INTEGRATED SERVICES

Some children and young people tell us that they want easier access to health services and settings and
easy access to a range of information in a range of venues and formats, with the adults who young people
approach for information being well informed. Young people want services provided locally, but not always in
school, so they can easily get there unaccompanied.

The recent JAR inspection ( 388kb) highlighted many areas of strong multi-agency working and integrated service delivery. The strategy so far in Sunderland has been to focus on specific groups of services to establish existing good practice and learn from them in order to inform the wider roll out of integrated service provision. Piloting of the common assessment framework (CAF) in some service areas has also raised awareness of the benefits of integrated service delivery, In 2007/8 the roll out of CAF will establish working practices and processes to support effective integrated services. The following charts our progress so far in those trailblazer service areas:

Extended service provision in Children’s Centres and schools

Our 11 existing Children’s Centres, and 6 planned Centres, form the bedrock of locality based multi-agency team working. Staff supporting Children’s Centre development and extended services in and around schools have been brought together to produce a 0-19 offer of universal and first tier preventative services, and swift and easy referral to specialist services. Under fives teams of health, social care and early education practitioners work alongside mental health practitioners attached to CAMH services and qualified social
workers. The ‘Request for Services’ – a multi-agency team around the child and family approach has been developed in Children’s Centres across the city and is the basis of good practice which we are evolving into the Common Assessment Framework. Almost all of our secondary schools and over half of our primary and
nursery schools offer access to the full, extended services core offer. Outcomes are already showing
improvement with Foundation Stage Profile results almost at national average.

Children and young people with Learning Difficulties and/or Disabilities

Key health and social care services for disabled children (Social Work Team, Support Services, Specialist Health Visitor, Learning Disability Nursing Team) are now co-located in Gilpin House to provide a more joined up and community focussed service across the city. Community nurses and social workers are now using a shared assessment format which means that support services can be accessed more quickly and without the need for duplication of assessment, in some cases reducing the number of professionals who need to be involved in order to meet the needs of a child and family.

Specialist Service hubs for children and young people with learning difficulties operate from school sites. These ‘hubs’ consist of multi-disciplinary teams of health, education support, and school staff providing school based and outreach support to children and young people and families. Hubs are currently based in 2 primary schools: Sunningdale hub for children with profound learning difficulties and their families; Columbia Grange hub for children and young people with autism and their families.

Child and Adolescent Mental Health Services (CAMHS)

The CAMHS Community Teams operate from school sites. They are Valley Road and Wessington Primary schools. The teams are multi-disciplinary and have most recently integrated the Sunderland Children’s Counselling Service into the service. The teams are structured around the Children’s Centre clusters.

Services for Young People

Young people tell us that they want one place where they can come and get advice on a range of issues that matter to them.

This integrated service, includes the Youth Drug and Alcohol Project, Keys (working with young people who are homeless), Accommodation Services, a Young Parents project and a further education project called Unlocking Potential. A multi agency team includes voluntary and community sector providers and offers young people the opportunity to access a range of understanding, skills and knowledge to meet their needs. Outcomes for young people are positive, particularly in engaging with services. Duty systems mean easy access to services and a prompt response when they want it most. Next year the Leaving Care Service will
become part of this expanding young people’s service which form a hub for the new integrated youth service
planned for 2008.

Youth Offending Service

The youth offending service is a fully integrated service. The recent inspection found “Sunderland YOS to be a highly effective organisation with excellent management and leadership structures.”

Social Care Services

A project is developing to deliver social care services in a more integrated way through existing community resources currently located within Children’s Centres and other local settings. We will maximise opportunities to use mobile technology to support flexible working practices, enabling social workers to work more closely with other professionals in the community to identify and meet the needs of vulnerable children more effectively.

Behaviour Improvement Programme

The Behaviour Improvement Programme (BiP) works with 18 primary and 4 secondary schools in Sunderland.
BiP focuses on the need to promote positive behaviour and attendance in schools. The measures employed by BiP seek to support teaching and learning in participating schools and focus on both individual needs and those of the wider community.

A key strand of BIP is The Behaviour and Education Support Team (BEST) a multi-agency support service that offers individual, family and school support for those children and young people showing signs of emotional and behavioural problems or who are at risk of developing such problems.

BEST brings together staff from different disciplines to use their collective skills, knowledge and experiences to devise preventative and early intervention strategies that are more effective, and represent a new way of working.

