Document Sample


              2001 - 2004

            March 2001


CONTENTS                                                                         Page

1. Purpose

2. Partners to the Plan

3. The national context

4. The Cambridgeshire context

5. Progress on Children's Services Plan 2000 - 2003
   - across the county
   - by County Council/District Council/PCO locality

6. Children and families in need
   - mapping need in the community
   - children in need survey 2000

7. Resources invested and activity purchased

8. Progress against the Government's objectives for children's services at 31 March 2001
   - across the county
   - by County Council/District Council/PCO locality

9. Improving outcomes for children and families in Cambridgeshire
   - objectives for children's services in Cambridgeshire
   - performance indicators
   - outcomes for children and families

10.An agenda for action 2001-2004
    - how will we demonstrate delivery?
    - how is your locality doing against this?
    - performance change action plan
    - what are the next steps?
       - locality partnerships
       - terms of reference
    - accountability mechanisms
       - to the commissioning partners
       - to children and families in Cambridgeshire

1. Children's Services Planning: The Government's planning model

2. Government objectives for children's services [Go to…]

3. NHS Plan requirements for children's services

4. Map of Government objectives for children's services against Cambridgeshire plans [Not

5. CSP 2000 - 2003 objectives and Cambridgeshire plans

6. HImP priorities for children and families: [Go to www/]
   - county-wide
   - by PCG/T locality

7. Progress on CSP priorities for change 2000 - 2003 [Not attached]

8. Needs analysis [Not attached - other than for "Children in Need Census" February 2000]

9. Resources invested and activity purchased [Will be finalised when health Service and
   Financial Frameworks completed]

10. Progress on Government objectives [Not yet completed]
    - across the county [This is in the Quality Protects Management Action Plan - see also
       Appendix 12]
    - by County Council/District Council/PCO locality

11.Objectives for children's services in Cambridgeshire 2001 - 2004

12.Quality Protects MAP 2001 - 2004: Policy Framework

13.Objectives, performance indicators and outcomes 2001 - 2004 [Not yet completed]
    - improving outcomes: "earned autonomy"
    - County Council
    - District Council
    - NHS

14.Locality partnerships - Draft terms of reference

15.Best practice in user involvement in Cambridgeshire [Not attached]
    - Cambridge City Youth Panel
    - Hunts young person's CHC
    - Bottisham shared policy on young people, drugs and alcohol
    - Fenland Sure Start
    - Red Hen
    - children with disabilities: joint playschemes, residential homes, BV consultation
    - child health promotion/family support [VB statement of current position]
    - consultation with families approaching Social Services [PW audit of service user
    - listening to children events 2000 [Josie Collier report]
    - independent visitor scheme [VB summary]
    - rights and advocacy service [VB summary]
    - "I'll Go First"
    - Teenager to Work summer placement scheme [VB report]
    - YOT
    - community planning
    - crime and disorder
    - Community Education Area Panels
    -   libraries
    -   leisure and recreation

16.Best Value reviews [Not attached: Go to…     and/or to
    District Council websites]
    - outcomes from 2000/01 reviews
    - programme for 2001 - 2004

17. Implications of 'Supporting People' from 1 April 2003 [Not attached]
Cambridgeshire County Council/District Council/Primary Care
Group and Trust Localities: The Locality Commissioning
1.0       PURPOSE

1.1   This Children‟s Services Plan for Cambridgeshire is the fifth since it became a statutory
      requirement for local authorities to:
       assess the needs in their area under Part III of the Children Act 1989 (children in need)
       consult with key agencies in assessing how these needs should be met.
       publish the resulting Plan.
1.2   The first Plan was produced in April 1997 covering the three years 1997–2000. The
      subsequent two plans rolled forward the needs analysis and updated the inter-agency
      objectives and implementation plan, in the light of progress and the developing local and
      national agendas.

1.3   It was originally intended that last year‟s Plan for 2000-2003 would be a complete revision
      as the start of the next three-year planning period. However, this was postponed in the
      light of Department of Health (DoH) guidance on Children's Services Planning received in
      November 1999, and the expectation that further definitive guidance would be issued
      during 2000.

1.4   The latter guidance was received in draft form in March/April 2000. This extended the
      scope of Children's Services Plans from children in need to vulnerable children as well.
      Although the final version of the guidance is yet to be issued by the DoH, the aims and
      objectives underlying the draft are not expected to change. These require that the
      Children‟s Services Plan should
      “…identify and deliver the priority outcomes for vulnerable children and their
      families …” (and)
      “… ensure that there is coherence between the priorities and delivery plans across
      the more specific planning documents [e.g., the QP Management Action Plan, Youth
      Justice Plan, Child and Adolescent Mental Health Strategy]”.

1.5   The emphasis (and, indeed, rationale) is on a Children‟s Services Plan that:
       defines the outcomes to be delivered
       ensures that the focus is on action that will make a difference to the lives of
         children and families
       establishes mechanisms that demonstrate delivery
       co-ordinates corporate activity by the County Council and between the County
         Council and its partners.

1.6   The purpose of the Plan, therefore, is to:

      This applies both to children and families in need and to those who are at risk of social
      exclusion or are otherwise “vulnerable”.

1.7   The approach to be adopted is the same as the joint investment planning model for adult
      client-groups. That is to say:
           - setting objectives
           - mapping needs and services
           - setting these against the resources invested by the commissioning partners
           - establishing whether the collective resources could be used more creatively and
               effectively to produce the defined outcomes
           - measuring the effectiveness with which those outcomes are delivered.

