Support needs
9. HR Implications
10. Management
11. Supervised contact options
12. Risk Analysis
13. Time line for project
14. Future needs
15. Conclusion
1. The Scope and Intention of the Systems Review
The systems review was initiated to understand why, despite investment, there
continued to be a year on year increase in the numbers of children accommodated
or subject to child protection registration. The review, now in its thirteenth month,
has undertaken a significant data collection exercise which led to setting up two
trial multi agency teams operating from Cwrt Sart and Sandfields Comprehensive
Schools.
The model for the review rests on using frontline professionals under the guidance
of a consultant to understand the organisation and delivery of services as a
system. Given the scope and complexity of Children and Young Peoples Services
it was decided to concentrate on reviewing the core functions of assessment and
case management.
The review team comprises of frontline Social Workers, an Independent Reviewing
Officer, an Administrative Officer, a Team Manager and a Principal Officer,
Education Welfare Officers and a Health Visitor. A Police Officer was seconded for
the early stages of the review. The only team changes have been recent increases
in the size of both teams.
Management oversight of the review has been through a weekly ‘Senior Leaders’
group who monitor progress, contribute to the projects development and endorse
any changes. Also being a Tier One project the review reports to a programme
board comprising of relevant Directors and Heads of Service.
In respect of partnerships and other agencies the review reports to the Children
and Young People Partnership, the Local Safeguarding Children Board and the
Local Service Board. The latter has played a key role in removing obstacles to the
progress of this review and making higher level decisions.
More widely the All Wales Heads of Children’s Services group has maintained an
active interest in this review. The South East Wales Improvement Consortium has
expressed an interest in the outcome of the review and the review team has also
come to the attention of the Independent Commission on Social Services in Wales.
2
Agenda item 7
The Welsh Assembly Government has been regularly briefed on the progress of
the review, along with the CSSIW.
2.1 Learning to Date
The systems review has undertaken the following key stages:




Extensive data gathering and analysis
Demand and capacity to respond
Mapping our population to shape how the trial practice model would be
designed
Characteristics of the current system.
This pointed to a number of conclusions:
1.
That there was a lack of integrated and coordinated early intervention work
at a number of levels
2.
That referring agencies were struggling with their own demand and their
referrals to Children and Young People Services often didn’t meet threshold
3.
That discussions at the point of referral were more focussed on threshold
and agency responsibility than on need and response
4.
That over time concerns escalated which meant that when referrals were
accepted by Children and Young People Services problems were acute and
complex, with a reduced opportunity to effect change
5.
That economic and threshold measures could not stem demand
6.
That managerial authorisation for placement of children rarely differed from
the Social Workers judgement to accommodate
7.
That despite investment and initiatives caseloads remained high
8.
That court directed contact placed high demands on resources
9.
That the system was overly bureaucratic and this burden was added to by
the Integrated Children’s System
10.
Social Workers did not feel trusted by the courts, the public, the media or by
their employer
11.
That beyond the initial stages the child protection process was not a truly
multi agency process
12.
That other agencies perceived the Children and Young People Services
workforce to be in constant flux
3
Agenda item 7
The view of the Chief Executive on receipt of this report was that Children and
Young Peoples services was not sustainable in its current form both in Neath Port
Talbot and beyond.
The Trial
The review was given a mandate by CDG to continue to a further phase of trialling
on a small scale the practice model within a specific geographic area. From the
lessons learnt at this stage the trial progressed onto its current form. The Cwrt Sart
School based team has been in operation since the beginning of June
(incorporating the small scale trial stage) and the Sandfields School Based team in
operation since the beginning of September. Lessons that have been learnt from
practice have fed back into practice guidance and this stage of the trial continues
as an iterative process. However important lessons have been learnt in respect of
the set up and organisation of the teams. These lessons are:
1.
The team works more effectively and derives greater benefit for families and
professionals when co located
2.
That the school setting is the right one, being a constant in a child’s life from
five onwards
3.
That co located agencies feel more confident in managing cases they would
have otherwise been referred to Children and Young People Services
4.
That decision making and planning happens much closer to the point of
referral
5.
That capacity is freed up for co located agencies
6.
That capacity is freed up for Social Workers to spend more time on direct
work with families
7.
That dedicated ‘problem solvers’ are needed to get the teams up and
running, for example IT
8.
That there are costs to setting up and running the teams, but these need to
be offset against current cross charging arrangements
9.
That multi disciplinary professionals can work effectively under a single
operational management structure
10.
That integration at the operational level opens up opportunities for
integration at other levels
11.
That business support works more effectively when embedded in the team
4
Agenda item 7
3. Measures
Along with many other new practices the Review Team is trialling the use of
measures as an alternative to Performance Indicators to measure the quality of
services for children and families. Children and Young Peoples Services is a highly
prescribed, regulated and legislated for service. The Performance Indicator
Framework is strictly laid down by the Welsh Assembly Government and used by
the CSSIW, along with other processes, to assess the services performance.
The Performance Indicator Framework is made up of targets and timescales which
predominantly focus on an adherence to process rather than informing about the
quality of service provided. The Systems Review Team have found that
performance targets can distort practice through generating work and lead to the
duplication of assessments of children. In an analysis 64 initial and core
assessments it was found that in 64% of cases the core assessment replicated the
information of the initial assessment.
Another aspect concerns the Integrated Children’s System which has been
designed to collect data to meet the requirements of the Performance Indicator
Framework. The review identified that other types of data would give a better view
on performance, but these were either not ready to hand or not being
systematically recorded. For example, data which tells us whether children and
their families are getting the right help they need and whether a positive difference
is being made to their lives in the long term is more informative than whether a
child is assessed within seven days. This data is now starting to be collected in the
trail but is not readily available through the Integrated Children’s System.
To access data that gives a better understanding of performance a set of
Measures has been developed (See Appendix C). The focus of these Measures is
less about counting frequency, occurrence and quantity of activities, such as
assessment timescales, and more about whether children and their families got the
help they need to thrive and be safe. The measures monitored the direction of
travel of performance for Children’s Services. Hence success would be measured
by a decline in the numbers of children needing to be looked after, a reduction in
children needing a child protection plan, lessening of re-referrals for the same
reason and greater consistency by reducing the number of Social Worker changes
in the management of a case. Timescales will remain, but rather than a one size
fits all approach as reflected in the current set of Performance Indicator, these will
be used to measure what is commensurate and proportionate to each child’s set of
individual needs.
An individual case management tool has also been developed and is being trialled.
These case management measures are a pictorial tool to show progress in a case,
whether it be improvement or deterioration. Starting with a baseline for involvement
based on an assessment, such as neglect, and using a simple 1 to 5 score, each
Social Worker uses evidence to chart a case over time. In this way there is less
possibility for ‘drift’ and indecision in the management of cases.
The review is analysing whether the strategic and case management measures
are providing the right type of information needed to help ensure quality outcomes
5
Agenda item 7
for children and their families. At a future stage the findings will need to be
presented to the Welsh Assembly Government for their consideration, as any
decision to deviate from the Performance Indicator Framework rests there.
4. Model For Roll-In
There has been strong feedback from families and professionals that the multi
agency community based teams as currently being trialled are providing an
effective method of working with new demand. Recently the trial has been stepped
up with more staff and their existing caseloads joining the two trial teams. This will
test the practice model further as it begins to work with open cases where a child is
Looked After, on the child protection register or subject to Court Proceedings.
Once these cases have been worked in the new practice model and staff trained a
more detailed picture as to how future operations will look will emerge, probably
around March 2011. However as has been already been stated community school
based multi agency teams are the proposed direction of travel.
One consequence of the change process is that the current model of operating a
single Referral and Assessment Team will be redundant. The experience to date of
the trial teams is that the main referring agencies (Education, Health and Police)
directly refer into the teams, which reduces the number of workers involved and
the number of times information is taken and quickens intervention and decision
making.
Based on an annual sample of 4098 referrals, 988 (317 from the public) referrals
would still require a Single Point of Contact (SPOC). Over time this figure could
drop as agencies become acquainted with the new system and refer directly into
teams. In addition referrals from the Court (60) and the Probation Service (111)
and information requests by CAFCASS are often made by post and form a small
percentage of value demand, suggesting that the single point of contact could also
act as a redistribution point to the community based teams.
Therefore whilst the majority of referrals will go directly into the community based
teams a SPOC will need to be maintained for the public and low frequency
referring agencies so as to ensure that there is a simple and clear contact point for
reporting concerns about a child. In terms of safeguarding children and young
people in the County anyone who then wishes to make a referral regarding a
child’s safety will be able to do so without any confusion or obstacle.
One of the recommendations is that the Referral and Assessment Team be
disbanded and redeployed into the Family Support Teams in the short term as a
staging point in the development of the new practice model.
Currently within the trial area referral demand is determined on the secondary
school catchment area, whilst in the remainder of the service it is dependant on
home address falling within a particular Family Support Teams footprint. Work is in
progress to ascertain whether the future demand footprint for each team should be
organised as per the trial area or as current practice. Appendix D shows the
relationship between demand and school, this work will be influential in
6
Agenda item 7
determining not just the possible locations of future community teams but also the
demand foot print.
Apart from direct team access the SPOC dedicated telephone number and
address would initially be located in one of the teams, with some additional
capacity built in to manage this. However development of a joint professional hub
with the Police and Health may supersede or blend in with this model.
Discussions with the Police are in progress regarding the development of a
professional ‘hub’ to deal with PPD1’s (police referrals into social services and
health) and relating to community policing links with the community based teams.
The professional hub is a proposal by the Police for the establishment of a team
comprising one Police Officer, a Social Worker from City and County of Swansea
and one from Neath Port Talbot CBC, and a Health Visitor, who would analyse all
incoming PPD1’s and make decisions as to the next course of action. Such
courses of action could include referrals to social services, or the commissioning of
a Team Around the Child (TAC).
In respect of the future development of community teams it is envisaged that there
would be a disability team linked to special schools and units. It is proposed that
these community based teams are now called Community Children’s Teams,
which will be preceded by the school base, for example, Sandfields Community
Children’s Team.
5. Roll-In Process
The roll-in process is complex and dependent on six factors:






