The Children’s Service Development Project
In last year’s report, we introduced a brand new project which has been ongoing during 2019-20. The aim of the project is to break the trend of rising numbers of Looked After Children, respond proactively to the crisis in care identified across Wales and the UK, and achieve better outcomes for children and families. There has been lots of positive progress made over the last twelve months within all the work streams of the overall project. Here is some further information:
Ensuring workforce sufficiency and practice
One of the many aims of the Children’s Services Development Project is to increase the numbers of Looked After Children who are placed with either family members or friends of the family. This type of placement is known as Connected Persons. This placement type avoids the need for children to be placed either with the local authority’s approved foster carers or within the independent foster care sector. We have developed our Connected Persons team within our Fostering section by recruiting a new team manager. A Connected Persons Coordinator is also in post. A new service model will also be implemented in the near future.
Rising Looked After Children numbers
We have an ambitious Looked After Children Strategy to look at everything we can do to reduce the number of Looked After Children and improve the quality of life for those children who have to be looked after. So far, we have been involved with the Regional Adoption Service Review to develop post-adoption support in line with national guidance. We have been working on providing a model of support to Special Guardians. A Special Guardianship Order (SGO) is a court order appointing a person or persons to be a child’s Special Guardian. It grants an individual special parental responsibility to all decisions in respect of the child. Under an SGO, the need for the child to be formally looked after by the Local Authority is removed.
Progress so far:
- The Connected Persons team has been active in contacting persons with SGOs. An introductory newsletter has been sent to all existing SGOs with a dedicated named person contact.
- Meetings are taking place with current SGOs to identify any additional needs or support.
- We are offering training on how to build up skills. SGOs can access the Foster Carer Hub on the internet to book themselves onto training courses previously available to foster carers only.
- The team have contacted SGOs to identify those who would be interested in being part of a focus group to provide feedback on what is required as part of the SGO offer.
De-Escalating Children with Complex Needs
Within the Strengthening Families Team (SFT) for Complex Needs and Edge of Care, recruitment and training has been carried out. The Strengthening Families Team are now using iPads to measure family progress. Also, work has been undertaken to give evidence-based tools to provide results for parents. We are in the process of completing the development and implementation of the Step Up/Step Down Therapeutic Model for complex needs. A Psychologist has been appointed to the role. Consultation and research has been undertaken looking at alternative support models. Early discussions have taken place and a transition process has been developed for young people from the current provision to the new model.
In collaboration with North Wales Police (NWP), it is proposed that Conwy Council pilot a Multi-Agency Safeguarding Hub (MASH) team. This team will combine officers from Childrens, Family & Safeguarding, Integrated Adults & Community Services, Community Mental Health and NWP to provide a single point for screening and processing all safeguarding reports across Conwy. Working in a more integrated environment will help with improved information sharing. Information-gathering from the various sources will build a richer picture of circumstances of the case and the associated risks to the child, adult or high risk domestic abuse concern. More informed decisions can be made dynamically about what action to take and support the most urgent cases. By working as one team they will be in a better position to identify low-level, repeat referrals which, taken in isolation, may not appear concerning but combined may suggest a heightened risk to the individual.
Sub-Regional Residential Childrens Assessment Centre
In partnership with Denbighshire Council and Betsi Cadwaladr Health Board, Conwy Council has submitted a joint bid to develop a sub-Regional Residential Children’s Assessment Centre to serve both Conwy and Denbighshire. The centre is not intended to be a permanent residential setting. It will be a setting where children can be safely cared for and nurtured by the on-site team. At the same time, the child and their parents/alternative Carers can undergo an assessment by the on-site therapeutic team who can also provide systematic therapy intervention during their stay.
The role and function of the setting is to enable a formulation of need with psychological input to ensure that the future care and support plan offered maximises the potential of the child returning home and to avoid the need for becoming looked after. A wide range of therapeutic services will be offered including ‘theraplay’, life journey work and self-esteem/worth work.
SPOTLIGHT ON: Mental Health Development of Community-Based Services
In Wales there are numerous legislative requirements and regional local drivers that place a key emphasis on prevention and early intervention. Nationally, one of these is the Social Services and Wellbeing (Wales) Act 2014. Locally, the ‘Together for Mental Health’ Strategy’ (T4MH) has similar ambitions and aims to offer a comprehensive range of services, which includes:
- Promoting health and wellbeing for everyone, focusing on prevention of mental ill-health and providing early intervention when required;
- Providing evidence-based interventions for people with common mental health conditions in the community as early as possible;
- Ensuring that services are community-based wherever possible, reducing our reliance on in-patient care;
- Identifying and providing evidence-based care and support for people with serious mental illness as early as possible;
- Managing acute and serious episodes of mental illness safely, compassionately and effectively;
- Supporting people to recovery, to regain and learn the skills they need after mental illness;
- Assessing and providing effective evidence-based interventions for the full range of mental health problems, and working alongside services for people with physical health needs.