The team offers support to schools to enable them to develop their range of whole school strategies for promoting emotional well-being, positive behaviour and attendance, as well as working with school staff and other professionals to enhance their skills and confidence in managing behaviour and attendance.

Voluntary and community sector

VCS providers are part of multi-agency teams in the YOS and in Children’s Centres. They are firmly embedded in the Children’s Trust arrangements with strong involvement in all children’s partnerships. The Trust has recognised the high profile role of the VCS by its commitment to the post of VCS Partnership Officer, with effect from April 2007. The role will improve the capacity of the voluntary and community sector
to engage with Children’s Trust arrangements and developments.

By 2009 we will:

• Strengthen existing joint arrangements for the collection of data, and analysis of need on a neighbourhood basis
• Jointly commission services to meet local need
• Provide children’s social care services from localities
• Use ‘smart’ technology for improved access to services in all our localities
• Implemented the Common Assessment Framework citywide
• Integrate services for children and young people who are looked after
• Have in place a Youth offer (by March 2008) - advising young people how they can access services at a universal, targeted and specialist level. It will bring services together to deliver targeted youth support, information advice and guidance and publish positive activities in a comprehensive and fully accessible way
• Establish and implement a clear plan to roll out integrated service delivery across the city using established best practice

Workforce development

Through the Every Child Matters (ECM) change for children agenda, there is a requirement for each local area to produce a multi-agency Workforce Development Strategy to support the management of change towards more effective multi-agency working to improve outcomes for children and young people.

Some key elements of Government strategy are:

• A Common Core of Skills and Knowledge, which has been introduced by the DfES
• The introduction of a Common Assessment Framework (CAF), which is seen as a key part of delivering frontline services
• The Children's Workforce Development Council is working with its partners in the Children's Workforce Network to develop an Integrated Qualifications Framework (IQF)
• The introduction of the role of Lead Professional (LP) as a key element of integrated support
• The introduction of the Agenda for Change (AFC) in the Health Service which has had a major influence on
  workforce strategy
• Training resources are now readily available for Police officers to support the ECM outcomes

Locally, the Children’s Trust has agreed a Workforce Development Strategy. A great deal of good work is already underway across the Children’s Trust. Examples of excellent practice already exist in Early Years and Childcare, the Youth Development Group, and in the area of recruitment and retention of Social Care staff, (leading to lower turnover of staff) and the successful implementation of workforce reform in schools.

The CTSP has commissioned work via Sunderland Children’s Trust Workforce Strategy Group with the following terms of reference:

• To provide a forum to exchange information and share experiences across the Sunderland Children’s
  Trust Area on the development and improvement of the Children’s Services workforce
• To deliver and maintain the Children’s Services Workforce Strategy
• To develop our managers to lead and inspire others

By 2009 we will:

• Have in place a more highly effective Children’s Services workforce through the use of appropriate training and development
• Develop and implement a strategy to proactively recruit and retain high quality staff to hard to fill posts
• Agree a baseline establishment from which to develop future structures to ensure capacity to deliver excellent services to children and young people
• Have developed and implemented an effective integrated workforce structure to meet the needs of Children’s Services
• Establish a baseline training needs analysis including common skills and competencies to inform workforce
  development plans in order to build capacity and deliver excellent services

Joint commissioning

The Children’s Trust acknowledges that effective joint arrangements for the planning and commissioning of services is essential to achieving improved outcomes for children and young people and for the Trust to achieve the priorities set out in the Children and Young People’s Plan.

Consequently, the Trust has decided to implement the DfES Joint Planning and Commissioning Framework. A gap analysis has been completed based on the framework and an action plan is in place to introduce joint commissioning arrangements across the Trust by March 2008.

The Trust has defined commissioning as:

It has set up a Project Board to implement planned work, building on existing joint commissioning activity in
Sunderland which has taken place over a number of years through a range of partnership work to implement strategic planning and prioritisation.

By 2009 we will:

• Establish a shared model and framework for future commissioning by testing the implementation of the
  DfES framework through the following areas of joint work: Early Years, Children Looked After, Youth Services, Education Psychology, and Training and Development
• Have in place the resources necessary to support and challenge services at all stages of the commissioning process by the establishment of a Children’s Trust joint commissioning team
• Have a clear Commissioning Strategy to implement our current 10 priorities in 2008-9 and for implementing the next Children and Young People’s Plan 2009-2012