establishing and sustaining multi agency buy in
embedding and sustaining the practice model
effecting cultural change amongst the workforce
embedding the measures as a means to effecting change
preventing drift in case management work
tracking performance and problem solving at an organisational level.
It was clear that a range of timescales were required to establish such a significant
change to a new operating model to ensure its long-term success.
Some of the roll-in work has already begun. Within social services, an Operational
Team Managers Group has been established, which has provided the forum to
discuss, plan and implement the ongoing phases of roll-in. Managers and Principal
Officers have begun attending sessions around the learning from systems, new
case file structures and methods of practice to begin to establish the necessary
knowledge and skills to take this work forward.
A critical element of this work is to identify and agree resource needs and costs for
the community teams and cross agency funding agreements. A detailed capital
and revenue costs exercise will be undertaken when the potential locations for the
future teams have been identified.
7
Agenda item 7
An additional element to the effectiveness of the systems review is blending in the
Team Around the Child (TAC) prevention and early intervention model. Building
upon the TAC pilots in Cymmer and Afan Valleys the Education and Lifelong
Learning Directorate is using Welsh Assembly Government funding to build up and
widen the TAC model, which will include the trial teams. This work is being
developed in partnership with respective Head Teachers; the systems review
project leader and the Principal Education Welfare Officer.
A decision has yet to be made on whether a fully integrated service with Education
Welfare and Health Visiting should be established. It is proposed that partners are
requested to agree to the development of a strategy for this, by early in 2011.
6. Data
Whilst quantitative data is being collected it will be at least six months from when
the trial teams went fully operational with new demand and existing cases before
quantitative trends will become apparent. This is because the trial has been going
through a transitional process from a small number of cases to its current position
of ‘rolling in’ a number of open cases. The data then will not be able to show
clearly and reliably the quantitative effect of the trial. Qualitative data points to
strong support for and benefit from the new practice model. (see Appendix H which
refers to a referral comparison) Over the remaining period of the trial the Project
Leader will be focussing on ensuring the integrity of the data, gathering qualitative
data on case recording, service user satisfaction and staff morale and gathering
more cost data for education and health for the economic model.
7. Training needs
It is recognised that NPT has a skills deficit in relation to the new model of working.
This is around early intervention and direct work with children, young people and
their families, the effective use of history in understanding a case, analysis and the
use of planning as a means to understand and measure purposeful involvement in
case management. These deficits do not lie with the Neath Port Talbot workforce
alone and have been recognised more widely through inspection reports, serious
case reviews, enquiries and commissions. As well as there being local training
issues these deficits are also matters that the bodies responsible for social work
qualifying and post qualifying training will need to respond to more generally.
Consideration also needs to be made for newly qualified workers who would not be
able to take and manage referrals, making the necessary decisions, due to a lack
of experience. In line with the Service’s draft 1st Year in Practice Model, this could
be amended to incorporate the new model of working and develop a process to
enable joint working and mentors for staff to develop the necessary skills from the
outset of their employment with the Local Authority.
Consultation has taken place with the Authority’s training department and there is
agreement that to roll-in a large number of staff into a new way of working at the
same time would dilute the practice model and endanger its sustainability. This
8
Agenda item 7
would mean a high risk of the practice model reverting back to existing practice
and undermine the implementation of the new model.
It is envisaged that small cohorts of managers and workers would move through
the training process to have the training and guidance needed to practice in the
new model of working.
The training programme will consist of:
1.
2.
3.
4.
5.
6.
7.
8.
Induction
Awareness of the practice model and supporting guidance (this covers
assessment, recording, planning, and monitoring)
Awareness of leading and individual measures
Awareness of case consultation and supervision
Awareness of systems methodology
Mentoring through practicing in the new model for practice
Developing an individual training plan for supervision
Children and Young People System- IT Training
In addition the usual core competency training for social workers will be provided.
Once a group of staff has completed their training another cohort would then
proceed with their training.
The current staff who have been part of the systems team are still part of the wider
workforce in Children’s Services. These staff are well versed in this model of
practice and are able to provide additional support within the Authority during the
phased roll-in of this programme.
8. Business Support Needs
It has been apparent from the learning so far from the systems review that having
business support staff located in the teams has evidenced a significant benefit to
the service provided to children, young people and their families. In addition
business support staff are reporting that they feel valued as members of the team,
have a good knowledge of what is gong on in the team and they feel that this
provides a better service to staff and families.
The trial has identified a role for Business Support that demands a high and
generic skill level in supporting team operations, multi agency panel meetings and
the team manager. As has been identified for the Social Work staff the skill set
needed from Business Services will require training to carry out a wider range of
tasks.
Administrative staff will continue to be line managed by Business Support
Managers. Business Support Managers primary responsibilities will be to ensure
staffing resources are distributed effectively throughout Children’s Services,
administrative staff are working consistently between Teams and staff are
appropriately trained and working to the required standard. However, on a day-today basis, Social Work Team Managers will determine the prioritisation of their
respective administrative staff’s workload.
9
Agenda item 7
9. HR Implications
A change management consultation phase has already been completed with the
Fairways Family Intervention Team and will commence with the Referral and
Assessment Team in January 2011. Although the new model does not change the
job roles within the service it is envisaged that some changes to locality bases will
be made. The change management work has been completed with advice and
support from Human Resources and unions.
An issue for consideration in the future will be around integrated teams and the
potential management of workers from a number of professional backgrounds, for
example, health visitors and education welfare officers. This would include issues
such as, day-to-day management, professional development and training which
will all need to be considered in order to establish a workforce from a multiprofessional background.
10. Management
Children and Young People Services, Principal Officers have taken over the
responsibility of the operational elements of this work from the 3rd January 2011.
Completion of the project overview will still remain with the current project leader
until the end of February 2011 at which point one of the Children and Young
People Services Principal Officers will take over this responsibility. Additionally the
current team manager will end their work on this project at the end of January 2011
and an alternative Team Manager from within the current service is now being
introduced to the Team to replace this role.
11. Supervised Contact options
As part of this work consideration has been given to the amount of supervision of
contact work undertaken in the Local Authority. This involves unqualified workers
supervising contact between looked after children and family members. The
analysis below evidences a high proportion of the working week is spent on
supervised contact sessions by staff from frontline teams.
The information below details the number of hours of supervised contact
undertaken weekly, fortnightly, monthly and during school holidays. Supervised
contact time for the teams does not include time for case recording which should
be added to this calculation. The following hours of supervised contact are spent
by each team on an annual basis:
TEAM
FST 1
FST 2
FST 3
CCDT
Total
HOURS
5,820
2,946
3,185
710 (plus additional holiday contact)
12,661 hours
10
Agenda item 7
Travelling time to and from contact increases the time taken to provide contact, for
example:
FST3
Total hours of contact per week
Total hours of transporting per week
61.25 hours
47.25 hours
Currently there are the equivalent of 15 Practice Support Worker’s working within
the operational teams who also undertake other duties within their teams. In
addition these staff have case responsibility for Children in Need cases.
Based on the information above there does not appear to be sufficient value in
changing these roles. However, should the new way of working impact upon a
reduced looked after population, then demand for contact will reduce.
During the initial phase of roll-in the Fairways Family Intervention Team (FFIT)
were disbanded on a trial basis. The Deputy Manager moved across to the
Systems Review Team along with 3 support workers. An additional vacant post
was also moved to the Systems Review Team, which was taken up by the Senior
Support Worker from FFIT. Three other workers and a vacant post were moved to
Action for Children as support workers. This gave the opportunity to consider
whether services needed to be provided directly by the Local Authority or whether
they could be provided effectively via partner agencies.
The team manager post originally in FFIT has been moved across to manage the
contact centre in Pendarvis as part of the pilot changes to the service provision.
This follows the outcome of one of the work streams of the Review of Family
Support Services where a decision was made to bring the service in house. This
move has been successful with Pendarvis now undertaking 70% more contacts per
week than when the service was outsourced. However the level of activity requires
co-ordination and a presence at the centre and therefore the need has been
identified to establish this post. This post is currently being job evaluated. It is
planned that this will become part of the establishment for the service in the future
as the trial period has been successful. In addition a significant number of contact
sessions take place in the community facilitated by workers from Family Support
and Disability Teams. See structure charts at appendix E and F.
12. Risk Analysis
There are number of potential risks in undertaking this work, for example, the
current regulatory framework from CSSIW and moving the teams into community
bases. (See Appendix H)
13. Time line for project
The proposed time line for the continued roll in of this model is outlined in appendix
G. The success of this roll in relies on a number of factors detailed in the time line.
This timeline provides the main tasks but does not include the specific details of
each task within this project.
11
Agenda item 7
14. Future needs








