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Matching Needs + Services -Tips
From the RiP London Seminar, MAY 1998
1
ACHIEVING A MULTI-AGENCY APPROACH
2 GETTING AND KEEPING USERS INVOLVED
3 DESIGNING AND IMPLEMENTING NEW SERVICES
4 HOW CAN YOU DEVELOP A CULTURE OF MANAGEMENT THAT
CAN MAKE GOOD USE OF MN+S INFORMATION ?
5 LINKING MN+S AND OTHER PLANNING MECHANISMS
6 MN+S AS A TOOL FOR ASSESSMENT AND EVALUATION WORK
1.
ACHIEVING A MULTI-AGENCY APPROACH
INVOLVE OTHERS EARLY ON
It�s worth the effort involved in going beyond social services for the first audit. It avoids problems of ownership of the audit findings. Otherwise, involve others later by running county-wide dissemination seminars, and planning services through multi-agency groups co-ordinated by a steering group.
INCLUDE ALL RELEVANT AGENCIES
SSD, health and education are key. But others,
including voluntaries, might be too. Housing is important in working out
a joint strategy for prevention and support around domestic violence, including
help for women and children to stay in their community. A user perspective
can add impetus to joint-agency work by highlighting the value of a flexible
response to needs by more than one agency.
IDENTIFY COMMON CAUSES
A shared concern can be a good stimulus to joint work. This might be a positive thing (we�ve worked well together on a pilot project, how can we extend the success to benefit a wider group of children?). Or it might be a negative (we spend a fortune on out-of-county placements and fail the children we place, how do we solve the problem that worries us all?). Take chances when the time is ripe, and use guidance on priorities, for, say, joint funding, to provide a basis for joint work.THINK ABOUT BUDGETS
A dedicated joint budget can be helpful because joint responsibility for managing the budget means there�s no argument about who�s paying for what. On the other hand, being responsible for a corporate budget can add impetus to joint work.SIMPLE YET COMPLEX
The audit is the easiest stage, but complex in terms of staff costs. But it gives simplicity of perspective on something that is at first difficult to grasp (thinking about needs, not solutions to problems). It�s worth doing because it has positive spin-offs - it enthuses staff and gets them more in touch with what the job�s about when the pressure of work has distorted that. MN&S is a useful training tool as well as an audit method.PERSONALITIES MATTER
It helps to have creative people who can work on the edge of their agency boundaries and aren�t defensive about them. And who are committed to start by identifying and describing need rather than being too hampered by agency definitions.MANAGE �SCOPE CREEP�
There�s a balance between taking on too much and being closed to new ideas. Guard against being too rigid, and so ossifying, or expanding beyond what�s manageable.BUILD ON SUCCESS
MN&S can show that different agencies speak the same language around need, and want the same outcomes although approaching things in different ways. Agencies can see the value of skills beyond their own. These insights help build confidence.2 GETTING AND KEEPING USERS INVOLVED
DECIDE ON THE MIX
Think about including young people and adults, reflecting the ethnic composition and geographical spread of the locality, the variety of reasons for being in touch with social services, the involvement of current and past users and those who got no service. Users have been involved in SSD audits - how about health and education trying it too ?IT�S WORK, NOT CONSULTATION
Payment of fees, at sessional worker rates, will underline the seriousness of your intent and of the work to be done. It will also help maintain full attendance. As second best, provide high-quality refreshments and gifts of thanks. Plus, for all, transport and child care costs, interpreters as necessary, and working hours within the school day.SUPPORT TO USERS
Allocate a staff member to be the users� link person. A two-page summary of MN&S for users is available from DSRU. The involvement of an external person or agency to run the audit work (or a staff member not directly involved in the professional audit) might convey the message that users can and should speak freely about their views.THE VALUE TO USERS
Users have said they have gained new admiration for the complex job of social workers. For themselves, they�ve gained confidence from the work experience, getting out of the home, traveling on their own, meeting and befriending others, and hearing their views valued. They�ve benefited from both giving and receiving tips about their children.THE VALUE TO PROFESSIONALS
User involvement challenges professionals to think differently about some of their need groups, and to think beyond a single-agency response. Users have highlighted the importance of the advocacy role of social workers, and of early, low-key support. The audit work can be a successful first attempt to involve users in planning.THE AUDIT AND PLANNING WORK
Users have been successfully involved in all stages of MN&S work, doing a shadow audit of cases (form filling and deciding need groups), comparing their results with the professional audit group, and planning outcomes and services for need groups. It pays to involve users from the start, so they understand and can own the process and findings.KEEPING USERS INVOLVED
The shadow audit group might become a longer-standing user group willing to be consulted on future child and family matters. The detailed work on planning outcomes and services for need groups is best done with users with direct experience of the needs. They could be a mixture of shadow group users plus others newly recruited for the task.OTHER WAYS OF INVOLVING USERS
An alternative to shadow audit work is to do home visits/interviews with a sample of family members newly referred for services, and feed the results into the dissemination seminars about the MN&S audit. Whatever the method, be clear with users what is expected of them, that there are no wrong answers, that their views will be taken seriously, and they will get feedback. Make sure they do!