The Population Needs Assessment reports that 10% of adults in Conwy are currently being treated for a mental illness. That’s 12,000 people.
In partnership with the Local Implementation Team for the Together for Mental Health strategy, the Vulnerable People Service have committed to the development of a community hub within the Conwy Mind building in Llandudno. The hub will be a focal point for GPs to refer to, avoiding people having to wait to see the Community Mental Health team and it aims to prevent deterioration of people’s mental well-being and to alleviate social distress/crisis. It will be run by a combination of volunteers, statutory and non-statutory service staff who can lend a listening ear and support people to identify and manage issues that impact on their mental health and emotional resilience. A Social Worker and Intervention Worker from the Vulnerable People Service will work sessionally from the hub to provide advice, guidance and support.
The partnership extends to other services, such as the libraries, and work has continued in the promotion of the Reading Well for Mental Health scheme (previously Books on Prescription) and developing the library staff to be a mental health-informed workforce, able to act as a well-being resource within the community.
The longer-term aim is to offer a programme of support in the pillars of recovery to enable people to understand and manage their symptoms, make social connections, build life skills and be confident and able to have a meaningful day and contribute to society. The hub will also host ‘well-being days’ once a week with a consortium of professionals attending in a one-stop-shop approach to offer advice and support, e.g. housing, welfare rights, Citizens Advice Bureau, Health, Carers support etc.
The hub formally opened on 3 February 2020 but the development has already created stronger working relationships with partners and will change the model of care for mental health service users. A Programme Board is being established to oversee the work of the Community Hub to ensure the hub evolves and sustains through the ownership of the hub by the community of people who will use it.
What were the challenges?
There were various challenges associated with mobilising a range of partners to work differently and provide capacity to support the hub whilst still maintaining their current service provision. There will be a period of time required to embed the hub and therefore divert from statutory services into the community and this transition from reactive to preventative provision will require managing. Cultural change is a long-term process and the challenges are still being worked through and we will continue to work to build confidence in the new model.
Also, the landscape changed rapidly during the process. For example, originally we planned to use the Rabbit Hole Café in Llandudno (the social enterprise attached to the Conwy Mind building) as the front door of the scheme, offering a welcoming and non-stigmatising café environment to people. Unfortunately this was closed during 2019 and plans needed be reviewed and revised accordingly. However, the space is now a discreet, bespoke and therapeutic area that will enhance the users’ experience of the service.
The funding process from the Healthier Wales Transformation monies was also challenging in that timescales for the bids submission was very short and costs would only be paid in retrospect, meaning that partners were taking a financial risk and paying up-front for associated costs.
- To continue to grow and evolve the hub to strengthen the ownership of the hub to the community and make sure they get a proportionate, appropriate and timely response to their mental health needs.
- The aim is to ensure that the hub is connected to and supported by all-age services and to promote a seamless transition and pathway between such services.
- To spread the model across each locality to equally support all the citizens of Conwy whilst recognising the varied needs pertaining to each area, e.g. adapting the model for the farming community.
- To work with the Community Mental Health Team and local GPs to provide a viable alternative to referring into Primary and Secondary Health Care.
- Pilot a new model of support for crisis to reduce the reliance on acute in-patient services and offer the ‘team around the individual’ approach that is outcome- and person-centred.
- Develop the Recovery Education element of provision to support people and their Carers in self-management of their diagnosis and symptoms to be empowered to gain back control of their own life journey and provide a meaningful and purposeful day.
We’ll provide an update on this important community resource in next year’s Annual Report.
Dementia Bus – Staff Event
We have recently held Dementia Bus events which were open to colleagues from Social Care, Health and the Independent Sector to attend. The events took place over a number of dates in various localities. The Dementia Bus/Virtual Dementia Tour is proven to be the closest experience that we can give a person with a healthy brain of what dementia might be like. By understanding dementia from the individual’s point of view, we can change practice, reduce issues and improve their lives. By ‘walking in the shoes’ of a person with dementia, individuals can start to understand the issues that they experience every day. Through the sessions the attendees will experience being confused, isolated, lost and vulnerable and much more. Therefore, through these experiences staff and informal Carers will understand what they need to change to improve quality of care.
The Dementia Bus/Virtual Dementia Tour uses specialist equipment creating a simulated environment. Attendees taking part will be expected to carry out simple tasks and will be able to understand the challenges that people living with dementia face.