Review of R16
Tasks listed at Appendix H
The data regarding the distribution of demand across the local authority will
inform the next steps regarding school bases including the Childcare
Disability Team
Continue with HR management of change processes
The extent of education and health integration needs to be agreed
Seek agreement with WAG to relax a range of PIs in favour of the outcome
measures developed through the course of the review
Review and monitor the economic model
Publicise across Welsh Children’s Services departments and WAG, the new
recording and outcome measurement processes and seek national
consistency
15. Conclusion
The review has made significant progress in trialling and redesigning a model of
service delivery and intervention. The review strongly concludes that the next
phase of roll-in will be better achieved through a phased approach with an
aspiration of achieving the full model by September, 2011.
Whilst the main phase of the review has drawn to a conclusion there are still a
significant amount of work streams to complete as indicated in point 14, and
therefore it is proposed that the local authority maintains this as a Tier One
Programme, managed through a Programme Board until the new style of service is
fully achieved and embedded.
16. Recommendations ‐ It is recommended that the local authority maintains this review as a Tier One Programme, managed through a Programme Board until a new governance arrangement is produced through the course of the roll‐in process. ‐ It is recommended that three more Community Childrens Teams are established in the areas of greatest need, across the authority. One of these
additional three teams will have a disability focus.
12
Appendix A CASE MANAGEMENT FLOW
(Throughout Multi Agency Planning Meetings (including Case Conferences/Core
Groups/LAC Reviews)
will be called in line with current guidance)
You
Resolve/Work
Demand
Consultation
Information
Gathering &
Sharing
(Understand
nominal
value
Who
works
?
We Work
No
Measures
1st
Assessment
Do we
need to
protect
1st Plan
Provide
Service
We Work
Together
Achieve
Outcome
End
Activity
Chang
e is
needed
Yes
Strategy
Discussion
Make Child
Safe in
Home
Remove
Child to
place of
Safety
13
Appendix B CURRENT ASSESSMENT AND CARE MANAGEMENT FLOW
No further
action
Closed
Contact
Child in
Need
Referral and
Assessment
Team
Demand
More than
3 months
Demand
Childcare
Disability
Team
Child
Protectio
n
Core
Group
meetings
Strategy
discussion
meeting
Referral
Less than
3 months
Initial
Assessme
nt
Referr
al
3x Family
support
teams
Initial
Case
Conferenc
e
Review
case
conferenc
Core
assessme
nt
14
Appendix C
CHILDREN’S SERVICES SYSTEM REVIEW TEAM
LEADING AND SUCCESS MEASURES AND BASELINE INFORMATION
24th December 2010
Measure
Leading Measures
Definition
Children and Young Peoples
Services
Do children, young people and Measure will be recorded at the
their families receive the help end of activity and/or at review, via
they need?
a 1 – 10 scale, scored by both the
child/young person/family and the
Social Worker.
Do children, young people and
their families receive the help
they need within the planned
timescales.
Baseline Information
Comments
Mean score of 5.6 based on Information derived from all
sample of 14 cases open to the case closures and/or reviews
SRT, but reflecting back on “old” within the chosen month.
world experience.
The variation between date activity Baseline information not available On a case/caseload basis Measure will be reported in a
planned to be provided and the in this form, pre-trial phase.
capability chart.
date activity started to be
provided.
On an organizational basis –
Measure will be reported
monthly, as an average,
delay in receipt of service
(within a capability chart).
15
Appendix C
Leading Measures
Measure
Definition
Baseline Information
Comments
The number of changes of Social Total number of times there are Baseline data to be recorded by Report as a continuing cap
Workers in managing a case
changes of social worker case trial Area (both “old” and “new” chart.
managing each case during the world).
relevant period*
CWRT SART
* Period for Reporting
470 cases open during the period
255 changes of SW
Cwrt Sart 1st June – 28th Feb.
Average (255/470) = 0.54
Sandfields 1st Sep – 28th Feb
The duration of accommodation
episodes and whether this varies
from the current plan.
How often do we accommodate
children when it is not preplanned
Where appropriate, how soon
does a child have a permanency
plan in place after becoming
accommodated?
SANDFIELDS
262 cases open during the period
101 changes of SW
Average (101/262) = 0.39
The
duration
and
variation Baseline information not available Report as a continuing cap
chart.
between the planned looked after in this form, pre-trial phase.
timescale and the actual looked
after timescale (excluding children
who receive respite care).
Those children accommodated Information
not
automatically Report as a continuing cap
where a looked after episode was captured on ICS, therefore chart.
not documented in the plan, prior concerns with regards to data
episode start date.
integrity of baseline data.
not
automatically Report as a continuing cap
Permanent arrangements = Where Information
the child’s long term care captured on ICS, therefore chart.
arrangements have been agreed. concerns with regards to data
Time from child becoming looked integrity of baseline data.
after to the point of agreement.
16
Appendix C
Measure
Success Measures
Definition
Percentage
of
Children Total number of referrals received
becoming Looked After
during the relevant period* (leading
to an assessment), where children
have subsequently become Looked
After during the relevant period*
* Period for Reporting
Cwrt Sart 1st June – 28th Feb.
Baseline Information
Comments
Baseline data to be recorded by .
trial Area (both “old” and “new”
world).
Cwrt Sart
178 Referrals leading to 21
Looked
After
Children.
Percentage of Children becoming
Looked After = 11.80%
Sandfields 1st Sep – 28th Feb
Sandfields
58 Referrals leading to 3 Looked
After Children.
Percentage of
Children becoming Looked After =
5.17%
How
many
episodes
of The number of times a child is
accommodation
a
child looked after for, with the exception
of those children who receive
experiences.
respite care, during 12 months.
Baseline data relating to the trial LAC Register to provide
against
this
period in both areas is insufficient. information
Additional Baseline data to be measure.
gathered
displaying
12mths
activity.
Consequently, for
comparison purposes with SRT
cases, data won’t be available
until late 2011.
17
Appendix C
Success Measures
Measure
Definition
How many changes of placement Definition to be clarified SRT
a child experiences during a
single episode of care.
Baseline Information
Baseline data relating to the trial
period in both areas is insufficient.
Additional Baseline data to be
gathered
displaying
12mths
activity.
Consequently, for
comparison purposes with SRT
cases, data won’t be available
until late 2011.
Numbers of Re-Referrals (for the Definition to be clarified by SRT
same
reason
as
previous
referral).
Baseline information to follow,