3
DESIGNING AND IMPLEMENTING NEW SERVICES
PLAN YOUR GROUP
It helps to have people who will approach the task constructively, who can focus on the agenda for the work, and who can think beyond the boundaries of their agency�s core services. Good chairing will help maintain direction and pace. And have a good note-taker, so you don�t go over old ground, but keep building on where you get to at the end of each meeting.
THE JOB�S BOTH EASY AND HARD
The task is to work from the need groups identified and build up a picture of outcomes, services and thresholds for each. Some aspects are easier than others. If people are clear about the range of families in a need group, they will be able to identify desirable outcomes for the group as a whole. The difficulty may be in making the objectives specific (this involves thinking about what you will be looking for to know objectives have been achieved). Ideal services should be those that research and robust evaluation have proved helpful to meet desired objectives. For some need groups there is not a lot to draw on, and it can be difficult to track down what is available.
BE MULTI-AGENCY
Be inclusive from the start. Have a good mix of people from both strategic and practitioner levels. A multi-agency conference to report on the MN&S audit might be a good source for recruiting enthusiasts for a particular need group or set of need groups. Include the voluntary sector. And don�t forget users. If you have separate work groups looking at different need groups, get them together from time to time to share ideas and bring a fresh angle to something a group may be stuck on.
WHAT SORT OF SERVICES?
Consider both services to create change in families and those that will provide longer-term support over years. The services you come up with are more likely to be enriching or topping up of existing services rather than radically new services. There is likely to be a clearer focus about who should be offering the service, from what base in the community, for how long, in what way (contract or open-door policy), and with what specific aim in mind.
TALK MONEY
Be creative about how a new service might be provided, especially as you are likely to be bound by current resources. Think about joint budgets, contributions in staff and volunteer time, and possibilities for attracting seed or pilot funding.
4 HOW CAN YOU DEVELOP A CULTURE OF MANAGEMENT THAT CAN MAKE GOOD USE OF MN&S
INFORMATION?
IS THIS A FAIR QUESTION?