Through taking part in this training approach attendees will be able to:
- Explain how the environment can hinder a person living with dementia
- Identify ways to improve communication
- Understand how to challenge stereotyping and labelling
- Understand the importance of person-centred care and approaches
- Describe how care and support can be adapted within practice to improve the lives of people living with dementia, and help them to achieve positive outcomes
Feedback from the events has been fantastic, with the majority of attendees stating that learning outcomes have definitely been achieved and the event has increased levels of knowledge and empathy.
Attendees also said:
The experience really made me appreciate what it is like to have dementia.
Excellent experience. A glimpse of just some of the fear, disorientation and difficulties that people [with dementia] may experience.
Becoming a Dementia-Friendly Organisation
Conwy County Borough Council is working towards becoming a dementia-friendly organisation, a status awarded by the Alzheimer’s Society. ‘Dementia Friends’ is a way for organisations to increase awareness and understanding of dementia, and as a local authority it will give us a better understanding of dementia in the communities we serve and for the staff within our organisation.
We asked for representatives from various departments across the Authority to form a project group, which also included an individual with dementia, and his wife. Meetings have been taking place for one year and the group have been working on an action plan and our application for ‘working towards dementia friendly organisation’ status from the Alzheimer’s Society. Two of our buildings have been inspected by people who live with dementia, and we have developed a poster to let the public know about the reduction in council tax for individuals with a diagnosis. We have also increased the number of Dementia Champions who are able to deliver Dementia Friends sessions, resulting in an increase in the number of Dementia Friends both within and outside of the authority.
The Carers Team
Our in-house Carers Team comprises of a manager and three full-time Carers Officers linked to the Community Resource Teams (CRTs) across Conwy. The team provides support to a large number of Carers with greater support needs. In Conwy, we offer a combination of in-house services with a range of third sector services commissioned to support carers. This balance of services creates a more effective network of Carer support.
Progress over the year
- Carers emergency cards were launched during Carers Week in June 2018, these have proven to be very beneficial, with positive feedback received from our partner agencies. More cards have been ordered due to high demand.
- We piloted drop in sessions within three local hospitals, however, this was not successful and the focus has returned to libraries. Carers Officers hold monthly drop-ins at Llanrwst, Penmaenmawr and Colwyn Bay libraries.
- Carers Viewpoint meetings are held on a regular basis and give an opportunity for Carers to meet and gain valuable information and advice. These have included First Aid sessions, input from the Wellbeing Team, guidance around the CCBC website specifically in relation to Carers in Conwy and the Alzheimer’s Society with regard to their new Dementia Connect information/advice service.
- The Carers Team have also supported various events in Conwy including; the National Eisteddfod, Carers Week, Carers Day, and Armed Forces Day, to name but a few.
What are the challenges?
A significant pressure within the team is around undertaking assessments and reviews of Carers Assessments. During particularly busy periods, letters are sent out to explain the delay, with contact details provided should the need become more urgent. Enquiries are screened daily and urgent cases are immediately picked up through the Carers Team duty system.
We’ll continue to progress forward and develop over the coming years to meet the needs of Carers within Conwy, particularly in relation to undertaking assessments and reviews. We will continue to promote Carers rights and to identify and provide support for new Carers across the county.
Carers Team Events
Carers Week was held from 10th to 14th June 2019. There were numerous information stands positioned across Conwy to promote Carers rights and share information. A further event was also arranged for Conwy Council staff who are also Carers. This was an opportunity to participate in well-being activities, including Sophrology and yoga. Partner agencies were also invited to share information and support available to Carers.
We are grateful to our partner agencies who assisted us with this event throughout the week.
Previously, the staff event has been held at Porth Eirias. However, with the move to Coed Pella a decision was made to relocate the event to the on-site Exhibition Room. This enabled staff to attend during their working day. The move proved successful, with positive feedback received from staff who attended.
Carers Rights Day Event
The Conwy People’s Partnership Carers Group organised a Carers Rights event to raise awareness amongst Carers of the services that can provide support to them. The event took place on 21 November (Carers Rights Day) at Coed Pella. This was a drop-in event for Carers, with various stalls providing information, advice and support. It was advertised online, via our distribution lists, through CCBC staff, CVSC and via the organisations taking part. The event was attended by several Carers organisations, including our in-house Carers team as well as the Welfare Rights team, Revenues and Benefits, Council Tax, Libraries, Warm Wales, Hafal and Person Shaped Support. Councillor Cheryl Carlisle was in attendance and further information from organisations and teams who couldn’t be present was also available.
A small number of Carers attended the event and each person was able to have individual attention at each of the stalls and receive personalised advice and support. The organisations felt it was beneficial, as they were not overwhelmed by large numbers of Carers at one time, so were able to respond to each person individually. Feedback from both the organisations and Carers was positive:
A very big thank you for looking after my Mum and I yesterday, it was so appreciated by us both…..this could make such a difference to my parents, fingers crossed.