upon clarification of definition.
Numbers
of
Re-Referrals Definition to be clarified by SRT
(regardless of reason).
Baseline information to follow,
upon clarification of definition.
Percentage of value demands Compare ‘Check’ data with Sep to 70% preventable and 30% Value
based 4,809 phone calls over a 9
received (“New World” only) Feb 10/11.
week period and 862 postal
compared
to
preventable
demands over a 5 week period,
demand within Children and
(between 11th Nov 2009 to 5th Feb
Young People Services.
2010).
Comments
Information to be recorded
within
System
Review
Teams (SRT) on a ‘Demand
Sheet’. SRT to forward to
CCPMT on a monthly basis.
18
Appendix C
Measure
Percentage of Children being
recorded on the Child Protection
Register or having a Child
Protection Plan.
Success Measures
Definition
Total number of referrals on
individual children received during
the relevant period* (leading to an
assessment), where children have
subsequently become recorded on
the Child Protection Register during
the relevant period*
* Period for Reporting
Cwrt Sart 1st June – 28th Feb.
Baseline Information
Baseline data to be recorded by
trial Area (both “old” and “new”
world).
Comments
Cwrt Sart
178 Referrals leading to 19
Children being entered onto the
Child
Protection
Register.
Percentage of Children entered on
the Child Protection Register =
10.67%
Sandfields 1st Sep – 28th Feb
Sandfields
58 Referrals leading to 11
Children being entered onto the
Child
Protection
Register.
Percentage of Children entered on
the Child Protection Register =
18.97%
How frequently are we seeing Measure to capture how frequently Baseline data based on ‘check’
children we are working with.
we are seeing children who are data sample of 12 CYPS cases. A
active cases (LAC, CP and CiN). To mean of 1.7 visits with UCL of 4.8
be reported as the average times a
child has been seen per month.
19
Appendix C
Success Measures
Measure
Definition
Of those invited to Multi-agency By System Review Team Area,
planning meetings, the numbers comparing “general” baseline data
with new world data between the
who attended
following dates:
Cwrt Sart:
1st Jun 2010 – 28th Feb 2011.
Sandfields:
1st Sep 2010 - 28th Feb 2011.
Education
Learning
and
Life
Baseline Information
The check data is based on a
sample of 50 CYPS cases. Out of
all agencies invited to Initial CP
conferences 56% did not attend
44% did.
Review CP Conferences 64% did
not attend 36% did.
Therefore there is no ‘like for like’
baseline data for this measure.
Comments
Baseline
Information
available from check phase,
detailing general details i.e.
Borough wide and over a
sample period.
Form to be created by
CCPMT and completed by
SRT.
Information to be
entered onto a spreadsheet.
Long
Has whole school attendance
improved
since
September
2009?
Has the number of days lost
through fixed term or permanent
exclusions
decreased
since
September 2009?
The measure will capture whether Cwrt Sart: 92.23% (09/10)
school attendance is increasing by Sandfields:90.50% (09/10)
tracking data over time
As above
Cwrt Sart: 237.5 Fixed (09/10)
Sandfields: 254.5 Fixed (09/10)
Have the number of fixed term As above
and
permanent
exclusions
decreased
since
September
2009?
The data will be presented
as a cap chart
The data will be presented
as a cap chart
Cwrt Sart: 74 Fixed/ 2 Perm The data will be presented
(09/10)
as a cap chart
Sandfields: 114 Fixed/ 1 Perm
(09/10)
20
Appendix D
Referrals that go to Initial Assessment
(November 2009 - October 2010)
Wards where referrals have originated have been approximated to secondary school catchment areas.
It should be noted that, particularly in Port Talbot, some areas may overlap, e.g. Dyffryn / Glanafan.
Schools providing a service to the whole authority, e.g. YG Ystalyfera and St Joseph's have been excluded
from the chart.
Sandfields, 105, 12%
Cefn Saeson, 41, 5%
Cwmtawe, 86, 10%
Llangatwg, 108, 13%
Cwrt Sart, 156, 19%
Glan Afan, 107, 13%
Cymmer Afan, 43, 5%
Dyffryn, 126, 15%
Dwr-y-Felin, 70, 8%
21
Appendix E Children and Young People Services Structure Chart (Current) Head of Service PO Looked After Children and Family Support PO First Response and Disability RAAT FST 1 FST 2 FST 3 CCDT EDT
PO Fostering, Adoption and Route 16 PO Safeguarding FFIT
IRO Team Fostering Adoption
Manager Hillside YOT
Route 16 SCB Manager 22
Appendix F Children and Young People Services Structure Chart (Proposed) Head of Service PO Case Management Operations PO Case Management and Strategic CONTACT CENTRE CCDT CCT
CCT
CCT CCT
EDT
PO Fostering, Adoption and Route 16 PO Safeguarding Strategy and Policy IRO Team Fostering SCB Manager Adoption
Manager Hillside YOT
Route 16 Key: Proposed changes CCT‐ Community Children’s Teams 23
Appendix G Task Commence 30 day consultation to disband RAAT Staff training with new model (see detail below) Set‐up operations Obtain sign‐up from partner agencies e.g. health Establish joint recording protocol Establish Police hub Set up and Implement TAC for nominated areas January February xxxxxxxxxxxx xxxxxxxxxx September xxxxxxxxxxxx xxxxxxxxxxx xxxxxxxxxx xxxxxxxxx xxxxxxxxxx xxxxxxxxxx xxxxxxxxxx xxxxxxxxxxx xxxxxxxxxxx xxxxxxxxxxx xxxxxxxxxx xxxxxxxxxx xxxxxxxxxxx xxxxxxxxxxx Implement TAC across NPT xxxxxxxxxxx xxxxxxxxxxx xxxxxxxxxxx
Agree management/ budget structure with health and education (initial) xxxxxxxxxxx xxxxxxxxxxx xxxxxxxxxxx
xxxxxxxxxxx
Consultation and awareness raising LSCB, CYPP, 3rd sector and other agencies Publicise referral arrangements March April May June July xxxxxxxxxxx xxxxxxxxxxx xxxxxxxxxxx xxxxxxxxxxx
August xxxxxxxxxxx xxxxxxxxxxx xxxxxxxxxxx xxxxxxxxxxx xxxxxxxxxxx xxxxxxxxxxx xxxxxxxxxxx xxxxxxxxxxx xxxxxxxxxxx xxxxxxxxxxx xxxxxxxxxxx xxxxxxxxxxx 24
Appendix H System Review Team - Comparative Referrals (Leading to "Work") Old World vs New World
"Old World" - Cwrt Sart
(01 Jun 09 –
10 Dec 09)
Briton Ferry
East
Briton Ferry
West
Neath East
Neath South
TOTAL
"New World" - Cwrt Sart
Referrals
That Go To
Initial
Assessment
(01 Jun 10 –
10 Dec 10)
Old World
Grand Total
Total
By
Ward
11
Briton Ferry East
9
2
10
21
36
63
32
142
Briton Ferry West
Neath East
Neath South
TOTAL
5
10
0
24
2
7
2
13
9
17
12
48
16
34
14
85
Referrals
That Go To
Initial
Referrals
Referrals
That Go To Awaiting Assessment
Assessment Outcome (Old World)
8
7
1
Total
By
Ward
16
"Old World" - Sandfields
(01 Sep 09 –
10 Dec 09)
Sandfields East
Sandfields
West
TOTAL
Referrals
That Go To
Initial
Referrals
Referrals
That Go To Awaiting Assessment
Assessment Outcome (Old World)
"New World" - Sandfields
Referrals
That Go To
Initial
Assessment
16
(01 Sep 10 –
10 Dec 10)
Sandfields East
13
29
Sandfields West
TOTAL
171 *
New World
Grand Total
7
15
6
13
5
6
18
34
119
* Due to changes in the Referral process during 2010 i.e. the use of RAAT Duty to gather further information
prior to Initial Assessment - the service has experienced a reduction of Referrals that go to Initial
Assessment, equating to 41.36% - Consequently if you apply this percentage drop to the SRT Wards, the
estimated number of Referrals that would have gone to Initial Assessment during 1st Jun - 10th Dec 2010
(Cwrt Sart) & 1st Sep - 10th Dec 2010 (Sandfields), would be as follows:
