Agenda item

To consider and comment on proposals for the Transitions Programme, including the establishment of a Haringey Integrated Transition Service, which will undertake a cross directorate, multi-agency approach to support and prepare young people (14-25) already known to existing teams within children’s services and young people who present as vulnerable as they transition into adulthood.

The Meeting in Common of the Adults & Health, and the Children & Young People’s Scrutiny Panels received a cover report and PowerPoint presentation which provided an update to Members on the development of a new Transitions programme in Haringey. The creation of an new integrated Transitions Programme would support young people, aged 14-25 to transition to adulthood. The programme would use a strengths-based approach to maximise independence and develop resilience to enable young people to reach their fullest potential, and in turn reduce dependence on Adult Social Services and whole life costs. Haringey Integrated Transitions Programme aimed to be a cross agency service with intentional co-dependencies with Housing, Health, Adults, Education and Community Sector partners, including faith leaders.

The report and presentation were introduced by Beverley Hendricks, AD for Safeguarding & Social Care and Vicky Murphy, Service Director for Adult Social Services, as set out in the agenda pack at pages 1-15. Ann Graham, Director of Children’s services was present for this agenda item, along with Dennis Scotland, Head of Children in Care and Placements. Cllr Brabazon, Cabinet Member for Children, Schools , and Families was also present.  The following arose during the discussion of the presentation:

a.    In response to a question, officers advised that they recognised that every child’s position and situation was unique and that they would be working holistically to improve outcomes for any given child. Officers emphasised that there were also opportunities to work closely with the Cabinet Member outside of the transitions programme. The example of providing bespoke aids and adaptions for a child with a particular set of needs was noted as an example of the type of work that would be undertaken by the Transitions service. The Director provided assurances that they would be working closely with partners in Health and other sectors, to look at how to improve pathways and minimise delays.

b.    Officers also set out that behind each of the four outcomes, there was a sub-group that would be in place to deal with the day-to-day task of clearing pathways and delivering improvements.

c.    The Panel sought assurances about a lack of a joined up approach in the past and how officers would ensure that there were clear lines of communication between different services. In response, officers set out that in the past the usual approach was to see how improvements could be made within existing structures. The Transitions approach was setting up a dedicated group to help the organisation better understand the psyco-social needs of our young people. Officers emphasised the fact that the system needed to have flex to reflect the fact that circumstances for an individual or family could change.

d.    In relation to housing, officers advised that a lot of work had been done by Adult Social Services on the locality model and keeping pathways clear so that young people could access support at different stages of their development. It was recognised that their support needs did not just stop at the age of 25. Officers emphasised the need to have housing that came with wrap around services. It was noted that there was no specific housing related budget that came with the Transitions programme, but that there was a corporate capital programme for new housing and the service would make representations to that pot of money to support provision of dedicated housing for young people with specific needs. Officers gave the example of the St. Ann’s site which would have some provision of supported housing that could be used by the service.

e.    The Panel sought clarification about differing thresholds for intervention for children versus adults, and how this could be managed as part of a transition to adulthood. In response, officers set out that the Care Act was very clear in terms of the thresholds that needed to be met to receive adult social care and not everyone transitioning to adulthood at 18 would meet this threshold. However, there were also a range of early intervention and prevention activities and a locality model that sat underneath this that would provide additional support to young people. Officers clarified that under Section 2 of the Care Act, the local authority had a responsibility to prevent the need for care and support through prevention and early intervention. This is where the locality model came in, and this was new for Haringey.

f.     The Panel sought assurances about what could be done to support the existing cohort of 14-25 year olds who would miss out on the new service and what mitigations were in place for those people. In response, officers advised that the locality model was open for everyone in all parts of the borough, to access support. Officers emphasised the ‘No Wrong Front Door’ approach.

g.    The Chair asked how the Transitions programme would support better communication with residents. In response, officers advised that within the proposed structure of the new service it was envisaged that the Duty/Screening Officers would be the first point of contact for those who contacted the service and they would help them understand what the service could help with and would also signpost them to other support services if appropriate. The leads for each area would also have responsibility for co-ordinating who was responsible for what and how advocacy and support would be provided.

