Features

Multi-Agency Working: Part 6 - Multi-tasking

In the final part of this series, Hannah Crown looks at what exactly training for multi-agency working should involve

‘Judge a man by his questions rather than by his answers.’ Voltaire’s famous statement may not have been uttered with multi-agency working in mind, but it is nonetheless true that the right questions asked at the right time go a long way to getting the answers needed to help keep children safe and well.

The experts tell us that without training, this will be hard. Training enables practitioners not just to be more assertive about asking questions, but also get a feel for what sort of information it is that they need. ‘You get a lot of professional politeness – people don’t really understand they can push or how much they can push,’ says Clare Joyce, training manager at training company Interface.

‘If practitioners haven’t had training, then they won’t know how to run multi-agency meetings and what to expect from other professionals in those meetings.’ It also brings confidence. ‘Practitioners say, “How do I tell a very clever child psychologist what to do in the meeting?” You say, “Well, you are all equal in this process” and they say, “Are we really?” But if you can get some training, you realise the psychologist is under similar stresses to you’.

Ms Joyce, who counts local authorities among her clients, is a firm believer in using multi-agency models for all training – not just training about multi-agency working. ‘Most of the training we do is multi-agency because it is how teams are set up. There will be police sergeants there alongside children centre workers, health workers and social workers. Often in this situation people then ask each other ‘What is it you do? When can I refer to you? What information can I share with you and how?’

She adds, ‘A social worker will be fully aware of what a section 20 is [where a child is accommodated by a council with the parents’ consent] but this might not be the same for a children’s centre worker. We have police in the room who have never heard of a CAF or know what their role is within it, and don’t really know what early help is. The message we give the agencies is exactly the same, but they need training on different levels.’

Where should multi-agency training start? Ms Joyce says her approach is to ask everybody in the room to write down a list of what is available in terms of children’s services in the area. Despite the multi-agency mix, she says, ‘We find that nobody in the room knows everything.’

Training is also a source of good information. Ms Joyce provides threshold documents on subjects that are slightly out of early years practitioners’ reach, such as alcohol abuse, or issues such as neglect. Training should also provide an awareness of how thresholds can change. ‘Child protection thresholds are so much higher than they used to be. Our child protection colleagues are really overwhelmed, and so practitioners can be working with complex families and needy children,’ she says.

This can lead to feelings of disenchantment with social services because referrals are not taken up, and this adds to a need for practitioners to have some understanding of where the cut-off level lies, she adds. Another reason for conflict can be when a case is dropped by social services and the early years practitioner doesn’t hear about it – but it can be because of a family’s wish to keep information confidential, adds Daniela Acosta-Pagliari of Achieving for Children. ‘It might be that the family don’t want the nursery to know something,’ she adds. ‘It’s important not to assume that it was overlooked, though of course that can happen as well.’

TRAINING FOR THE TEAM AROUND THE CHILD (TAC)

Ms Acosta-Pagliari is strategic head of integrated working at the not-for-profit company, which now provides children’s services for Kingston and Richmond Councils. Ms Acosta-Pagliari provides training in the Early Help Assessment process for all relevant agencies. A key part of this training is on ‘soft skills’, such as how to communicate with difficult parents. She says, ‘Practitioners are very aware of the skills they have and don’t have. A worry is they don’t know how to talk to parents about financial issues or mental health. They don’t want to damage their relationship with parents by talking about something so personal. But actually they might be the first person to notice something like that – it could be a late payment or a child being in old clothes. It’s approaching them and saying, “I’ve noticed this and I think there is a service that can help you, and do you want to talk about it?”

‘We also talk about timing; understanding the cycle they are going through. Sometimes they are not ready, but at some point they might be ready. We talk to practitioners about being resilient.’

When it comes to the TAC meeting itself, Ms Acosta-Pagliari says, it’s important to have an agenda and stick to it, and state the ground rules upfront. These should include its aims and the fact people are going to take it in turns to express views. This is particularly the case where it involves two parents who are separated, who can sometimes ‘take the opportunity to have a go at each other’, she adds.

Practicalities such as how the room is laid out can make a difference.

‘It’s important to make it friendly. It can be scary for the parent to come into a room with a panel of professionals. Only having the relevant professionals there (i.e. not a huge number), setting out chairs in a circle and, if parents have separated, putting a couple of professionals between them, can make a difference. Also make sure they are not sitting near a door so they can’t get too easily distracted,’ Ms Acosta-Pagliari says.

The most common challenge that practitioners are worried about is that ‘we don’t have the time to spend two hours going through an assessment’, she adds. In Richmond, the Early Help Assessment is now shorter than the previous incarnation (the Common Assessment Framework). Another big problem is the lead practitioner role, which people tend to be reluctant to take on because they think they will have to do all the work.

Ms Joyce says, ‘You do not have to do everything if you are the lead practitioner. It’s your job to pull all the information together and make sure everybody has the information. It is not your job to do everything on the plan. It is important you know what services there are to help you, and how to get information.

‘If someone says they can’t turn up to a meeting, it’s not your job to change dates and chase everyone. Get the person who wants to rearrange to do it. Often you find they can make the date after all,’ she advises.

Another key recommendation is knowing how to write targets. ‘It’s important to set goals when you fill out an assessment. We always say fewer targets are better. If you give a family 15 things they have to do, then they won’t do anything. Never use the words “ongoing” or “as soon as possible”,’ Ms Joyce says.

‘I still see things like “make Johnny happy” as a target, which drives me crazy. They should be achievable and realistic. For example, you are not going to clear debt in a month – but you might be able to have a meeting with a debt adviser in that time.

‘The biggest problem is people not turning up to meetings. But this can change if the right relationships are in place.’

POLICY UPDATE

In part 3 of this series, on the challenges of sharing live birth data between health service and councils, identified as a priority in the report Information Sharing in the Foundation Years, we stated the Government had not yet allocated any money for a national system to address this. Now, however, the Department of Health has said it has found some funding to ‘explore options’.

Jean Gross, who wrote the report highlighting the problem, says this means the Health & Social Care Information Centre is proceeding with a scoping exercise to shortlist possible technical solutions for sending data feeds from DH to local authorities. She says, ‘Governments move in mysterious ways and it’s never possible to know quite why particular decisions are made. But I do think Nursery World’s interest has pushed this issue up the policy agenda, enabling the really excellent civil servants who have worked on this to argue successfully for the funding to be allocated.’