Projected 2010 Referrals
Leading to I.A. (based on
reductions experienced due
to change in practice within
RAAT)*
Old World
Grand Total
171
Less 41.36%
Deduction
71
Estimated Total
Referrals
100
25
Appendix I Risk Analysis
ISSUE
Roll-in occurs too
quickly (4)
Moving into community
based offices
Regulatory frameworkCSSIW
Data integrity analysis
Economic Model
RISK
Dilution of new model of
working which results in
reverting to old way of
working
LEVEL
High
RESOLUTION
Ensure a managed
programme of roll-in is
implemented
Ineffective roll-in to
managers
Increased costs to the
LA related to rental,
heating, lighting,
computers, telephones,
printers etc.
Maintenance of current
regulatory framework
No capacity to complete
this task
High
As above
High
Establish costs and seek to
address any potential cost
increases
High
The anticipated
reductions in children
looked after by the local
authority and cases
requiring court
proceedings, and hence
the increase in capacity
and reductions in
budgets are not realised
High
Liaise with WAG in relation to
Outcome Measures
Release capacity via
additional staffing mid
January 2011
Ensuing sufficient and
effective cross agency
operation of the practice
model
High
26
Agenda item 8
NEATH PORT TALBOT LOCAL SERVICE BOARD
14TH MARCH 2011
NEIGHBOURHOOD MANAGEMENT
The attached draft report will be presented to elected members shortly. It
describes the progress made to date in developing and implementing a Neath
Port Talbot neighbourhood management model and is presented for information
and comment.
PSG
4th March 2011
Agenda item 8
1
THE DEVELOPMENT OF A NEIGHBOURHOOD
MANAGEMENT MODEL FOR NEATH PORT TALBOT
Purpose of the Report
1.1
To describe work undertaken to date to develop a neighbourhood
management model for Neath Port Talbot and to seek endorsement for
the way forward.
Background to the Report
1.2
Just over a year ago the Chief Executive asked the Head of Corporate
Strategy and the Community Safety & Youth Offending Strategic
Manager to research neighbourhood management models and to develop
a proposal for the introduction of such a model in Neath Port Talbot. At
that time grant funding was available from the Home Office for
Community Safety Partnerships to introduce neighbourhood
management. The Safer Neath Port Talbot partnership submitted an
application which proved unsuccessful.
1.3
The Community Safety & Youth Offending Strategic Manager and the
Local Service Board Research and Development Officer undertook some
desktop research into neighbourhood management pilot schemes that had
been introduced in England and Cardiff Council’s recently introduced
neighbourhood management model. The outcomes from this research
were reported to the Local Service Board which endorsed a proposal to
hold a partnership workshop to examine the potential benefits of the
introduction of neighbourhood management in Neath Port Talbot.
1.4
The workshop was held in late July 2010 and was well attended by a
range of partner organisations and Council services – at senior
management and front-line levels. As this work had commenced from a
community safety perspective, the initial focus for the workshop was on
crime and disorder, anti-social behaviour, local environmental issues and
the quality of life of a neighbourhood. The first workshop session – “If it
ain’t broke, don’t fix it” – examined whether a neighbourhood
management model was needed in Neath Port Talbot, whilst the second
session examined how partners, working collaboratively at the front-line,
could improve neighbourhoods.
1
Agenda item 8
1.5
The workshop concluded that Neath Port Talbot would benefit from
introducing a neighbourhood management model; that any model would
have to be “fit for purpose” for Neath Port Talbot rather than copied from
elsewhere; that any model would have to embrace all services that
operate in our local communities and neighbourhoods, including health
and social services, voluntary services, education and youth services as
well as local environmental services; and that effective community
engagement would be a key success criterion for the model.
1.6
Following the workshop, and in conjunction with the system review work
being undertaken by Streetcare Services, representatives from the South
Wales Police and Mid & West Wales Fire and Rescue Service joined a
Streetcare Operational Group that is redesigning the delivery of its
neighbourhood services. This has begun to examine ways in which local
neighbourhood environmental problems can be tackled more effectively
and collaboratively.
1.7
The outcomes from the workshop were reported to the Local Service
Board last November and the Board endorsed further developmental
work on the model.
Other Influences on the Model
1.8
The Council and its partners are working through a significant period of
change. There are a number of transformation projects being worked on
that address the issues of improved service delivery and better
collaborative working between partners at the front-line and all of these
have the potential to impact on and influence the development of a
neighbourhood management model. Public service delivery models are
changing, and will continue to change, over the medium term. These new
models could remain single agency services or become multi-agency
services or fully integrated services. Those that are considered to most
influence any neighbourhood management model are mentioned below.
1.9
The Children’s Services System Review is moving forward apace. A
new model of integrated children and family services is being piloted in
two comprehensive schools – Cwrt Sart and Sandfields – based around
their catchment areas and feeder primary schools. The integrated team
includes social workers, education welfare officers, health visitors and
police officers. It is hoped that the model will be rolled out across Neath
Port Talbot by September.
2
Agenda item 8
1.10 The TOPS programme is about transforming services for older people,
ranging from residential and nursing care to home care to intermediate
care to preventative services. Local collaborative or fully integrated
health and social care services for older people, alongside accessible
preventative services, are key features in the TOPS programme.
1.11 The Council’s community engagement mechanisms are well developed
and diverse. However, apart from perhaps Communities First areas,
community engagement is not designed on a locality or neighbourhood
basis. The Police have their Partnerships and Communities Together
(PACT) arrangements which provide an opportunity for more effective
local engagement. The Policy and Resources Committee in its role as the
Crime and Disorder Scrutiny Committee has decide that its first scrutiny
topic will be the Safer Neath Port Talbot Partnership’s community
engagement activities, including PACT arrangements. This scrutiny
review presents an opportunity to consider community engagement from
a neighbourhood management perspective.
Important Success (and Failure) Criteria
1.12 A successful neighbourhood management model for Neath Port Talbot
will have to incorporate the following key elements:

