Making 'early response’ the norm

At the APSE Social Care Forum this summer, Damien Cole and Kevin Makambe of the London Borough of Barking and Dagenham spoke about successfully redesigning their services from first principles to help ensure early intervention. APSE Principal Advisor for Social Care, Lorna Holland, provides an overview of this pioneering and highly effective scheme.

“The evidence from social workers, academics and service leaders is overwhelming: early help services reduce the need for crisis support later on. It is a farce that social workers and service leaders have to put cases to one side… knowing full well that many of those same cases will be back with a vengeance later… at much greater expense to our services.”

The words of Anna Feuchtrung, Director of the National Children’s Bureau, perfectly sum up the feelings of many of those involved in the delivery of social care. Though Anna’s comments – coming in response to a recent report published by the All-Parliamentary Group for Children - referred specifically to children’s services, her words could easily apply to adults, housing and other ‘peoplebased’ services.

The benefits of early help cannot be stressed enough. Early intervention is strategically advantageous since it avoids complex, more challenging situations at a later stage. Late intervention cases are often harder to resolve and are likely to result in more costly interventions and greater suffering.

For example, supporting tenants with debt management can help avoid eviction, inviting older people to attend strengthening exercise classes can help them avoid falls and working with young people as they leave care to find employment and housing will help avoid their lives being stung by economic deprivation or homelessness at a later stage in life.

Currently, most funding for social care is reserved for immediate intervention. Unfortunately, this means public service professionals are committing themselves to only responding to vulnerable people when they are at crisis point. As pressures on funding increase, it is now widely acknowledged that if social care professionals are to secure funding for early intervention, it is necessary for them to build a robust ‘business case’. 

At the London Borough of Barking and Dagenham, the workforce have re-imagined their working model to make ‘early response’ the norm. The Borough has re-designed services away from a model fit for providing specialist support in particular crisis situations and towards a model that provides holistic responses at the point of emerging need with - in the less likely event of it being required - specialist support available. In this way, early intervention is not the ‘added extra’ for which funding is argued for but the everyday. By adopting this approach, the Borough hope to reduce the frequency of emergency and complex situations of need arising.

The London Borough of Barking and Dagenham is ranked the twelfth most deprived local authority area in the country with an estimated 32% of children living in poverty, and the highest percentage of DWP benefit claimants of any borough within London. It is also a growing economy; in the next 20 years, the Council aims to build 50,000 homes and create 20,000 new jobs.

Motivated by the level of need within their borough and by keen residents eager to seize the availing opportunities in the local labour market, the Council sought to redesign its services to support residents to get upstream of emerging difficulties early on and be ready to play their part in the borough’s growing economy. Furthermore, as demand for services was growing, the Council sought to embed an approach that would help stem demand away from specialist services and in so doing, realise savings necessary to meet a funding shortfall of £68m.

As a consequence, a proposal was taken to the Council’s Cabinet in April 2016 for Community Solutions, a working model amalgamating the services in to a single service area, with customer interactions directed and teams organised by the level of difficulty faced by the customer; providing a holistic service coordinated across specialisms and service areas.

In effect, this extended the troubled families paradigm of a holistic response, delivered by a single staff worker, helping to weave together specialist support in a way that responded to the customer’s whole situation to all of the Council’s ‘People’ services. Customer support is now provided at the level of ‘Access’, ‘Universal’, ‘Triage’, ‘Support’ or ‘Intervention’.

With regards to reorganisation, redundancies were avoided wherever possible. Although the re-structure encompassed 400 roles, just two individuals left the organisation due to redundancy whilst 18 left to pursue other opportunities. Job-matching and recruitment to the new working model was undertaken within 3 months and without challenge though one appeal was received from a staff member on the outcome of their matching process. 

Reflecting the intention to focus resources on early intervention, the frontline cohort of the staff has been boosted through the restructure, which has enabled a reduction in baseline staff costs.

After 6 months of operation, positive signs are emerging of the efficacy of this new model:

• Placements in temporary accommodation have fallen by 17%.

• Through income maximisation support, a further £600,000 has been accessed for residents entitled to support.

• All social worker roles have been filled permanently, avoiding the need for agency staff and reducing staff costs by £150,000.

• The Council has seen a reduction in referrals in to social care.

• 1.8 million has been removed from base costs through both asset rationalisation and reduction in staff costs.

Whilst it is too early to credit the Community Solutions model with superseding its predecessor, it is a bold new adventure in organisational structure with a model of delivery for people-based services, designed from the ‘first principles’ of early intervention and holistic support.

The approach may be construed as the sector, ‘putting its money where its mouth is’, testing foundational beliefs about ‘what works’ in supporting people services and examining the opportunities of structural transformation to deliver this vision.

Having transitioned to the new working model, the Council now intends to significantly improve digital access to services through improvements to the information about Council and partners’ services online. Also, the Council is looking further to improve joint-working with partners, to encapsulate the community’s wider services within Community Solutions’ vision.

Click on the image to enlarge.

• For more information on this scheme please contact Lorna Holland at [email protected] or call 01865 749365