I was glad to have been part of the event.
National Eisteddfod 2019
We were excited to play host to the National Eisteddfod during August 2019 where some our teams based themselves on the Maes to showcase the work we do. Social Care and Well-being was one of the four themes adopted for the week-long event so members of our Fostering, Carers and Disabilities services were on-site, promoting our services and answering queries from members of the public.
Dr Catrin Hedd Jones from Bangor University joined us for a presentation on the personal experiences of living with dementia and the benefit of bringing people together. She was joined by one of Conwy’s Carers who was able to give an insight into life with someone living with dementia, and all the challenges that brings.
We were also able to promote Social Care as a rewarding career choice through informal chats with members of staff who love what they do and are taking advantage of the opportunities presented to them in their roles (pictured).
Collaboration between Children’s Service Assessment and Support Team and the Family Centres
The Assessment and Support Team (AST) work closely with the Family Centres both prior to and following allocation. The team works on a ‘no wrong door’ policy. This means if a referral goes to a Family Centre which should have come to AST then the Family Centre will forward those referrals on to AST. The Family Centre may also discuss with AST and attempt to engage the family to work with them if appropriate. Should concerns escalate and the family begin to disengage then the Family Centre will liaise with AST with a view to escalating the need to managed care.
The Family Centres are able to establish excellent relationships with families, so in the event of the case being allocated to a social worker, we are keen to work within the Family Centre model. The work continues in unison with the family worker as opposed to replacing them.
This way of working has made a difference in that we are able to close cases. The family worker has consistently remained involved and will continue involvement with the family. Agencies and families have more confidence to close cases knowing that this service is still available to them.
Learning Disability Transformation Programme
There are a number of ongoing projects in Conwy under the auspices of the LD Transformation Programme. The programme has been ongoing throughout 2019-2020 and in a number of project areas a collaborative approach in conjunction with our partners has been adopted to deliver the aims of the overall programme. Some of our exciting projects are detailed below.
An exciting project for people with Profound and Multiple Learning Difficulties (PMLD) to be delivered through Making Sense CIC. Making Sense is a community interest company that works with museums, galleries and other public spaces to run creative projects that make exhibitions and collections access to wider and more diverse audiences. A multi-sensory approach is delivered through all projects, working to benefit people with disabilities or who are socially isolated.
Working in Collaboration with the Conwy Arts Trust and Denbighshire Arts Service to identify upcoming activities across the county that will potentially be of interest in a multi-sensory accessible way – each month “Sensory Parcels” will be created and sent out to participating day centres, the parcels will each be the catalyst for sensory activities for the month led by care staff that will include day trips, sensory workshops, and creation of sensory artwork and installations in the centres.
The parcels will be carefully developed each month by professional artists and guest artists containing sensory objects, sounds and smells along with suggestions for sensory interactive activities and trips. Working closely with local venues who will be prepared to welcome accessible visits, behind the scenes tours and gallery workshops as part of the Sensory Parcel Service.
If successful the project could become a permanent monthly parcel service with the support and partnership of arts and cultural venues with ongoing training opportunities for staff and visits from artists.
Developing Under 5 Provision
It was identified that there is a lack of suitable provision of activities for children aged under 5 years old with complex needs. Families accessing the Child Development Centre have previously commented on how isolated they feel, particularly in summer before their child is due to start full time school. Accessing mainstream summer holiday activities can be difficult. There are some activities available to children with complex needs, however these can be often limited and often not enough.
We will be developing provision through mapping needs across Conwy to gain a clear picture of what families want and what stops some children from accessing activities in order to develop activities that will be able to meet needs appropriately.
Once the mapping has taken place, the information and feedback will be used to shape the activities which will be piloted, utilising funding awarded by the LD Transformation Programme. It is envisaged that we will be working with the third sector to deliver pilot projects.
Integrated Health and Wellbeing Learning and Activities Programme
Conwy has secured funding from the Integrated Care Fund and from the Transformation Programme to deliver and integrated health and wellbeing learning and activities programme.
The programme will provide bespoke learning and activities specifically for people with learning disabilities and the people who support them, focused on specific aspects of health and well-being. The aim of the programme is to increase knowledge and understanding and to change behaviours, so as to improve health and well-being. This includes (but is not limited to) sessions covering the following subject areas:
- Diet & exercise
- Sexual health
- Menopause and ageing
- Health checks and health screening
- Mental wellbeing
- Relationships, friendships and community activities
- Safety, including internet safety
Subject areas identified by the needs and preferences of participants during the course of the programme. The Sessions will be held in community based venues.