An organic approach to neighbourhood boundaries. Not all services
will “fit” the same geographic boundary. The important issue is to
have effective collaborative front-line working. The model will need
“fuzzy” boundaries. Work has already begun to map local service
delivery boundaries and it is already clear that services are organised
spatially according to the nature of the service and the resources
available to deliver the service. Services must not be “shoe-horned”
into neighbourhood management areas unless it is beneficial to do so.

Good communication between front-line staff and teams; between the
front-line and management; and, between managers.

Effective community engagement on a face-to-face basis backed up by
good provision of information to local residents and communities.

Having a clear understanding of the role of local elected Members in
community engagement and the value of that role; and the importance
of keeping local elected Members informed about what is happening
in their communities.
3
Agenda item 8

An intelligence-led, “tasking” approach to solving problems. This is
the approach adopted by the Safer Neath Port Talbot Partnership in
tackling local issues and the approach being developed by the
Children’s Services System Review in piloting the new integrated
Children’s Services teams. This is about ensuring that all relevant
services contribute to a holistic solution to the problem.

The availability of data and information about neighbourhoods to
inform effective neighbourhood management and service delivery. A
performance management framework that includes only a few key
measures to enable performance to be assessed to help improve
service delivery.

The ability to share data and information confidentially, securely and
with confidence. This should not be a problem given the range of
information sharing protocols that are in place but in practice there
remains a reluctance to share personal information.

A senior manager, at Head of Service level or equivalent, to take
responsibility for a specific neighbourhood, acting as a trouble-shooter
and a resource to the front-line to remove any barriers to effective
collaborative working.
1.13 There are also factors that would act against effective neighbourhood
management in Neath Port Talbot and these must be avoided.

A rigid geographical model designed from the top down. The model
must be able to accommodate a range of services that may be
organised along different boundaries.

A bureaucratic structure that is dependent on creating a plethora of
working groups which meet on a regular basis. The important
interaction is at the front-line with staff meeting to analyse issues and
problems to develop and deliver solutions.

A resource-intensive data and management information system.
4
Agenda item 8
Conclusion
1.14 A Neath Port Talbot neighbourhood management model must take
account of the current work being done in re-designing services and
developing collaborative and integrated service models. It also has to be
clear about community engagement; its importance and how it is done. It
needs to define the role of the elected Member.
1.15 If the model is to be “fit for purpose”, resilient and future-proofed, it must
be an organic model, able to adapt with ease to reflect changing
circumstances. It cannot be designed with rigid boundaries and it cannot
be weighed down by bureaucratic structures and complicated data and
information systems.
1.16 The Council and its partners face difficult budgets over the coming years.
The model has to be designed and introduced in a way that doesn’t add
cost to the system and, more importantly, enables the Council and its
partners to maximise the impact of the resources spent on delivering
services to our local communities.
1.17 The model is in effect already being implemented through the current
work described above in Streetcare Services, Children’s Services and the
TOPS programme. The ongoing work to map local service delivery will
inform the ongoing development of the model and the proposed scrutiny
review of community engagement will help to build effective community
engagement into the model. The Heads of Service leading the above
work will track progress regularly ensuring that neighbourhood
management considerations are taken into account as services are
redesigned and building up the neighbourhood management model.
1.18 A progress report will be presented in four to six months time.
Recommendation
1.19 That the work to date on developing and implementing a Neath Port
Talbot neighbourhood management model is endorsed and that a progress
report is presented in four to six months time.
5
Agenda item 8
Reasons for Proposed Decision:
To enable the development of a neighbourhood management model for
Neath Port Talbot to continue.
List of Background Papers:
Research report
Workshop report
Local Service Board reports
Wards Affected:
All
Officer Contact:
Philip Graham, Head of Corporate Strategy
01639 763171; [email protected]
6
Agenda item 9
NEATH PORT TALBOT LOCAL SERVICE BOARD COMPACT
Preamble (inside front cover)
(List of organisations represented on the Local Service Board)
This is the first Partnership Agreement or Compact between all partner
organisations represented on the Neath Port Talbot Local Service Board. The
Local Service Board is Neath Port Talbot’s prime partnership body comprising
representatives from public, voluntary and private sector organisations who,
individually and collectively, are committed to delivering high quality, cost
effective public services and improving the quality of life for Neath Port
Talbot’s citizens and communities.
The Compact is available on Neath Port Talbot County Borough Council’s
website at www.npt.gov.uk. If you require a hard copy or a large print, Braille,
tape or disc version, please contact the Council’s Corporate Strategy Team on
01639 763173 or at [email protected].
Introduction
Statement of Partnership
This Compact represents a commitment to partnership working by all
organisations represented on the Neath Port Talbot Local Service Board. The
Compact reflects their shared vision for Neath Port Talbot as set out in the
Community Plan. It recognises the wide range of differing skills, experience
and abilities that each partner brings to the table, all of which make important
and valuable contributions to the quality of life of local residents and
communities in Neath Port Talbot. It is built on the principles of integrity, trust,
openness and mutual respect.
The Compact is also founded on a shared interest in building a fair and just
society where there is equality of opportunity for individuals to reach their full
potential, playing a full role in the life of their communities. It also
encompasses the expectation that individuals also have a responsibility to
maintain and enhance the quality of life of their community.
The Compact provides the opportunity for partners, whether from the public,
voluntary or private sectors, to work together to develop and implement policy;
to agree and take forward strategic programmes; and, to collaborate intensely to
improve public services whether delivered on a single or multi-agency basis or
through the creation of fully integrated services.
LSB Compact – Second Draft
1
Agenda item 9
An effective Compact will result in shared principles; better and more effective
relationships; greater transparency and inclusiveness; and, respect for the value
all partners add to the quality of life of local residents and communities. This
will lead to cultural change at all levels in partner organisations, embracing a
commitment to building a better quality of life and improving public services
through effective collaboration.
Finally, a successful Compact will embrace the principle of engaging service
users, citizens and communities in the planning and delivery of public services
and in influencing the wider determinants of an improving quality of life.
Shared Principles
The Compact is based on the following underlying principles and values:

