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Case study

Thrive, Wandsworth


4 Sep 2018

This case study is part of EIF’s ongoing work to understand the challenges and issues that local authorities face in attempting to evaluate the impact of early intervention services, and to provide support for high-quality, rigorous evaluation and testing.

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Wandsworth Children’s Services are currently developing an early help offer for families and children. It is driven by a need for services to work more effectively in partnership, to intervene earlier, to build strength and resilience, and to reduce the pressure and spend on children’s social care. They are currently exploring how their early help offer should be configured, and how they will embed a whole family approach across the workforce. They are at a very early stage of developing a range of common practice approaches and a language that can be adopted across children’s services, their main commissioning services and voluntary and community sector partners.

They have recently launched their strategy for THRIVE Wandsworth, which sets out the principles that will drive and underpin their approach to working with children and families. THRIVE Wandsworth will:

  • be informed by the evidence of what works for families and children
  • be targeted at those families who will benefit most
  • will adopt a whole-family approach to supporting wellbeing
  • be responsive to providing the right intervention, in the right place and at the right time
  • innovative; and
  • be valued by families, staff and local partners.

The structure is being designed with the intention of being simple to navigate and avoiding any duplication between services. It will also draw on online information and resources to keep in touch with family members at key points and transitions in their lives and ensure they receive timely and effective early help. Their approach has been informed by the learning from other local authorities with promising early help offers, including in-depth study visits to other London boroughs.

Critical to the success of THRIVE Wandsworth is the development of the Early Help Pathway which is a universal front door (or single point of contact) for concerns about children, young people and families below the threshold of social care. Where a child is identified as needing targeted support or help that cannot be met through universal services, an early help assessment is carried out. This is used to develop a Signs of Safety and Wellbeing plan. Practitioners work in partnership with the child and family to form a Team Around the Family, who work together to meet the objectives and deliver the outcomes in the plan and to build resilience in the family. They track the progress of families using Mosiac.

Wandsworth is the largest inner-London borough, with an estimated 320,000 residents. One-fifth of its population (65,800) are under the age of 20, and this is projected to increase by 7% by 2025 (75,500). In line with the national picture, there are increasing numbers of children coming into care at a later age. In common with other London boroughs, areas of deprivation are situated alongside very affluent areas.

Current evaluation plans

Wandsworth are at an early stage of developing their plans to assess the impact of their new early help offer. Their aspirations are to be able to prove change at the population level which can be attributed to the whole system as well as looking at the achievements of individual services and distance travelled of individual children. They have agreed a quality assurance process and started to identify indicators to use to track the progress of their early help offer and measure this over time. They are planning to use the Outcomes Star to track progress for families across early help. It is already being used by their Family Support Team and Edge of Care Service. They are also considering how to evaluate the transformation of their workforce as they adopt a whole family approach and work together more effectively to engage families as early as possible.

There is an interest in capturing the idea of dosage in their approach to early help, experimenting with caseload sizes and intensity of practitioner investment and duration. If they can agree a specification for different early help models then this could be tested as part of their evaluation.

The success of early help will result in a reduction of the ‘revolving/recurring families’, as a result of the workforce being better equipped to intervene earlier and to build resilience. Their aspiration is for the workforce to be more confident and clear about their role, the way they work and the impact that they are having. Ultimately, however, the success of THRIVE Wandsworth will be judged on whether it has reduced pressure on children’s social care and children are only being referred to care as a last resort.

They have piloted their Early Help Pathway to assess whether the team are correctly identifying thresholds and levels of risk, and closing cases where there is no social care or early help role. They have commissioned an independent consultant to review the data resulting from this.

They are also interested in evaluating the Early Help Pathway process and the optimum time taken from the initial point of contact to making a referral and then to engagement with a service. They also want to test whether families do find the Pathway easier to navigate and are more able to support themselves to make their own decisions.

Strengths of their current approach

There is a strong commitment and energy behind the early help agenda; internal staff at strategic and operational levels seem to have bought into it and understand what it is trying to achieve. At a senior level there is a shared commitment to the agenda and the measures of success. Operational staff are positive about the way the THRIVE agenda and the use of Signs of Safety are helping to break down the organisational silos and create a common language.

They are committed to evaluating the impact of their early help offer and to developing an appropriate cost-avoidance or cost-benefit model. There is an ambitious framework driving their evaluation commitment, which will inform how they reconfigure their services.

Areas to consider

THRIVE Wandsworth presents an exciting opportunity to test the case for prevention and early intervention. The challenge of developing an early help offer is that it is not a discrete programme but a diverse set of activities that may not be easily brought together in one system. Carrying out an evaluation of this kind is a complex undertaking which will require dedicated and specialist research capacity with experience of evaluating complex systems.

It is not yet clear how the governance for the programme is monitoring key performance indicators or driving the development of the evaluation strategy. There are also discussions still to be had about the timeframe over which it is realistic for this programme to drive change in the key indicators of success. Most immediately, there is a need to capture a baseline measure across all the key outcome measures, including workforce culture and family- and child-level indicators, if the evaluation is to effectively measure change. Careful consideration will also need to be given to the choice of family measures, to ensure that they are reliable, standardised and not subjective or liable to fluctuate according to other factors, as EIF has previously expressed concern about the use of Family Stars as a measure of impact.

Critical to the successful transformation to THRIVE Wandsworth is a programme of culture change which needs to happen alongside the reconfiguration of services. This needs to be measured from the perspective of staff and service users to see if there is a common understanding and shared value. Measuring culture change is challenging, but an annual survey to assess the extent to which staff recognise and have adopted the values and principles of the strategy would be one potential way of assessing this.

There are positive indications that staff are already bought into the strategy and starting to develop a common language and response, evidenced through their use of the Signs of Safety and Wellbeing. There is a need to capitalise on this, and to think more about how the new early help offer will translate into a change in attitudes and practice. Senior managers and leaders with Wandsworth need to set realistic goals in terms of the culture change they expect to see and the timeframe over which they expect it to happen. This all needs to be managed alongside the pressure to demonstrate the value of investing in early help and realising a reduction in referrals to statutory services.

There is a need to go beyond high-level measures of success (through tracking re-referrals and pressure on social care) to a richer set of key performance indicators that will capture the change which leaders in Wandsworth are expecting to see delivered. These need to be defined by Wandsworth, but at EIF we have seen examples elsewhere of authorities using data on areas such as school attendance, rent arrears and contacts with the police as family- and child-level outcomes. Work is underway to develop measures to track progress for individual services, but there is a need to centralise these approaches and align them across all agencies and service providers. There is also an opportunity to rationalise management information systems and make better use of linking existing admin data and developing the IT software to achieve this.