Alternative Response Model (ARM) Presentation to NUIG Conference - A.R.M. PRESENTATION

A.R.M. PRESENTATION

    Alternative Response Model (ARM)
     Presentation to NUIG Conference
               16th June 2011

OUTLINE OF PRESENTATION

   •   S.D.C.S.C.
   •   ARM/DRM
   •   ARM TALLAGHT
   •   CASE STUDY
   •   NUIG EVALUATION
   •   NEXT STEPS FOR D. 24
   •   ANOTHER SDCSC PROJECT

CHILDREN’S SERVICES COMMITTEE cont/..

   •Children’s Services Committees are being set up around the country to
   implement the strategic plans and policy that come from the National Child
   Care Strategy Implementation Group. They have 3 objectives:

   •Develop strong cross agency working relationships
   •Secure support for joint implementation of policies which require interagency
   action.
   •Maximise integration of service delivery at local level.

   •INTEGRATION is the KEY WORD. All areas in the country have a number
   of services for children and families but linkages between services are
   POOR. This is a direct and concentrated effort to improve interagency
   working.

1. BACKGROUND

     SOUTH DUBLIN CHILREN’S SERVICES COMMITTEE
     (S,D,C,S,C,)

       May 2007                 Launch of S.D.C.S.C.
                         Interagency Management Group

        August 2008       Work Plan: 14 Actions
        1 Action Under: Child Protection, Welfare and Family
           Support is:
        “Identify children at risk of not achieving their full potential:
           promote community/agency responsibility for, and
           awareness of the identification of all children at risk of not
           achieving their full potential”

1. BACKGROUND

 CONTEXT:

 •   (1991) Child Care Act:
     Children and Families should be supported with the aim of enabling the child to be brought up
     within his/her own family.

 •   (1999) Children 1st Guidelines
     Needs Children and Families at the centre of Child Care and Child Protection activity and that a
     partnership approach must inform the delivery of services.

 •   (2000) Our children – Their Lives, The National Children’s Strategy
     “Whole child” perspective

 •   (2006) 10 Year Framework “Social Partnership Agreement 2006 – 2016”
     Lifestyle approach to its vision for the population. One statement is “that every child should grow
     up in a family with access to sufficient, resources, supports and services, to nurture and care for
     the child, and foster the child’s development and full and equal participation in society”.

1. BACKGROUND

•   (2007) The Agenda For Children’s Services, A Policy Handbook
    New way to work with children and families and communities. A Key objective is to provide
    managers and delivery services.

                                  Promoting Good Outcomes
                                                              Aspired for and
                                                              achieved
                                                Outcomes

                                 Services                        Policy

                                                Academic/
                                                Scientific
                                                evidence

1. BACKGROUND

 WHY ALTERNATIVE RESPONSE MODEL (A.R.M.)

 INTERNATIONAL CONTEXT
 Concerns emerging about direction of child protection, creating risk
  averse system where services becoming more defensive and forensic
  and not perceived as helpful to families.

 Research (U.K., New Zealand, U.S.A.) – Main Findings
 • Referral rates increasing.
 • Investigative process not supporting the complex needs of families.
 • Once immediate safety aspects were resolved, cases were frequently
   closed, without other issues being addressed.
 • High rate of re-referrals
 • Public perception of Social work Services seen as negative.

1. BACKGROUND

 WHAT IS A.R.M.

 Late 1990’s Shift Happening

 • ARM provides families the option of a non-investigative, family-friendly
   assessment and utilises a less structured, more family driven approach to
   delivery of services.
 • Move towards needs bases, rather than fact finding.
 • Moves to partnership and collaborative approaches.

                   CORE ELEMENTS OF A.R.M.
 • Screening and acceptance of referral for A.R.M. (e.g. neglect and
   child behavioural problems).
 • Child Protection Cases dealt with by traditional assessment.
 • Some A.R.M. cases may identify child protection concerns and are
   therefore referred over (from A.R.M.) to child protection.