Equal rights and responsibilities for all partners, based on integrity, trust,
openness and mutual respect and a shared vision for Neath Port Talbot;

Individual and collective accountability and openness to scrutiny;

Effective engagement, communication and collaboration between partners
from all sectors and at all levels within partner organisations;

Recognition of the crucial role played by an independent and diverse
voluntary sector in improving community well-being and quality of life,
and in facilitating effective engagement with service users, citizens and
communities;

Commitment to equality of opportunity for all citizens;

Commitment to:
 Meeting all requirements under equality legislation (specific duties);
 Eliminating unlawful discrimination, harassment and victimisation;
 Advancing equality of opportunity between different groups; and,
 Fostering good relations between different groups;
 These different groups are defined by:









Race
Age
Disability
Sex
Religion or belief
Marriage and civil partnership
Pregnancy and maternity
Gender reassignment
Sexual orientation
LSB Compact – Second Draft
2
Agenda item 9

Belief in a fair and just society with a commitment to tackle all aspects of
social exclusion;

Commitment to sustainable development principles;

An understanding of the differing characteristics of the people and
communities of Neath Port Talbot, celebrating diversity and working to
promote mutual understanding and respect;

Commitment to effective engagement with citizens and communities to
understand their needs and aspirations and to influence service planning and
delivery; and,