Managers may know how to link new information to practice. Or there may be problems to overcome, which might be about adjusting to the newness of having information available, being under pressure to respond to short-term financial pressures and local politics rather than having time for reflection, or coming from a social work background which lacks a sound evidence base.MAKE MORE USE OF RESEARCH
Research needs to be used more in reaching and justifying day-to-day operational decisions. Practitioners need to draw on research with greater confidence and be ready to answer questions about it. Much emphasis has been put on risk factors recently; we now need to increase knowledge about probabilities, realistic outcomes and protective factors for children.CREATE TIME FOR REFLECTION
The need groups emerging locally from MN&S audits may well come as no surprise. Their value is in pulling together what is felt to be the case, giving substance to anecdotal information. The audit work gives time for reflection. Practitioners need time to reflect, as well as react, in their daily work.DEVELOP BASELINE KNOWLEDGE
The first audit provides baseline information about patterns of need. But managers need to build on this information, doing subsequent audits to check the first exercise, to check outputs and outcomes, and to adjust for new needs.CULTIVATE THE LANGUAGE OF NEED
The challenge is to incorporate the common language of need into an agency�s everyday work, and to work to see it incorporated into other agencies too. Using the language of needs, outcomes, services and thresholds in training within agencies can help develop its value and use.ENCOURAGE AN EVIDENCE-BASED APPROACH
In the NHS, the evidence base for funding applications and for work methods is becoming a routine requirement. This is the result of pressure from managers, but it stems too from the increased knowledge and expectations of patients. In social care we cannot rely on centralised cash or co-ordination to help in this, but have to find our own solutions. We need to develop expectations for how staff will operate. One way could be to ensure that every policy document includes the evidence base for its content.IMPROVE INFORMATION COLLECTION AND USE
We need to develop better models for extracting information from records. The plethora of IT systems makes comparisons difficult. Practitioners will remain reluctant to record information for planning purposes unless they can see the value of doing so, and this leaves managers with incomplete information with which to plan. The MN&S analysis of information about children and family circumstances, and the aggregation of cases into need groups, help to highlight the use that can be made of information recorded on files.5 LINKING MN+S AND OTHER PLANNING MECHANISMS
INFORMING THE CHILDREN�S SERVICES PLAN
CSPs have tended, so far, to list the services provided for children in need, as if this defines the needs of those children. MN&S audit findings enable agencies to focus first on need groups identified by local managers and practitioners, providing a baseline from which to develop services and against which to judge needs arising from future audits. Additionally, an account of user involvement in the development of need groups will help satisfy the requirement under the Children�s Services Planning Order to consult with users and the wider community.
DEVELOPING THE CHILDREN�S SERVICES PLAN
MN&S work can help with the detailed planning and development of ideas presented in CSPs. Consider auditing the needs of referrals for services in a locality of, say, 50-100,000 residents. Adopt a multi-agency approach and involve service managers as well as planners and commissioners. Assume a timescale of about two years to audit needs and plan for revised services. And use the next CSP to report progress and flag up proposals for future developments.
LINKS WITH SOCIO-DEMOGRAPHIC DATA
The recording of family postcode, as part of the case identifier for the audit sample, will enable agencies to analyse need according to neighbourhood areas and to plan for the location of services where they are most needed.
THE VALUE OF MAKING LINKS BETWEEN PLANNING MECHANISMS
Close links between MN&S and other planning initiatives can help develop a common language of need and a common approach to work with particular user groups. In providing solid information to support - or challenge - anecdotal information, it aids the desired shift to evidence-based culture and practice. Elected members have found it helpful in identifying patterns of need and the importance of a corporate response. The process itself generates an enthusiasm amongst participating agencies, including social services, health, education, police and probation.
6 MN+S AS A TOOL FOR ASSESSMENT AND EVALUATION WORK
Practitioners and managers who have used MN&S for audits of either looked after children or new referrals, or both, are suggesting other useful applications of the audit model.
MN&S provides a typology approach to evaluation. Its starting point of needs and family circumstances lends itself to considering questions about �who we are working with� and �what works with whom�. It also raises the needs of parents (mental health, substance misuse, domestic violence) which impinge upon family difficulties and breakdown.
In residential work, MN&S provides additional material to the Looking After Children material on individual children, by providing aggregated data for strategic planning.It can help agencies determine the range, size and mix of residential units needed, and holds potential for shaping the purpose and functions of residential care. For information on the links between MN&S and DSRU�s research into Structure and Culture in Children�s Homes, see Newsletter Winter 1996/7 (available from the Dartington Social Research Unit, phone 01803 862213).
In family support work for children living at home, it raises questions about how responsive services are to child and family needs as opposed to agency needs. For instance, the division of adolescent support work into short-term and long-term teams might look rather different if they were structured instead around the need groups of potential service users.The MN&S audit form offers a framework for an initial assessment for child and family services. A pilot project to test the value of duty team social workers completing such a form would be useful. The audit form could also be used for self-assessment by families. This approach is being tested by women�s refuges across one county authority.