ARM MEMBERSHIP

  •   An Garda Siochana
  •   Barnardos
  •   Daughters of Charity
  •   HSE Children & Families Social Work and Nursing
      Services
  •   National Education Welfare Board
  •   Probation
  •   South Dublin County Council
  •   Tallaght Youth Service
  •   PAKT/YMCA
  •   Community Addiction Service

2. PRINCIPLES OF A.R.M.

    • Child Protection referrals will be managed by
      the H.S.E. Social Work (casework) Team.
    • Child Welfare referrals into H.S.E. Social Work
      Team (D.S.W.)
    • Where appropriate any participating agency
      who has made a referral should have informed
      the family of the referral.
    • Initial need identification and analysis by HSE
      Social Work Casework Team undertaken and
      presented to A.R.M. Committee.

Principles of ARM (ctd)

    • Identify lead agency/service (need to consider what
      happens currently) response appropriate to initial
      identified need.
       – Continue with assessment of need and to plan to
         meet that need.
       – “Lead Agency”/Service can seek support from other
         agencies/service to work collaboratively on case.
       – Lead agency has overall responsibility to pursue the
         plan and to present the family support
         plan/outcomes of the identified plan to the A.R.M.
         Management Committee.
       – Lead Agency/Service can change to another agency
         dependant on the current need identified.

Principles of ARM (ctd)

    • Broad progress reports on family support plans
      and presented to the ARM Management
      Committee
    • If family support plan fails – risk is identified
      and evidenced , decision to leave ARM
      process and move to Child Protection process.
    • When referral is primarily of a Domestic
      Violence nature, the Social Work Department
      (F.R.C.) will take lead responsibility, in
      conjunction with other agencies.

2. PRINCIPLES OF A.R.M.

    •   Timeframes Agreed
        Referral into SW Dept and Initial Assessment     10 working days

        Referral to A.R.M Committee and take up
        by lead agency/service                           2 – 4 weeks

        Present back to A.R.M. Committee for decision    4 weeks

    •   New Concerns

        Child Protection -> H.S.E. Social Work/Casework Service

3. Principles Of Good Interagency Working

     ARM provides families the option
     of a non-investigative, family-
     friendly assessment and utilises
     a less structured, more family
     driven approach to delivery of
     services.

3. Principles Of Good Interagency Working

Benefits of Inter-Agency Working for Children
& Families
• Easier or quicker access to services and
  expertise.
• Improved educational attainment and
  engagement in education.
• Early identification and intervention.

3. Principles Of Good Interagency Working

BENEFITS OF INTER-AGENCY WORKING FOR
CHILDREN AND FAMILIES
• Better support for parents.
• Children’s needs addressed more
  appropriately.
• Better quality services.
• Reduced need for more specialist
  services.

Role of Lead Agency in ARM
                       Case Study
•Family known previously to Barnardos
•Barnardos became lead agency after consideration of presenting need by
ARM committee
• Welfare issues included parental addiction, family mental health issues,
education issues and parenting
• As lead agency Barnardos took responsibility of the following:

   o Convening and chairing case planning and review meetings
   oTaking and circulating minutes of meetings
   oCase managing the planning and coordination of interventions
   o Acting as the key point of contact for the child, family and for
   other agencies
   oEnsuring that information was shared appropriately

Role of Lead Agency in ARM
Case Study cont.
    •   Initially too many agencies were involved with the family (at different
        levels – up to 12 organisations)
    •   To ensure better co-ordination this was reduced to Barnardos, HSE
        Family Support Service, NEWB and the school. HSE Social Work Team
        Leader also attended meetings if required
    •   Barnardos provided individual work to the child, including parent and child
        work and HSE Family Support Service supported mother
    •   Interventions ran for one year
    •   Planning / review meetings were held every 2 to 3 months
    •   School offered more generic service when case was closed
    •   Outcomes included child attending school more frequently, mother and
        child reported improved relationship & child reported better relationships
        with peers
    •   ARM process ensured improved co-ordination between organisations;
        better communication with family, clarity on organisations roles and better
        sharing of information

Alternative Response Model Pilot

    ARM committee - 18 cases (Sept ’09 – June ’10)

    46 children in the families involved.

