1.1 Explain the importance of multi-agency working and integrated working:
Before multi-agency working came into place, parents of children with additional needs or families needing some extra help and support were essentially on their own and had to see lots of different professionals in order to get to a point where help was being given. Children were also quite likely to fall through the net and in the UK we have seen many cases of child abuse and neglect, which have ended in the worse possible outcome for the children involved. One of these incidents, the case of Victoria Climbie, who died on 25th February 2000 after suffering what was described by Dr Nathaniel Carey, the Home Office pathologist who examined her body, and found 128 separate injuries and scars, many of them cigarette burns, as “the worst case of child abuse I’ve encountered”, (BBC News, Online, 2003). This case launched a huge reshuffle in how children’s services are handled and the Governments Every Child Matters (ECM), framework ensures that different departments within the childcare and child services sector work together towards a common goal, which is a positive outcome for all children and is incorporated into the ECM five outcomes:
enjoy and achieve
make a positive contribution
achieve economic wellbeing
Multi agency working allows different professionals to work together and communicate about children they are seeing. It ensures that the child in question will receive the help and support they need from all areas, for instance a Special Education Needs Co-ordinator, (SENCo), in a pre-school may realise that a child needs extra help with a speech difficulty and will be able to liaise with the local health visitor and a speech and language therapist to ensure that the child is seen and helped.
Integrated working involves any service or person that works with children combining their efforts to ensure that children have their needs met and that they have every opportunity to live a fulfilled and happy life. This can be influential in a child’s life from a very young age, for instance, a health visitor running a baby clinic ensuring that babies and toddlers are gaining enough weight, receiving their inoculations and being looked after well.
Integrated working is apparent in the lives of all children and young people as listed below:
Birth – 1 year – Being seen by a Health visitor
1 – 3 years – Parent and toddler groups being run by Sure Start centres. 3 – 4 years – an early years provider, i.e. Pre School or nursery. 4 – 11 years – teachers, mid day assistants and afterschool club providers and child minders. 11 – 18 years – teachers, pastoral managers, youth workers and sports coaches.
When all of these professional are working together for the good of the child it means that they are working in an integrated way.
By working jointly with different sectors, professionals and organisations, practitioners can help improve the outcomes for children in their development and learning, which is a requirement of the Early Years Foundation Stage (EYFS).
Integrated and multi-agency working is jointly known as partnership working, this partnership working ensured by many professionals who now work together to support children and young people including:
Safeguarding officers who are responsible for the safety of children within their setting, for the training of all staff and for dealing with any issues that may arise.
Social workers, who will work with the child and their family to ensure the child/ren are being cared for properly.
Police, who will investigate any wrongdoing or harmful behavior towards children and young people, or by children and young people.
Practitioners and managers within an early years setting who will work closely with the children on a day to day basis, their families and if the need arose, the safeguarding officer.
Educational Psychologists who will help to council a child or young person who may be experiencing emotional or behavioral problems.
Health Visitors, who are available to help new parents with the health and development of their baby.
Speech and Language therapists who will work alongside SENCo’s to help children with speech and communication difficulties.
Portage workers who work closely with children centres and other settings offering a home based teaching service for children with developmental delays.
1.2 Analyse how integrated working practices and multiagency working in partnership deliver better outcomes for children and young people:
Children and young people will have a better chance of a positive future if the adults in their lives are communicating effectively to ensure they receive the best possible support. In order for this to happen every significant adult involved in a child’s life must share any information that is relevant to the child’s safety, health, well-being and development.
There are many areas of a child’s life that may benefit from integrated and multiagency partnership working as listed below:
A child may attend 2 different early years settings, they may be finding the transition between each setting and leaving their parent carer difficult, which is causing distress. If the key workers in each setting communicate with each other via an “all about me” book, they can ensure the wants and needs of the child are conveyed to make the transition easier and promote a more positive experience for the child.
A children’s centre such as “Sure Start” can offer many services within the same building. If a child who attends the nursery on the premises has a special education need they may be able to be seen by the SENCo and a specialist teacher on the premises. This would guarantee that the child receives the best possible care, will enable all parties to communicate effectively and ensure that the child has the best possible outcome.
A child may be overweight and the setting may be concerned about the health and wellbeing of the child. The key worker may get the family in contact with a nutritionist who, as well as recommending a healthy eating programme, may put the family onto a MEND, (Mind, Exercise, Nutrition, Do It), programme that runs weekly exercise and healthy eating classes.
A mother may be new to the area and may be alone with a young child. A Sure Start centre may offer a mother & toddler group or a stay and play session. The m other may attend the group and meet new people as well as being offered the opportunity to attend parenting classes and be given back to work help. All of this would combine to offer a better outcome for the child if his mother had better parenting skills, a network of help and the chance to find employment.
There are many disadvantages for children and young people if there is no multiagency and integrated working. This is evident in many of the child abuse cases that have been documented in the news, the most recent case being Daniel Pelka, who died in March 2012 at the hands of his mother and her partner after suffering “terrifying and dreadful abuse “. (BBC News, online, 2013). Daniel Pelka was systematically abused and starved to the point where he would try and take food out of the rubbish bins at school. His teacher and teaching assistant both tried to bring this to the attention of the authorities who despite contacting his mother, made no effort to remove Daniel from the situation he was living in.
