2. Context
๏ New approach to delivering childrenโs services which aimed to improve
outcomes and reduce costs
๏ Resources refocused into prevention; early help for vulnerable families;
joining up resources and services to free capacity; empowering families
and communities to develop local solutions to meet local need
๏ Evidence based - earlier investment, both in terms of age of early support
and at the onset of issues, is cheaper and more effective than specialist
support which is offered only once problems become entrenched
๏ 5 AFSTs (children and adult social work, health, youth work, family
support, welfare rights) located in childrenโs centres, schools or other
locally accessible buildings; no new posts all staff redeployed
3. Research questions
๏How were the AFSTs working?
๏What, if anything, did they add to
existing service provision for families?
๏How was the support experienced by
families?
4. Methodology
๏ Qualitative, longitudinal tracking of 15 case study
families; identification of key stakeholder
perspectives; economic evaluation
๏ Data collection โ file data; observation of practice;
interviews with children, young people and parents;
interviews with frontline staff; financial data
๏ Individual case study data used to construct a narrative
of each familyโs journey and a journey map of
presenting and emerging issues, support provided and
outcomes arising; thematic cross case analysis
5. The intervention
๏ No formal referral criteria/thresholds
๏ Families with children age 0-18
๏ Short term intensive support - high number of home visits,
day to day contact with families
๏ Direct support (emotional, practical and financial);
advocacy; referral to specialist services
๏ Solution focused, capability/resilience based approach that
tackles all ecological levels โ the individual, the family and
the community and empowers families to take control of
their own lives
6. Diverse range of families with multiple and
complex issues:
๏ non-attendance/ behavioural
issues at school
๏ mental health problems
(adult and child)
๏ domestic violence
๏ housing issues - threat of
eviction, neighbourhood
issues
๏ offending, anti-social
behaviour and gang activity
(adult and young person)
๏ substance misuse (adult and
young person)
๏ problematic parenting
๏ safeguarding
๏ unemployment, poverty and
benefit issues
๏ literacy
๏ disability and significant
health issues (adult and
child)
๏ young carers
๏ bereavement
๏ bullying
7. AFSTs
๏ Bottom up approach, key role of strategic leads in removing system
barriers
๏ Autonomous team, collective decision making
๏ Locally based teams that can respond to local need โ the AFST is an
important information point in the community, this advice role may
lead to a reduction in the number of inappropriate referrals
๏ Professional boundaries and traditional silos broken down,
professional challenge, time built in for critical reflection
๏ Contingency planning has been an issue
๏ Need to ensure teams are genuinely multi-agency
8. One familyโs journey
๏ Mum 40
๏ Daughter 16
๏ Son 13
๏ Grandson 5 months (son of 16 year old)
๏ Traveller family
9. Presenting/emerging issues
The family wanted support with:
๏ Financial problems
๏ Prevention of eviction
๏ 16 year old wanted to go to
college and to attend mother
and baby group
๏ 13 year old wanted to do boxing
Other presenting/emerging issues:
๏ Mental health
๏ Literacy and numeracy
๏ Previous DV
๏ Offending
๏ Relationship between mum and
daughter
๏ Education
๏ Safety and welfare of baby
๏ Substance misuse
10. Support provided
Direct support โ purchased cot mattress and bedding, school clothes,
shoes and bag, food vouchers, support with gas and electric, lunch
money, food from food bank, paid for counselling; provided a buggy and
clock; one to one sessions with 16 year old around vulnerability and
safeguarding
Advocacy - attended school meetings with mum; attended health
appointments with various family members; provided financial advice;
arranged housing repairs; arranged activities for 13 year old; secured
accommodation for daughter
Referral to other services โ referral for counselling for 13 year old
11. Outcomes
๏ Improved financial circumstances
๏ Prevention of eviction and improved housing conditions
๏ Secured safety of baby
๏ Engagement in activities (son)
๏ Reengaged in education/training (daughter)
๏ Increased confidence (mum)
๏ No further offending (mum and daughter)
๏ Prevention of suicide?
12. Status of cases at end of study
Outcome Number of families
Family stepped down 8
Family stepped up 1
Family transferred to another AFST 1
Case closed due to non-engagement 1
Still working with family 4
Total 15
13. Outcomes
๏ Linear progression towards sustainable outcomes is rare, most families have
periods of progress followed by crisis/set back then subsequent progress; the
AFSTs play a key role in managing crisis/stabilising risky situations
๏ Average length of intervention 4.7 months; maximum 10 months
๏ Hard, transformative achieved outcomes include improvements in
educational attendance and attainment; engagement/reengagement in
training, education or employment; reduction or cessation of risky behaviour;
reduction or cessation of criminal behaviour; prevention of eviction
๏ Soft achieved outcomes include improved self-confidence/self esteem;
improved mental health; improved domestic environments; improved inter-
familial relationships and dynamics; improved personal and social skills;
raised aspirations
14. Added value/cost effectiveness
๏ AFSTs address families needs holistically and can solve problems more
quickly than traditional structures of support
๏ AFSTs have been particularly effective at working with large families,
and engaging fathers and teenagers
๏ Some early evidence of cost effectiveness - comparison of costs without
intervention and costs of intervention indicate a potential difference of
ยฃ564k a year
๏ Need to develop more effective ways of tracking families and of
measuring avoided costs such as reductions in crime, unemployment,
health care and benefits expenditure
15. Key strengths
๏ Comprehensive consideration of familiesโ needs, holistic, whole family approach
๏ Ability to engage families
๏ Small caseloads
๏ Use of personalised budgets and spot purchasing provision
๏ Better utilisation of resources within communities
๏ Co-ordination of multi-agency support and strong partnership working
๏ Skill in crisis management, risk reduction, and stabilisation of family circumstances
๏ Utilisation of a range of one to one, group work and peer support and a range of emotional
and practical support
๏ High volume of home visits
๏ Non judgemental approach that empowers families - families are listened to and able to
reflect on their situation
๏ Greater flexibility in service provision and removal of system barriers
๏ Autonomy of the team
16. โThey really helped me personally.
I was at the point where I was
breaking โฆ it was all getting too
much. There was so much
pressure. They lifted a burden off
meโ
โI was having problems at school, Iโd been out
of school for ages โฆ no one at school was
helping. I felt really uncomfortable when I
had to go to meetings at school. They
wouldnโt let me explain how I felt. They
wouldnโt let me put what I thought on the
tableโ
โThey have been absolutely
fantastic. I canโt thank them
enough. I would have been on
the streets or in a box without
their supportโ
17. Contact details
Dr Sharon Vincent
Reader in Child Welfare
Social Work and Communities
Northumbria University
sharon.vincent@northumbria.ac.uk