    9 of the families were headed by a person parenting alone.

    Referral sources: Barnardos, ISPCC, NEWB, Gardai, Schools
     (including a school counsellor), Probation Service, St. V. de P and
     self-referral.

    In eight cases, family were aware of the referral.

    The nature of the referrals

Stakeholders Experience
 of the set-up of ARM

     • There was a pre-existing context and culture of good
       inter-agency working relationships in Jobstown and in
       Tallaght which was conducive to the set up of the
       ARM.

     • The existing arrangement of social work and family
       support services was also conducive.

Stakeholders Description
of ARM

    • Characteristics emphasised were inter-
      agency working; coordinated
      interventions; preventative, shared
      responsibilities; quick access to services
      for families.

PERCEPTION OF
THE IMPACT OF ARM

    • A substantial amount of interviewees felt that
      they had learned a lot from being involved in
      the process.

    • At the organisational level there was again
      consensus that involvement in the ARM had a
      positive impact.

PERCEPTION OF
THE IMPACT OF ARM

    • The impact of the ARM was experienced at the
      inter-organisational level, the amount of inter-
      agency working had increased as had the level
      of mutual understanding.

    • Stronger relationships and communication.

Stakeholders Views on
 Strengths of ARM

    • Amount of agencies involved and their level of
      commitment and enthusiasm

    • The contrasting approaches, pooling of expertise and
      networking associated with inter-agency working was
      considered a strength.

    • The speed at which the ARM delivers a coordinated
      response to families was considered a strength

Positive Impact
and Strengths

    • Removal of cultural barriers.

    • Shared Ownership and shared sense of purpose

    • Partnership approach made agencies feel fully part of the process
      and improved their practice development

    • A culture of peer accountability.

    • Increased confidence and understanding of roles.

Challenges Encountered and Areas for Further
Development

    • Structure and Membership

    • Anonymising of Referrals

    • Consent and Family Participation

    • Communication between all parties involved

    • Child Protection and Welfare Thresholds

Challenges Encountered and Areas for Further
Development

    • Capacity of Agencies to Lead

    • Joint Case Planning and Reviewing

    • Resources

    • Training

ARM Process Map

Alternative Response Model

   • Considering the well-established challenges of
     inter-agency working in general and in
     particular within the context of complex child
     protection and welfare work, the Jobstown
     ARM has achieved a great deal in a short
     period of time. The beginnings of a very new
     and different way of working have emerged.

Inter-agency Casework Protocol

   •   Families experience an integrated
       support package which helps them to
       address their needs in the most
       effective way possible.
   •   Not an alternative to reporting child
       protection concerns
   •   Interagency referrals – format
   •   Maximise the participation of parents
       and children

Case Planning Meeting

   • Agree need
   • Agreed outcomes sought
   • Agree plan for supports / services to be
     provided
   • Agree a lead agency / worker and named
     workers in other agencies
   • Agree timeframe for review

Interagency Case Review meeting

    • Review the operation of the plan to date
    • Consider any significant changes – positive
      and negative – since the last meeting
    • Review the needs, the outcomes and the
      supports / services.
    • Agree to continue, update or conclude the plan
    • Agree if other supports / services are needed
    • If necessary agree any change in Lead Agency
    • If necessary discuss any agency’s proposal to
      cease their involvement with the child / family
    • Agree the date for the next review

Inter-agency Casework Protocol

   • Implementation of pilot phase
     – Two areas in South Dublin County,
       Killinarden in Dublin South West and North
       Clondalkin in Dublin West LHO Area
     – Training delivered Jan – May 2011
     – Technical support available
     – Pilot phase 20 cases – 2011/2 – case
       selection
     – Roll out to all county 2012 -

QUESTIONS AND ANSWERS

  • Discussion