h.    The Panel questioned the governance structure of the Transitions Board and the extent to which the bodies that fed into the Board had decision making powers. In response, officers advised that the Transitions Board was chaired by The Director Children’s Services and that it was the Board who would have overall control of decision making about the Transitions programme. The Board would be supported by a range of specialists, both those sitting on the Board and also external specialists. The activities under the groups shown in the orange boxes would be chaired at Head of Service level and they would feed into the Strategic Operational Group, who would make recommendations to the Board.  

i.      In response to a question about the legislative framework referred to in the presentation, officers advised that due to the mixture of needs involved in the programme, there was a range of legislation that was relevant. It was commented that the primary piece of legislation was the Care Act, which talked about a eligibility and a duty to asses.

j.      In relation to a questions about local government finances, the Cabinet Member shared Members’ concerns about a lack of funding from central government and acknowledged that whoever was in power after the election would face tough funding choices and that local authorities would need to lobby government for additional funding. The Cabinet Member commented that this was one of the most important social policy areas that the Council had focused on for a long time and suggested that the authority should be very pleased about the service having been set up, because it was such a crucial area for young people and their families.

k.    Officers agreed to come back to Members with a note from colleagues in Housing about the regulatory framework and the background to the new proposed legislation referred to in slide 4. (Action: Beverley Hendricks).

l.      The Panel commented that they would like to see some more detail to some of the proposals, particularly in relation to how the programme will achieve improvements. In response, officers acknowledged that the funding for the programme was agreed in March and that the granular detail was still being developed. Officers set out that the purpose of the meeting was to bring to scrutiny the proposals as they stood and that further details, such as KPIs, will be brought back to Members in future.  Members requested that a future update include more information around the details of the community housing design. (Action: Officers to note).

m.  In relation to the financial cost pressures, the Cabinet Member set out the huge challenge that existed nationally across the care sector with the privatisation of residential care facilities and the fact that they were increasingly seen as a profit making investment for private equity. This resulted in local authorities having to place children in private institutions at vast cost. The Cabinet Member commented that the challenge being faced was how could this be clawed back into the public sector, as local authorities were essentially being held to ransom by private sector providers in the current system.

n.    The Chair of the Adults Panel requested more detailed information on how the Council could reduce its dependence on costly private sector placements if the current model of care remained the same. This was requested for the next time the two panels received an update in the future. (Officers to note).

o.    In relation to concerns about financial risk, the Director of Children’s services emphasised the fact that the Council did not have a dedicated transitions service at present, and so if the authority was to do nothing then there was no way that it could seek to improve outcomes in key areas like education, employment, housing and health, whilst also bringing down demand pressures and costs.  The DCS urged Members to read the Business Case for the Transitions programme for a fuller understanding of the assumptions behind the programme. The Service Director for Adults, commented that this was a different place in terms of the services working together and across partnerships. Early intervention and prevention was crucial in being able to support people earlier and more effectively.

p.    The Panel sought clarification about the numbers of people within the cohort who may not need significant support as part of the programme. In response, the DCS advised that she did not have those figures available, but that modelling that was used for the programme could be found in the Business Case. The DCS acknowledged that the service was not going to be a panacea and that it was recognised that the needs of our young people continued to increase, particularly in relation to growing mental health needs and increasing levels of autism/neurodiversity. One example of where cost reductions could be made was through a reduction in expenditure on residential placements through helping young people into supported community housing settings.

q.    The Panel sought clarification about the task and finish groups set out in the proposed structure chart (the orange boxes on page 13 of the agenda pack), and questioned the extent to which these would have a finite lifespan. In response, officers advised that these groups were part of the programme and would have a long life. The task and finish groups would work with the strategic operational group to work through some of the more complex issues that arose and to unblock pathways for improved outcomes across the five main areas identified in the slides.