1.8   As it happens, this is the approach that last year‟s Plan for Cambridgeshire began to adopt.
      However, even twelve months on, it remains clear that we are still only at the start of the

2.1   There are three sets of partners to this Children‟s Services Plan:

         the statutory agencies that commission services (local government, particularly the
          County Council and five District Councils; Cambridgeshire Health Authority and its
          three Primary Care Groups [Cambridge City, East Cambridgeshire, South
          Cambridgeshire]; three Primary Care Trusts [Fenland, Huntingdonshire, South
          Peterborough]). These are the authorities that are held to account for delivery.

         the agencies that provide services (Social Services, Education, NHS Trusts, District
          and Parish Councils, Primary Care Trusts and GP practices, the voluntary and private
          sectors, Police, Probation).

         children and families themselves.

2.2   The Plan has not been discussed directly with either children or families. However, there
      are already a wide range of mechanisms in place to draw on the views of children and
      families in Cambridgeshire. As was indicated would happen in last year‟s Plan, they have
      been extended considerably over the last twelve months. A lengthy (but not necessarily
      comprehensive) list of such mechanisms is set out in Appendix 15.

2.3   All the other partners have been consulted directly on the Plan. In addition, they are all
      closely involved in the specific planning and commissioning mechanisms (see Appendix
      1) that this Plan seeks to co-ordinate. Furthermore, all were invited to the two
      Cambridgeshire Children‟s Conferences held over the last year, that in July 2000 and the
      whole day event on 23 January 2001. The approach adopted in this Plan reflects the
      agreements reached at those Children‟s Conferences.

3.1     As mentioned in the preceding sections, the Government has given very clear signals of its
        expectations of commissioning authorities in drawing up Children‟s Services Plans.

3.2     Coherence and Co-ordination

3.2.1   The planning model that the DoH is promoting on behalf of all Government departments is
        set out in Appendix 1. This clearly demonstrates the role of the Children‟s Services Plan in
        providing strategic co-ordination for the thematic and other planning tiers that underpin it.

3.2.2   The diagram in Appendix 1 also emphasises the position that this Plan occupies for
        vulnerable children in relation to the universal, community and performance management
        plans that over-arch it.

3.3     Government Objectives for Children‟s Services

3.3.1   Last year‟s Plan set out in Section 3 in some detail [Go to…]
        the Government‟s objectives at that stage.

3.3.2   These have been developed further since September 1999. The latest version is attached
        as Appendix 2. [Go to….]

3.3.3   These have been augmented subsequently by the NHS Plan and its associated
        implementation programme. The specific requirements for children‟s services are set out
        in Appendix 3. These include the “planning milestones” against which local government
        and the NHS, as the primary commissioning authorities, will be held to account at a
        national level.

4.1   Each local authority, Health Authority and Primary Care Trust is also being held to
      account through the inspection and performance management mechanisms of the DoH
      and Audit Commission for its local delivery of these objectives and its contribution to the
      planning milestones.

4.2   An early attempt has therefore been made to map the Government‟s objectives against
      Cambridgeshire plans. This is attached as Appendix 4.

4.3   Although this was done as recently as June 2000, it already needs updating.

4.4   However, an alternative way of establishing progress in Cambridgeshire, especially as
      the government focus is not on what was planned but on what was delivered, can be
      found through the County Council‟s budget books [Go to]
      which clearly associate resource deployment with performance (actual and targets),
      through the NHS Service and Financial Frameworks [Go to], and
      through the Best Value Performance Plans for local authorities in Cambridgeshire [Go to

4.5   Progress can also be seen year on year through the Health Improvement Programme
      (HImP) and the other universal plans set out in Appendix 1.

4.6   As well as the national objectives that this Plan has a key role in delivering for vulnerable
      children and families in Cambridgeshire, it is of course necessary to take account of the
      specific local needs and requirements that apply in the Cambridgeshire context. Indeed,
      the first three Children‟s Services Plans for Cambridgeshire (those published in 1997 to
      1999) probably emphasised this “bottom-up” approach more heavily than they did the
      national requirements. This was appropriate at that stage given:
       the limited performance of the Cambridgeshire system in making a difference to
           children‟s lives; and that
       the national priorities were still developing.
4.7   Although there remains a considerable amount to do to improve local performance (both
      in particular service areas, such as for children with disabilities or in child and adolescent
      mental health services, and in particular localities, whether for reasons of deprivation,
      rural isolation or poorly co-ordinated services), the health and social care system has
      made considerable progress in recent years in Cambridgeshire. This can be seen
      through comparing Cambridgeshire performance over time or with similar authorities
      through the NHS and Social Services Performance Assessment Frameworks [Go to
      www.doh…..]. This is especially the case considering the relatively low resource base
      with which the commissioning authorities in Cambridgeshire are working.

4.8   Appendix 5 sets out the linkages between the priority objectives in the last two Children‟s
      Services Plans (1999-2002 and 2000-2003) and some of the other key Cambridgeshire
      plans in which the action to be taken to achieve them is specified in more detail. This
      Appendix essentially provides an INTERNET route map for anyone who wishes to follow
      through on the detail set out in the thematic and implementation plans.

5.1     Across the County

5.1.1   Progress across the County on the objectives in last year‟s plan can be seen from the HImP
        [Go to or see Appendix 6] in relation to the specific top-level
        priorities included there, or in tabular form in Appendix 7.