Actions that reflect and are responsive to the views expressed by local
citizens and communities.
Consultation and Engagement
The Local Service Board will build on earlier work undertaken to improve
consultation and engagement with service users, citizens and communities
through the further development of the Talking NPT website. Partners are
committed to sharing opportunities to minimise costs and maximise outcomes to
gain a better understanding of the needs and aspirations of individuals and
communities, which do not always conform to partners’ organisational and
service structures.
Resources
All partners are committed to maximising the resources flowing into Neath Port
Talbot from all sources. All relevant funding opportunities will be pursued with
secured resources being used effectively to achieve quality outcomes for service
users and residents.
Statutory sector funding for the voluntary and community sector will be based
on the principles set out in the Welsh Assembly Government’s code of practice.
Individual statutory partners are encouraged to develop and agree a funding
code of practice with the sector, based on these principles.
Volunteering
The Local Service Board recognise, and celebrate, the important role played by
volunteers in their communities and their commitment to making a significant
contribution to community well-being and improved public service delivery.
Volunteers help to develop, deliver and sustain many local projects, initiatives
and services. The Compact will support, develop and promote volunteering
whilst acknowledging volunteers themselves need to be sustained through
effective support mechanisms.
LSB Compact – Second Draft
3
Agenda item 9
Workforce Development
All partners are committed to developing their workforce for the future,
supporting employees with training and development opportunities to help them
meet future challenges. When accumulated the resources partners dedicate to
training and development are significant. The Local Service Board is keen to
maximise the impact of these resources and will encourage shared training
programmes and opportunities particularly collaborative or integrated services
are being developed. Whilst this happens already in some areas, more will be
done.
Monitoring, Evaluation and Review
This Compact is designed to build on existing good practice, seeking
consistency in the way partners work together. It will be constantly developing
and changing; any written version is embedded at a particular point in time.
Developments in the areas highlighted above will be monitored and reported
back to the Local Service Board annually. If as a result, amendments or
additions to the Compact are required, a formal review will be undertaken and
the Board will be asked to agree a revised version. In general, it is anticipated
that reviews will take place every three years.
Signed on behalf of individual partners as follows:
Cllr Ali Thomas
Leader
Neath Port Talbot County Borough Council
_______________________
Mr Steven Phillips
Chief Executive
Neath Port Talbot County Borough Council
_______________________
Mrs Margaret Thorne
Chairperson
Neath Port Talbot Council for Voluntary Service
_______________________
Mrs Gaynor Richards
Director
Neath Port Talbot Council for Voluntary Service
_______________________
Mrs Hilary Dover
Locality Director
Abertawe Bro Morgannwg University Health Board
_______________________
LSB Compact – Second Draft
4
Agenda item 9
Mrs Annie Delahunty
_______________________
Public Health Wales
Chief Superintendent Mark Mathias
Divisional Commander
South Wales Police, Western Division
_______________________
Mr Ken Wall
County Commander
Mid and West Wales Fire and Rescue Service
_______________________
Mrs Mary Youell
_______________________
Environment Agency Wales
Mrs Pam Sutton
_______________________
Jobcentre Plus
Mr Julian Smith
_______________________
West Wales Chamber of Commerce
Cllr Arthur Davies
_______________________
Town and Community Councils
Mr David Richards
_______________________
Welsh Assembly Government
Dated this
day of
LSB Compact – Second Draft
2011
5
Agenda item 10
NEATH PORT TALBOT LOCAL SERVICE BOARD
14TH MARCH 2011
COMMUNITY SPIRIT
Following the last Local Service Board meeting, I wrote to all partners seeking
decisions on whether they wished to commit to Community Spirit for a further
twelve month period and, if so, the level of financial contribution they would be
able to make.
Having received replies from all partners it is clear that there is insufficient
finance to continue with the publication. The current March 2011 edition will
be the last one.
PSG
4th March 2011
Agenda item 11
LSB European Social Fund (ESF) Communities First
1. As noted in the last Local Service Board (LSB) meeting held in January,
we have received confirmation from the Welsh Assembly Government
(WAG) that the bid for European Social Funding (which covers all LSBs in
the Convergence Area) has been successful. This came into effect on 1st
January 2011 and will last until March 2015.
2. To reiterate from the last LSB meeting, there are two strands of funding
that we may bid against. The first is the core funding pot which will fund
the LSB Development Officer Post.
3. The second strand is for projects. Each LSB is eligible for funding up to a
total of £100K per year of the lifespan of a project. This £100K is made up
of £50K from WAG, which is match funded with £50K from the LSB ESF.
We have submitted two bids against this money for two LSB projects: the
Air Alert System to warn people who are potentially vulnerable to poor air
quality; and the bid to create shared capacity and capability for the LSB to
accelerate the transformation of local services.
4. A third LSB ESF funding strand has now been offered by WAG. This
strand is specifically for projects involving the Communities First
Partnerships, and is targeted towards projects that support and enable the
development of stronger links between the Communities First Partnerships
and the LSBs. Proposals relating to Communities First Partnerships
should demonstrate completion of the initial project within 12 months, so
for the period 2011 – 2012.
5. WAG have informed us of the eligibility criteria for LSB ESF funding, which
are listed below:
i. Applicants seeking grant funding under the LSB ESF Project will need
to provide evidence within their proposal of specifically meeting three
or more of the criteria below:
 co-ownership or co-design across counties (collaboration)
 co-ownership or co-design across public service organisations
(collaboration)
 implementation of innovative methods or models
 clear long-term benefits to the prosperity of an area
 improves outcomes for citizens
 generates efficiency savings
 develops the LSB as a collective
 creation of secondment opportunities
ii. All projects will need to show how they:
 support equality and diversity
 support environmental sustainability
 support sustainable development
 will be sustained once funding ends - exit strategy
 will monitor the performance of the project and evaluate it
Agenda item 11
 have considered project resource across and between the partners,
including issues such as pooled budgets.
 will bring additional outputs where activity has already been
undertaken
iii. Projects working with Communities First areas should also
demonstrate:
 identification of a joint outcome priority
 the Communities First Partnerships involved in the proposal
 high levels of community engagement with Communities First
Partnerships
 a framework for better integration of community activity with
strategic outcomes
 how they will involve innovation such as co-production
 a strong commitment to culture change
6. Discussions are taking place between the NPT LSB support team, the
Communities First Central Team and the Communities First Partnerships
regarding potential projects for funding. Projects will require the support of
the LSB prior to being submitted to WAG. As and when projects are
submitted by the Communities First Partnerships, details of them will be
considered at the LSB meetings.
7. Victoria Bishop, Senior Partnership Support Officer with the Communities
First Central team is working with two other Communities First
Partnerships on a proposal for two six-month secondment opportunities.
Details of the proposal are given in Appendix 1 below.
Recommendations
The LSB to formally note in principle its support for this draft LSB ESF
Communities First project. This will enable us to develop the project proposal
with WAG prior to formal submission of the final bid by 13th May 2011 in time
for the next WAG Advisory Board, which will take place on 21st June 2011.
Contacts
Karen Devereux
[email protected]
Victoria Seller
[email protected]
Victoria Bishop
[email protected]
Agenda item 11
Appendix 1
Description of the Proposal
Funding is required for two full-time posts a Communities First (C1st) and
Local Service Board (LSB) Development Officer to ensure that there is an
improved link between the C1st Programme in Neath Port Talbot (all C1st
Partnership areas) and the LSB; and a Project Officer identifying how
integrated services for older people can be designed and delivered to respond
to local need.
C1st and LSB Development Officer
The C1st and LSB Development post will monitor the progress of the priority
projects, ensuring, where applicable that C1st’s priorities are linked into them
or involved in the process.
Aim
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To identify opportunities for potential collaboration and joint working
amongst local partners to deliver more integrated, citizen-centred
public services;
To develop links between LSB and local communities to identify
priorities for future LSB projects;
To ensure that the LSB is kept up-to-date on the progress of C1st and
it’s related projects and made aware of any barriers to progress, which
need to be resolved;
Ensure the communities of Neath Port Talbot are aware of the aims of
the LSB and its priority projects;
High levels of community engagement with Communities First
Partnerships.
Objectives
 To assist the LSB in the co-ordination, implementation and
communication of the priority projects;
 To manage the communication and engagement programme for the
LSB by, for instance, promoting the ‘Talking Neath Port Talbot’
engagement hub;
 To identify issues impacting on the achievements for the Community
Plan, associated partnership strategies and plans and the opportunities
for and barriers to more integrated service delivery;
 Contribute to the review and production of the Community Planensuring C1st is linked into the plan through ‘mini-roadshows’;
 To lead on the development of joint approaches to effective citizen and
public engagement to inform both strategic and integrated service
planning;
 Promoting the features, benefits and outcomes of LSB intervention to
communities;
 Developing overarching workplan and providing information to LSB on
current community priorities.
Agenda item 11
Project Officer
The Project Officer post will identify how integrated services for older people
can be designed and delivered to respond to local need. This post will
combine three priorities specific to the Local Service Board and the
Communities First programme whilst linking to the Time to Change
transformation programme driven by NPTCBC:
 TOPS (Transforming Older People’s Services);
 Delivering citizen centred services;
 Neighbourhood management.
The neighbourhood area selected will be The Afan Valley, Pelenna and
Cwmafan. Existing universal, targeted and voluntary sector provision will be
mapped against need to identify and deliver actions that will contribute to an
increase in the well being, independence and quality of life for older people.
The Project Officer post will:
 Identify and integrate existing services to respond to the needs of older
people/carers;
 Improve communication between older people and service providers
through best use of resources and data bases available;
 Establish a neighbourhood approach to service delivery that involves
key partners including Communities First Partnerships, Neath Port
Talbot CVS, ABMU, NPTCBC, Public Health and NPT Homes;
 Deliver two initiatives that respond to needs identified during the
development stage of the proposal.
How will this proposal contribute towards the development of the LSB
Partnership as a collective?
The posts will enable there to be an improved link between the communities
of Neath Port Talbot and all of the LSB members and agencies and help in
facilitating opportunities for those members to come together both formally,
through working on projects, but also more informally when relevant
opportunities arise or necessitate this. These opportunities all serve to
strengthen the cross-agency working and relationships between partners and
Communities First which will ultimately contribute to strengthening the LSB.
The aim and objective for the LSB and C1st Development Officer post is to
assist the Board in developing improved engagement with the public and this
post will be an effective way to do this. The expectations of indicative projects
between C1st and the LSB is development of stronger links between Local
Service Boards and Communities First Partnerships to jointly tackle agreed
priorities.
This project will demonstrate:
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identification of a joint outcome priority;
Agenda item 11
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high levels of community engagement with Communities First
Partnerships;
a framework for better integration of community activity with strategic
outcomes;
how they will involve innovation such as co-production;
a strong commitment to culture change.
The posts will be for a period of 6 months until March 2012 and will be
managed by the Communities First Programme manager of NPTCBC and
based within Communities First Central Support Team. The posts will also be
linked into the Corporate Strategy Team, where the current LSB Development
post is situated. The project will provide an opportunity for secondees.
Funding required.
The total funding required for this project will be £64,000.
Communities First Support for the Project
The Communities First Central Support Team and a number of the
Communities First Co-ordinators have met to discuss potential projects, with
some contributing to the outline proposals for the two complementary posts,
which would provide valuable additional capacity to improve the links between
the LSB, Communities First and Citizens. If the outline proposals are
accepted in principle by the LSB, any further consultation required will be
undertaken with the relevant Communities First Partnerships.
These are the project proposals received to date and as and when any further
are received, details will be reported to future LSB meetings.