r.     In relation to a question about who sat on those groups, officers advised that the groups were led by professionals and that they would set out in their terms of reference how they would involve stakeholders such as parents and carers.

s.    The Panel commented that they couldn’t see any housing related specific work in the proposals and it was contended that finding housing for a diverse array of needs was going to be crucial to the success of the programme. Members questioned what the role of the housing service was in the programme. In response, officers advised that the housing service was represented in the task and finish groups and that the Independent Living and Housing group was co-chaired by a senior officer in the Housing Demand service. Officers set out that there were also other forums for working closely with housing officers, this included having Housing representation on work that was taking place with the Children Safeguarding Board and the Adult Safeguarding Board. Officers were working with Housing colleagues to ensure that children living in Temporary Accommodation were supported whilst in TA.

t.     The Panel sought assurances about the extent to which elements of co-design would be incorporated into the task and finish groups. The Panel emphasised the importance of getting the views of service users. In response, officers set out that incorporating the voice of children and young people was imperative to the development of the new service. Examples given included the role of Aspire in feeding into this programme. Officers advised that they were also talking to young people through the life story work, as well as elevating youth through the work with special school heads to build in feedback mechanisms like the disability register. Officers set out that the closer they worked with service users, the more likely the service would be successful. Officers advised that all of the task and finish groups would have input from young people in one form or another. Officers also advised that they had sought out interest from parents & carers in feeding into these task and finish groups at a recent learning event.

u.    The Panel stressed the importance of accessible housing provision and suggested that the current position of one in twenty new build council homes being accessible may need to be increased. The Panel was hopeful that the new service could have an impact on worsening mental health and wellbeing levels within the affected cohort of teenagers and people in their early 20s. It was suggested that measuring things like a reduction in suicide rates would be a long term process. In response, officers welcomed the support of Members for the programme but cautioned that this was just one programme in the lives of young people and it was not realistic to expect it to have a tangible impact on reducing suicide rates. It was suggested that outcomes and impacts on the complicated impact of suicides were many and varied, but that the Council operated within a wider system and there was scope to influence as part of a wider infrastructure. Officers set out that Children’s Services worked with young people in schools on mental health and that there was an emphasis on community support and locality based services to support their mental health needs as they transitioned to adulthood.

v.    The Chair thanked officers for coming to a joint meeting of the two scrutiny panels and presenting the proposals for the Haringey Integrated Transitions service. Members expressed their appreciation for being able to look at the proposals whilst they were still in their infancy.

After a brief period of summation, the Panel Members put forward the following points of feedback/recommendations:

1.    That Members would like to see some baselines and KPIs for the overarching outcomes

2.    That Members would like to see more information on the core membership of the Task and Finish groups – both in relation to senior officers and how we will incorporate service users (co-design).

3.    Members requested more information on a breakdown of costs. Particularly in terms of breaking down housing costs versus specific care needs

4.    Members suggested that they would like to see a mapping exercise undertaken to identify suitable accommodation. What is the strategy for identifying and developing suitable property.

5.    Members requested that a further update be provided to the panels at a future date. It was suggested that this should be in one year’s time.

6.    Members requested that the future update include reference to the engagement strategy for the programme and details of how we will be communicating with parents and carers.

7.    Members requested that the future update refers to how information sharing between different services will be improved.

8.    That the future update refer to staff training and how we will try to ensure that staff are directing service users down the correct pathways.

9.    That colleagues from Housing, Health and Education are invited to the follow up session.

10.Members requested that further details be provided at the next joint meeting around the savings that are going to be made. How will these be identified and what do we mean by ‘cost avoidance’.

11.That the next update provides assurances around the financing of staffing posts. Members commented that they would like to see some further explanation of housing staff will be part of the programme, along with the locality teams in Adults.

12.In relation to the ‘ No Wrong Door’ approach, Members requested further information at a future meeting about how service users will be signposted to the correct services.

13. Members commented about communication and how important it was to communicate the new service to residents effectively. Members request that the future update mention how communication with residents was progressing, how it was being measured and how the services would be learning and improving as a result.