5.2     By County Council/District Council/PCO Locality

5.2.1   This is set out in Table 1 on the following page. It reflects the top five achievements in each
        locality as identified by the commissioning partners. A space in any of the cells in Table 1
        does not necessarily mean an absence of activity in that area, but only that none of the
        commissioning partners identified this area as one in which they had made the most
        progress in 2000/01. (At this stage Table 1 is incomplete. Contributions are still awaited
        from Cambridge City and South Cambs localities, and both those from Fenland and East
        Cambs are not as yet completely inter-agency.)
TABLE 1: Locality Progress on Objectives in 2000-2003 CSP

2000-2003 CSP           CAMBRIDGE CITY      EAST CAMBS                  FENLAND*                    HUNTS*                      SOUTH CAMBS
1    Child protection                       Good inter-agency           Multi-agency training       Programme to embed
                                            working at the acute        taking place within local   good practice extended
                                            end via good                area. Health visitors       to primary care and key
                                            attendance at core          trained in HNA tool         „non children‟s services‟
                                            groups. At the              developed by Sure Start     in hospital.
                                            preventative end            team. Supporting
                                            through the interagency     development of
                                            family forum and the        Teenage pregnancy
                                            joined-up working           strategy ensuring robust
                                            initiatives. Overall this   links to HPSi and Sure
                                            has contributed to a        Start.
                                            reduction in
2    Children looked                                                                                Additional resources to
     after                                                                                          develop the health
                                                                                                    assessment team with
                                                                                                    Hinchingbrooke on
                                                                                                    behalf of Cambs
3    Enhancing life                         The establishment of a      Sure Start and joint
     chances                                local contact centre.       working with
                                            Joined up working           Community Education
                                            group has put on            and Community Safety
                                            seminars attended by        Partnership to promote
                                            local agencies.             positive approaches.
2000-2003 CSP       CAMBRIDGE CITY      EAST CAMBS                 FENLAND*                       HUNTS*                   SOUTH CAMBS
4    CAMHS                                                         All Tier III staff in place.   Shared understanding
                                                                   Temporary                      of local needs through
                                                                   accommodation being            participation in CAMH
                                                                   provided, work ongoing         strategy. However no
                                                                   to develop proposals for       new resources
                                                                   a childrens‟ centre            committed via the
                                                                   within North                   SAFF.
                                                                   Hospital site. Primary
                                                                   Mental Health Care
                                                                   workers progressing
                                                                   well with parenting
5   Children with                                                  Developing proposals           Strong commitment to
    disabilities                                                   within North Fenland for       developing joint
                                                                   a childrens‟ centre.           arrangements. Shared
                                                                   Exploring potential for        understanding of local
                                                                   PCT to gain charitable         need. Keen to improve
                                                                   status to enable local         availability of
                                                                   communities to raise           communication aids
                                                                   funds for equipment to         and enhance level of
                                                                   support children‟s             health support in
                                                                   services. Bid approved         special schools to
                                                                   by PCT partnership             reduce educational
                                                                   development Fund to            exclusion of disabled
                                                                   ensure equitable               children but no new
                                                                   access for therapy staff       resources committed in
                                                                   to equipment for               the SaFF.
6   Educational                         SSD supported City of
    quality and                         Ely college successful
    engagement                          bid re social inclusion.
                                        Others also assisted
                                        with this. Closer links
                                        forming via the joined-
                                        up group.
7   Day care for
    under 4s
2000-2003 CSP        CAMBRIDGE CITY      EAST CAMBS                FENLAND*                   HUNTS*   SOUTH CAMBS
8    YOT and crime

9    Drugs and                           Bottisham Drugs Policy    Funding approved for
     alcohol                             developed by local        Brief Intervention
                                         community of schools      Alcohol Worker to
                                         together with ELH‟s       support families and
                                         PSE Adviser.              misusers. (Needs
                                                                   assessment performed
                                                                   in 1999 highlighted
                                                                   need). Commenced
                                                                   “Proof of Age” scheme.
10   Geographical                        There has been specific    New GP practice in
     targeting                           initiatives targeting         Huntingdon, located
                                         Littleport and High           on the Oxmoor
                                         Barns regarding social        opened 12 March.
                                         inclusion. Also contact       Funding by Type 2
                                         centre.                       allocation from
                                                                       DoH. Bid increased
                                                                       health visiting
                                                                       service in the area
                                                                    £1.4 million in SRB
                                                                       bid to develop
                                                                       shared one-stop-
                                                                       shop facility
                                                                    Submitted PMS
                                                                       greenfield pilot
                                                                       proposal to develop
                                                                       additional primary
                                                                       care services in St
                                                                       Neots. Bid
                                                                       focussed on needs
                                                                       of family and
                                                                       children moving into
                                                                       the area. Outcome
                                                                       will be known May
2000-2003 CSP             CAMBRIDGE CITY      EAST CAMBS                       FENLAND*                  HUNTS*                 SOUTH CAMBS
11   Young carers

12   Educational

13   Advice and

14   Sure Start

* These two localities include the registered population covered by South Peterborough PCT resident in Cambridgeshire
  Locality partners are the commissioning agencies of the County Council, District Council and PCT together with the agencies
  that provide services on their behalf
  See Appendix 5 for detailed descriptions

6.1     Mapping Need in the Community

        [Chris Owen, Fay Haffenden providing; linking to Mike Streather as necessary]  Appendix 8i.
        Considerable information is also available by locality through the new Neighbourhood Statistics
        service [Go to] and through DETR‟s revised Index of
        Multiple Deprivation [Go to…].

6.2     Children in Need Survey 2000

        This is attached as Appendix 8(ii). Further analysis is taking place to provide information from
        this Census at a locality level.


        [Vic Blickem co-ordinating across Social Services/Education/District Council/NHS]  Appendix
        9. This Appendix cannot be completed until this year‟s health SAFF (budget) round is finalised
        for Cambridgeshire. This will set out the commissioning intentions for 2001/02.


8.1     Across the County

8.1.1   Progress at 31 January 2001 was set out in the Quality Protects MAP 2001-2004 [go to…]  Appendix 10i.

8.2     By County Council/District Council/PCO locality

8.2.1   [To be completed once SAFF round is concluded]  Appendix 10iii.


9.1     Objectives for Children‟s Services in Cambridgeshire

9.1.1   The agreed objectives for children‟s services in Cambridgeshire over the next three-year
        planning period are set out in Appendix 11. These are based on the Government objectives but
        re-order, and amplify, them in the Cambridgeshire context.

9.1.2   They have been consulted on extensively over the last three months, including at the whole-
        day Cambridgeshire Children‟s Conference on 23 January 2001. The overwhelming majority
        of the partners in para 2.1 were represented at this event, including the voluntary sector and
        some parents.

9.1.3   Formal endorsement is now being sought from the ELH and Social Services Committees of the
        County Council, from Primary Care Trusts, from District Councils and from Cambridgeshire
        Health Authority. They are also expected to be formally considered by the Boards of the three
        Primary Care Groups.

9.2     Performance Indicators

9.2.1   These are set out in the Social Services and NHS Performance Assessment Frameworks [go
        to www.doh….] and in the Quality Protects MAP [go to…].
9.2.2    Performance in 1999/00 is set out in the Quality Protects Policy Framework 2001-2004 [go to…]. This information is attached as Appendix 12.

9.3      Outcomes for Children and Families

9.3.1    These are also referred to in Appendix 12 (and, when it is completed, will be associated with
         the objectives and [for the County Council, District Councils and PCOs] the relevant
         Performance Indicators in Appendix 13). They will be augmented and developed over the next
         two years – partly as a result of the additional Social Services PAF indicators being introduced
         over this period (mainly measures of responsiveness, equity and accessibility), partly through
         the implementation programme for the NHS Plan, and partly as a result of the development of
         commissioning frameworks and partnerships at a locality level in Cambridgeshire. (See section

         AN AGENDA FOR ACTION 2001 - 2004

10.1     How Will We Demonstrate Delivery?

10.1.1   The commissioning partners (see para 2.1) are clearly the agencies accountable for
         demonstrating delivery and improving outcomes for vulnerable children and families in their
         area. At a county-wide level this will be demonstrated primarily through the NHS and Social
         Services PAFs.

10.1.2   Appendix 13i.provides a model framework against which locality progress can be assessed.
         All localities are tackling the issues, and making progress against the “ideal” stages in this
         “spiral of earned autonomy” at different rates. This reflects a variety of factors, including local
         needs and priorities, contributions from other partners (particularly NHS Trusts and District
         Councils), quality of working relationships, and capacity to co-ordinate the overall local and
         national agendas.
         Locality                                                 Stages (1-8, but 5 is max at 31 March

         Cambridge City
         East Cambs
         Fenland (incl. S P‟boro PCT)
         Huntingdonshire (incl. S P‟boro PCT)                     5
         South Cambs

         (At 21 March a response had only been received from the Huntingdonshire locality to this.)

10.2     Performance Change Action Plan

         [To be completed following consultation, particularly as regards locality progress in response
         to 10.1.3 above.]

10.3     What Are The Next Steps?

10.3.1   It has been agreed by the key commissioning partners that, from 1 April 2001, locality
         partnerships will be established in each of the five County Council/District Council/PCO
         territories in Cambridgeshire. They will all work to the same terms of reference (see
         Appendix 14) and will report to both their constituent commissioning agencies and to the
         Cambridgeshire Children‟s Conference via the Children‟s Services Plan Implementation
         Group. Although the task is to drive forward the commissioning change agenda in order to
         improve outcomes for children and families in their locality, the membership of each
         partnership will involve all relevant parties in the area (as specified in the terms of reference),
         including providers in the voluntary sector.

10.4     Accountability Mechanisms

10.4.1   As well as the accountability mechanism prescribed in the terms of reference in Appendix 14,
         and described in para 10.3.1, each locality partnership will be expected to account for their
         performance to their local community, particularly children and families themselves. How
         they choose to do this will depend on local circumstances, but the options could include:

             -      an annual conference involving children and families
             -      an annual report to the Cambridgeshire Children‟s Conference
             -      through the District Council Best Value Performance Plan
             -      through the community plan for the area
             -      through the Primary Care Trust annual report
             -      through the Social Services Team plan.

10.4.2   In some localities several of these mechanisms may be appropriate. It is anticipated that
         they will develop over time. Future Children‟s Services Plans in Cambridgeshire will refer
         directly to them, either including them as appendices to the Plan or by highlighting the
         website addresses through which they can be accessed.
                                                                                               Appendix 3

To help narrow the health gap in childhood – and throughout life – between socio-economic
groups and between the most deprived areas and the rest of the country in line with NHS Plan

National health inequalities targets are being developed for early 2001 and will be supported by the
establishment of a health poverty index in 2002 and specific targets for children. All of these targets will
be developed with stakeholders and experts in early 2001.

We expect much more developed planning for children‟s services in the second phase of the planning
round (to take place next summer), taking into account the development of a child health inequalities
target and the forthcoming guidance on vulnerable children within Local Strategic Partnerships. The
NHS must work with Social Care and other partners to deliver the Government’s Objectives for
Children’s Social Services.

Planning milestones:

   6,000 extra severely disabled children to receive support services for the first time by April 2002.
   By May 2001, all Health Authorities and local councils must have an agreed, by Regional CAMHS
    leads, a joint CAMHS Development Strategy which sets out how local and national priorities are to
    be met, including 24 hour cover and outreach services and increasing early intervention and
    prevention programmes for children. These must link to regional commissioning arrangements to
    provide an extra 30 CAMHS in-patient beds by March 2002.
   By March 2002, Health Authorities, with other relevant agencies, to prepare for the co-ordination,
    extension and quality improvement of Children‟s Health and Antenatal Screening Programmes by
    putting in place an infrastructure for delivering change effectively. Detailed advice about changes to
    screening programmes for hearing, vision, haemoglobinopathies and Downs Syndrome, in the first
    instance, will follow.
   By March 2002, Health Authorities and local councils will produce a joint report demonstrating
    satisfactory progress in implementing their agreed ten year teenage pregnancy strategy, and in
    making progress towards their agreed local targets of a 15% reduction in under 18 conception rates
    by 2004 and a reduction in the range of 40-60% by 2010.
   Contribute fully to every Youth Offending Team including undertaking a review of the resources, both
    staffing and revenue, required by YOTs from health and social services to properly assess the needs
    of children and young people at risk of offending and to develop a service programme accordingly.
   Contribute fully to any local Sure Start programmes and to developing 250 such programmes by
    2002 as a key means of tackling health inequalities.
   By 2002 to increase the number of GPs in deprived areas. By then there will be a third of all GPs
    working in PMS and it is expected that a majority of these PMS Pilots will be working in deprived

Improve the life chances for children in care by:

   Improving the level of education, training and employment outcomes for care leavers aged
    19, so that levels for this group are at least 75% of those achieved by all young people in the
    same area by March 2004;
   Increasing the percentage of children in care who achieve at least five grade A* to C GCSEs
    to 15% by 2004.
   Giving them the care and guidance needed to narrow the gap by 2004 between the proportion
    of children in care and their peers who have been given a final warning or have been
    convicted; and
   Maximising the contribution adoption can make to providing permanent families for children.

Planning milestones:
Local councils and NHS to continue to deliver the Quality Protects programme, specifically the priorities
for 2001/02 set out in LAC(2000)22:HSC 2000/033 The Quality Protects Programme: Transforming
Children’s Services 2001-02.

   No more than 16% of children in care should have three or more placements in any council by
    March 2001 and thereafter.
   Every looked after child to have an annual health assessment.
   Demonstrate that the level of employment, training or education amongst young people aged 19 in
                                                           th          st
    2001/02 who were looked after by Councils in their 17 year on 1 April 1999, is at least 60% of the
    level amongst all young people of the same age in their area.
   12,000 young people to receive help under the new leaving care arrangements, by April 2002.
   Increase to at least 50% by March 2001 the proportion of children leaving care at 16 or later with a
    GCSE or GNVQ qualification; and to 75% by 2003.
   Every looked after child should have a personal education plan.
   Increase the use of adoption as the choice for children in care where it is in the child‟s interests (a
    national target will be set in the White Paper).
   Develop and improve post-adoption support services, including health services provided to adoptive
    families, to increase successful adoptive placements.
   All councils to complete by January 2001, a rapid scrutiny of the number of looked after children
    waiting for adoption for more than six months and approved adopters who have been waiting for
    more than six months to be matched with an appropriate child. Identify where avoidable delays are
    occurring and take steps to rectify the position.
   Eleven specified councils will work with the Adoptions and Permanence Taskforce from December
    2000 to improve performance and spread best practice.
                                                                                        Appendix 8(ii)


1.1     The Children in Need census, a survey of activity and expenditure, was undertaken under the
        Quality Protects initiative. It was carried out nationally during a “typical” week of February
        2000. It included children looked after and children supported independently or at home who
        were known to Social Services Departments during that week.

1.2     The census was an ambitious undertaking, involving significant additional work for frontline
        staff which has provided valuable data on all children known to Social Services Departments
        in the country. While there was considerable data available about looked after children and
        those on child protection registers, information was not routinely collected on other children in
        need. The census has highlighted the extent of work with children and families, which hitherto
        had been significantly understated in official figures.


2.1     The census data provides a profile of need, activity and expenditure across the county and at
        team level which will inform services to children and families in Cambridgeshire. The data is
        also useful as a means of comparison nationally. The DOH is aware of some differences in
        interpretation of guidelines by some authorities and has therefore advised that the figures
        need to be treated with some caution.

2.2     In Cambridgeshire data collected in the census is being used in a number of ways including:
        a) an analysis of children with disabilities. In the census 530 of the total number of children
        were identified as being disabled. Of these children, 410 were reported as having learning
        disability (but there is no indication as to how severe the disability might be). Just over 10%
        had seven or more disabilities.
        b) an audit of referrals to the Department. Census data was used to provide details of new
        referrals to the area teams during the census week.

3.0     FINDINGS

3.1     Incidence of children in need.

3.1.1   In Cambridgeshire a total of 3560 children were identified as being in need. 556 of these were
        looked after children, including those receiving respite care, and 3004 were children supported
        independently or at home. 3560 represents a rate of 27 per thousand of the 0-18 population.

3.2     Number of children receiving a service in the census week

3.2.1   In Cambridgeshire, 2032 children, 57% of the total, were reported as receiving
        a service during the census week. Of the looked after children, including those
        receiving respite care, 84.4% received a service during the week as did 52%
        of the children supported independently or at home.
3.3     Children receiving a service during the week: Ethnic Origin

3.3.1   In Cambridgeshire 90.6% of all children receiving a service during the week were white. Of
        the looked after children the proportion of white children was 93.8% and of other children
        89.6%. Nationally, 74% of all children were white, as were 82% of the looked after children
        and 71% of other children in need. Information on ethnicity was not well reported at national
        level, where there was a high proportion of missing data. This was not true in

3.4     Children receiving a service during the week: Categories of Need
                                            Children looked after*        Other children in
           Need code                                 %                           %
        Abuse or neglect                            50.5                        37.9
            Disability                              24.1                        17.3
   Parental illness/disability                       8.7                         7.5
     Family in acute stress                          3.4                         8.9
       Family dysfunction                            6.4                        14.7
Socially unacceptable behaviour                      2.8                         6.8
          Low income                                  -                          1.9
        Absent parenting                             2.8                         1.0
Cases other than children in need                    1.3                         4.0
              Total                                 100                         100

*Includes children receiving respite care

In Cambridgeshire, for both children looked after and other children, the largest proportion is in
the abuse or neglect category. Nationally abuse or neglect is also the main need for Social
Services intervention, for 56% of looked after children and for 28% of other children. Compared
with the national picture, the proportion of children with disability appears to be high in
Cambridgeshire – nationally the figure for looked after children is 10% and for other children
14%, compared to 24.1% and 17.3% respectively in Cambridgeshire.
3.5          Children receiving a service during the week: Costs

3.5.1        Children receiving a service during the week: Average cost per child

                                                            Cambridgeshire    National*
                      Staff/centre time                           69.4             70
                      Ongoing costs                               84.3            100
                      One –off costs                               1.9              5
                      Total costs                                155.6            175
        * Figures from DOH preliminary report

        The table above shows the average cost (£ per week) per child receiving a service in
        Cambridgeshire and nationally, based on the census week. It appears that while staff/centre
        time costs are almost identical, overall the national figure is almost £20 per week higher than
        that of Cambridgeshire.

3.6          Children receiving a service during the week: Time spent

                                                        Cambridgeshire           National*
                                                    Average hours per week   Average hours per
              Children looked after                          3.9                    4.3
              Other children in need                         2.9                    3.2
             Figures from DOH preliminary report

        The average hours spent by staff in Cambridgeshire on looked after children and on other
        children in need appear to differ very little from those reported nationally.
        Nationally the percentage of time spent on looked after children was reported as being 34% and
        in Cambridgeshire it was 29%.

3.7         The next CIN census

3.7.1       The experience gained in the February 2000 census should inform the undertaking of the next,
            planned for October 2001. The information generated in these surveys provides a much more
            detailed picture of work with children and families than was previously available and should
            contribute to a firmer foundation for assessing effectiveness and value for money in children‟s
Appendix 11


These are based on the Government's objectives for children's services.

1. Promoting health and welfare: To ensure that the health, welfare and well-being of all children is
   safeguarded and promoted, through both universal services and those targeted to prevent children
   becoming vulnerable.

2. Protecting safety: To ensure that children receive safe and effective care throughout their

3. Providing support: To support vulnerable children and their families in order to prevent family
   breakdown (particularly through early intervention) and promote better life chances for vulnerable
   children through co-ordinated and integrated action.

4. Ensuring access: To ensure that vulnerable children have their life chances optimised through
   access to educational and training opportunities, health and social care, housing, and leisure and

5. Enhancing inclusion: To ensure that vulnerable young people of all ages are not isolated by raising
   their achievement so that inequalities in attainment are reduced, and that those entering adulthood
   are enabled to participate socially and economically as citizens.

6. Responding to need: To ensure that referral and assessment processes discriminate effectively
   between types and levels of need and produce a timely response.

7. Reviewing needs: To ensure that children with specific social needs (e.g., as a result of a disability
   or health condition) receive effective support and appropriate opportunities in line with their needs,
   and that their assessed needs are regularly reviewed.

8. Involving users: To actively involve children and families in planning services and in tailoring
   individual packages of care, and to ensure mechanisms are in place to handle complaints.

9. Providing a skilled response: To ensure that education, health, housing and social care workers
   are appropriately skilled, trained and qualified, and that the take-up of training is promoted at all

10. Optimising resources: To maximise the benefits to service users from the resources available,
    demonstrate the effectiveness and value for money of the care and support provided, and allow for
    choice and different responses for different needs and circumstances.

11. Partnership: To require that agencies plan jointly, co-operate effectively and co-ordinate their
    activity so as to ensure effective outcomes and impact for children and families.

12. Innovation: To enhance the quality of service delivery (in particular through innovative
    approaches), testing this against best practice to demonstrate that it is responsive to the needs and
    preferences of children and families.

                                                                                          APPENDIX 12

       Social Services

2.0    AUTHOR
       Colin Green, Assistant Director – Children


       Quality Protects Management Action Plan 2001/02 and planned projections for performance
       indicators 2002/03 and 2003/04. Th Quality Protects Management Action Plan is attached as
       Appendix 1.

       PLAN 2000/01

4.1    Quality Protects provides the core objectives and agenda for the improvement and
       development of Children‟s Social Services and related services with our partners in Health,
       Education, Voluntary and Independent Sectors. The issues arising from the review of the
       Management Action Plan for 2000/01 are as follows:
       a) Sustaining the substantial improvement in service performance demonstrated by the
          performance indicators for Children‟s Services and by the inspections of Children‟s
          Services by the SSI.
       b) The engagement of partner agencies with the Quality Protects agenda and its related
          objectives. Substantial progress has been made. It is evident to all partners that we are
          only at the beginning of what could be possible through better integration of services.
       c) Development of consultation with service users and involvement of service users in
          service planning and development. The necessary focus on improving the performance of
          the service has meant less attention to the development of user and carer involvement.
          Overall we have made less progress in this area than we would wish.
       d) Quality Assurance. Substantial progress has been made in developing standards and
          Quality Assurance framework but this remains at an early stage of development and it is
          far from bedded into the core of our service.
       e) Cost pressure. There are developing cost pressures within Children‟s Services both in
          Social Services and with partners arising from the increasing complexity of needs
          presented, local market pressures and the requirements of the Quality Protects agenda to
          achieve a step change in quality of service and assure the quality of the service.


5.1    The aim of the Quality Protects initiative is to achieve transformation in Children‟s Services for
       children in need and children who are looked after by local authorities. The step change is to
       be demonstrated through substantial improvement in the outcomes for children looked after
       and children in need as measured by a range of performance indicators eg stability of
       children‟s placements, percentage of children adopted from care, educational outcomes for
       children in care and children in need.

5.2    The Quality Protect objectives are as follows:
       1) To ensure that children are securely attached to carers capable of providing safe and
          effective care for the duration of childhood.
       2) To ensure that children are protected from emotional, physical and sexual abuse and
       3) To ensure that children in need gain maximum life chance benefits from educational
          opportunities, health care and social care.
       4) To ensure that children looked after gain maximum life chance benefits from educational
          opportunities, health care and social care.
       5) To ensure that young people leaving care as they enter adulthood are not isolated and
          participate socially and economically as citizens.
       6) To ensure that children with specific social needs arising out of disabilities or a health
               condition are living in families or other appropriate settings in the community where their
               assessed needs are adequately met and reviewed.
         7)    To ensure that referral and assessment processes discriminate effectively between
               different types and levels of need and produce a timely service response.
         8)    To actively involve users and carers in planning services and then tailoring individual
               packages of care and to ensure effective mechanisms are in place to handle complaints.
         9)    To ensure through regulatory powers and duties that children in regulated services are
               protected from harm and poor care standards.
         10)   To ensure that social care workers are appropriately skilled, trained and qualified and to
               promote the uptake of training at all levels.
         11)   To maximise the benefit to service users from the resources available, and to demonstrate
               the effectiveness and value for money of the care and support provided, and allow for
               choice and different responses for different needs and circumstances.

5.3      These objectives were set in 1998 and we expect them to remain the objectives for the
         remaining years of the Quality Protects programme running to March 2004.

5.4      With the exception of objective 8 all have a range of associated performance indicators.
         These indicators are nearly all outcome focused and therefore provide good measures of
         whether the objectives are being met and of whether our services are making a difference to
         the lives of children and their families.


6.1      The key policy drivers for delivering the Quality Protects objectives and which influence the
         selection of service improvement, change and partnership development priorities can be
         summarised as follows:
         a) promotion of Family Support and early intervention services and reduce the numbers of
              children whose best interests are served by becoming looked after.
         b) achievement of stability for children by provision of high quality placements for those
              children who need to be looked after and of sustainable support services to achieve
              change so that children can remain safely and securely within their own families.
         c) providing quality assessment services which accurately identify needs of children and
              families and provide services for those in need and for those in need of protection.
         d) development of service standards and a Quality Assurance framework, which provides
              accurate feedback on service performance and quality to members, service users and
         e) development of Leaving Care services within the framework provided by the Care
              Standards and Leaving Care Act.
         f) development of our services within a framework, which, at micro and macro levels,
              involves service users in consultation about their own services and the service
              development of planning.

6.2      Sustaining performance
         Figure 1 maps current performance in relation to the key children‟s performance indicators.
         This indicates where our performance lies and the relative importance we attach to the various
         indicators. Those indicators in high importance low performance area e.g. A2 Educational
         Qualifications & D35 Long Term Stability of Children Looked After, will be those which will be
         prioritised for sustained management attention to improve performance.

Figure 1 Performance Matrix

                                         High Performance

  5 * Band                                                                    A1, B7, C22,
                                                                              C23, C25

  4 * Band
                       Low Importance                                           E44, B8                               A2, D35
                        3 * Band
                                                                                                               High Importance

                                        2 * Band                A3                                  E45

                                        1 * Band

                                                                              Low performance

                       6.3                    Development agenda.
                                              Figure 2 sets out the development agenda for Children‟s Social Services. It identifies those
                                              service areas where a mandate is sought for implementation of significant change in the
                                              organisation of the service or how it is provided, those where the focus is on improvement
                                              within existing policy and organisational frameworks and those areas where the emphasis is on
                                              sustaining current performance. For example we expect focus on improvement and significant
                                              organisational change:-
                                               Adoption and Fostering
                                               User & carer involvement
                                              and focus on improvement in but not organisational change:-
                                               Assessment & care Management
                                               Quality Assurance
                                              and maintaining current good standards for residential child care services

                       Figure 2 Development/Improvement Grid
                              High            Assessment & Care                                    Family Support
Improvement Focus

                                              Management (Local Teams)                             Adoption and Fostering
                    Improvement Focus

                                              Quality Assurance                                    Leaving Care
                                              Management information
                                              Children with Disabilities
                                              User & Carer Involvement

                                                               Residential Child Care              Under 8s Service

                                            ( Sustaining)
                                                               Low                                                              High
                                                                                     Level of Change

                       6.4                   Development of partnerships.
                                             Figure 3 sets out relative priorities between areas of Children‟s Services in relationship to
                                             developing partnerships with Health and Education Services. Those deemed high
                                             development priority and high partnership priority are service areas likely to see significant
                                             change. It is in those areas we will take opportunities, as they arise, to integrate services on
                                             both a local and county basis. This means that while Adoption and Fostering and Quality
                                             Assurance are high priorities for service change and development they are lower priorities for
                                             partnership development. Family support service and Assessment and care Management are
                                             both priorities for development or improvement and priorities for partnership working.
Figure 3 Partnerships
                 High      User & Carer Involvement            Family Support
                                                               Children with Disabilities
                                                               Assessment & Care
                                                               Management (Local Teams)
                                                               Public Parent Role
                           Residential Child Care              Adoption and Fostering Leaving
                           Under 8s Service                    Care
                           Management information              Quality Assurance

                           Low                                                              High
                                            Service Improvemenyt/Development Priority

7.0      RESOURCES

7.1      Children‟s Services gross budget is to remain stable.

7.2      Quality Protects grant to be substituted for existing children‟s services expenditure to allow
         release of children‟s expenditure to Adults and Older People‟s services.

         Within the Children‟s budget development to take place within the parameters outlined in
7.3      table 1. This means decreasing expenditure on residential service including out county
         placements from 14% share of budget to 12% or increasing family support‟s share by 2%
         would be acceptable but member approval would be sought for any greater shift in the
         balance of resources.

Table 1 Resource Share within Children‟s Services
Service Area                  Current share       Desired Direction & Boundaries of Change for
                                                  share of resources
Assessment & Care             20%                 + or - 0.5%
Residential                   14%                 -2.0%
Residential Disability        12%                 No Change
Adoption and Fostering        21%                 +2.0%
Legal expenses                3%                  -0.5%
Family Support                16%                 +2%
Quality Assurance & Review    2.5%                -0.5%
Early Years                   2.5%                No change
Management & Support          8.4%                No Change
Total                         99.40%

8.1       The Quality Protects Management Action Plan is driven by the objectives set by government
          in 1998 for Children‟s Services for children in care and children in need. This is a tightly
          prescribed programme within which the “what” is defined.

          How the programme is delivered does allow more discretion. However the core issues are
8.2       concerned with effective implementation of good professional and managerial practice
          within Social Services and with partner agencies.

8.3       Figures 1,2, 3 and table 1 above set the parameters for service development over the next
          year. The purpose of these developments is to continue the improvement in performance
          and capacity of the service to sustain and improve on existing levels of performance. The
          key themes are:
          1) Continuing to implement effectively the service changes and developments already
          2) Development of our ability to listen to service users and involve them in service planning
              from the micro level of their own service plan to the macro level of major service change
          3) Maintain the emphasis on Family Support and earlier intervention.
          4) Continue to reduce the numbers of children whose best interests are served by
              becoming looked after.
          5) Continue to follow the policy of active risk management through improvement of
              assessment of children‟s needs and provision of appropriate and effective services.
          6) Development of Quality Assurance and audit capacity.
          7) Achieve the above within the existing resources and demonstrate those which are put to
              best use.

Appendix 13I



                            7. Outcomes for
                            Children and

                                               6. Performance

                              8. Performance
                                                         5. Refined Objectives
                                                         (National & Cambs)

                            3. Outcomes
                            for Children
                            and Families

                                                                   2. Performance

                                    4. Performance

                                 1. National

           Yrs 98/99 to 99/00: focus on “getting house in order”, co-operative working with other
           Yrs 00/01 to.01/02: focus on sustaining the improvements, joint working with other agencies
           Yrs 02/03 on: focus on integration with other agencies, collective and creative use of shared
                                                                                          Appendix 14



1.0    PURPOSE

1.1    The purpose of the partnership is to drive forward the commissioning and implementation of
       changes in Children's Services to improve outcomes for children and families in the
       partnership locality.


2.1    The following are tasks which partnerships will need to undertake or contribute to
       undertaking to achieve the purpose.

           1. developing strong, local, inter-agency networks to facilitate communication and
              sharing of information.
           2. develop effective means to involve and consult children and their families in
              providing feedback on existing services and input to the development of service
           3. mapping of existing services and resources.
           4. evaluation of existing services against national objectives and performance
           5. developing an understanding of the meaning of those performance indicators for the
              locality in relation to outcomes for children and families.
           6. developing a performance change plan for the locality based on 1-5 which leads to
              refined objectives, national and local, which will contribute to improving the
              performance indicators and outcomes for children and families.


3.1    The partnerships will be based on District Council and Social Services Team boundaries.
       which are broadly coterminous with Primary Care Group or Trust boundaries.


4.1    The membership of each partnership will involve all relevant parties in the area. At a
       minimum this will include: Health Commissioners and Providers, Education Services, Social
       Services, Voluntary Sector and Independent Sector Providers, representatives of parents
       and children's organisations. Each partnership can determine the best way to take forward
       development of their partnership membership and structure.


5.1    The partnership will have direct links through common membership or other communication
       mechanisms to the Children's Health Improvement Programme Advisory Group and its sub
       groups, the Children's Services Plan Implementation Group, and to other planning and
       implementation groups eg Educational Development Plan, Care and Education Partnership,
       Youth Offending Team Executive, Drug Action Teams, Teenage Pregnancy Initiative etc.


6.1    Each locality partnership will be expected to account for their performance to their local
       community, particularly children and families themselves.

       Options to achieve this include:
            an annual conference involving children and families
            an annual report to the Cambridgeshire Children's Conference
       through the District Council Best Value Performance Plan
       through the Community Plan for the area
       through the Primary Care Trust Annual Report
       through the Social Services Team Plan

Future Children's Services Plans in Cambridgeshire will refer directly to the work undertaken
by locality partnerships.
                                    [BACK COVER]

                                                 and long-term
                                                   support for
                          Level 4                 children and
                                                   families in
                                                chronic difficulty

                Level 3
                                          Services for children and
                                            families with severe

      Level 2
                                        Support services for children and
                                                families in need

Level 1                                      Universal services

                  Four tiers of intervention in family support services
                                (after Hardiker et al., 1995)

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