This is an extreme example of how a lack of multi agency and integrated working can result in the worst possible outcome for children. A less extreme example could be a child with a speech and language difficulty not getting the extra support they need because a key worker feels unable to bring it up with the parents. Without getting permission from the parents the key worker is unable to bring in extra help in the form of a speech and language therapist. This will not bring about a positive outcome for the child if they are unable to communicate properly. Early intervention is proven to dramatically improve an overall outcome.
1.3 Describe the functions of external agencies with whom your work setting or service interacts:
Within my setting we interact with many external agencies, they are listed below:
Speech and language therapist
To offer extra support to children who have been referred or when a key worker becomes concerned whist working with a key child on speech and language development. Speech and language therapists will find ways of helping children to work through an impediment or find ways of communicating such as Picture Exchange Communication Systems (PECS) or Makaton. Diabetes Nurse
To offer ongoing support and training to all staff regarding a child who has type 1 diabetes. To ensure that all staff are able to test blood and if necessary give injections if the child shows signs of becoming hypoglycemic. Health Visitor
To offer weigh in clinic and developmental checks during the stay and play sessions run by our setting. Behavioral Support Service (BEST), may include:
Behavioral Support Staff workers
Education Welfare Officers
Social Worker or family workers
Primary Mental health workers
Youth Offending Team
To offer support and training to staff that may be dealing with a child who is displaying unwanted behavior. They also liaise with the keyworker, SENCo and parents to make sure that the child is being supported both in the setting and at home. If the child is older and has committed a crime they may be put under the Youth Offending Team who will offer the young person and their family support and help to rehabilitation, the Youth offending team will also work closely with social workers and the education welfare officer.
To offer extra support and specialist teaching to children requiring extra support, for instance a child with severe autism whom needs specialist help with sensory learning. Area SENCo
Team Around the Child
To offer extra support to the SENCo within the setting, to arrange specialist teachers and to create a Team Around the Child, (TAC), with the parents/carers, manager, keyworker, specialist teacher and SENCo.
If, for instance, a child has special education needs it is important that the child’s parents or carers, SENCo and Key Worker work together to ensure that additional help is gained, this can be done by putting together a Common Assessment Framework, (CAF) process to enable information to be gathered and assessed in relation to the individual needs of the child. Once consent has been given by the child & parents that information may be shared, the initial task for a key worker or SENco is to advise other relevant service professional to come together in a Team Around the Child, (TAC). A TAC consists of a multi agency team of professionals working together on a case-by-case basis to support a child, young person or their family.
TAC has all the elements of good professional practice in multiagency and integrated working and with information sharing and early intervention can ensure positive outcomes for children and their families.
1.4 Explain common barriers to integrated working and multiagency working and how these can be overcome:
There are many situations where barriers can be formed with integrated and multiagency working. Every barrier can be overcome if it is approached in the right way, below are a list of possible barriers and possible solutions:
It may be that different agencies use confusing language and terminology which can prove perplexing to the other agency involved.
Both agencies could attend a meeting to talk about the terminology that they use and provide one another with a list of specific language used. Some people may find it difficult to be managed by someone else or someone new and may feel resentment. It would be prudent to discuss the roles that everyone plays so that each party is aware of what they need to do and who they need to report to. In a situation like this it would be an idea to assure the party feeling resentful that they are working as part of a team and an equal rather that being managed. People may have a different way of dealing with problems and this may cause a breakdown in finding a solution. Every party should have the opportunity to put their ideas and case forward. If possible a solution to a situation should be reached using the best parts of all solutions, a coalition solution.
Parents, practitioners and other professionals may be unsure of how to share information or uncertain about whether the information should be shared. A meeting with all professionals involved is the best way to overcome this barrier, it gives every party an opportunity to share the information they have in an environment where everything that is said can be documented and will be guaranteed to remain confidential. Parents may bring up barriers to their child being helped by external agencies because they may not wish to accept that there is a problem. It would be a good idea to sit down in a private meeting with the parents to assure them that everything is confidential and to let them know about the positive outcomes that could be gained with early intervention for their child.
1.5 Explain how and why referrals are made between agencies:
Referrals are made between agencies if a child is deemed to need extra support and help in a specific area. For instance, it may become apparent that a child with sight impairment needs to be referred to an Orthopist for diagnosis and treatment and possibly be put into a scheme that offers extra support to children with limited sight or eye problems like childhood cataracts.
To deal with referrals being made between agencies and professionals, many local authorities have created a Multi Agency Referral Panel (MARP), which includes an array of local professionals who make up the panel. The panel usually consists of the following professionals:
School Attendance Officer
The panel will convene often to ensure that the individual needs of the child are met and that the right people are involved in the case. Each individual case should remain open and active until the situation is resolved or the child is being given the extra support and help they require.
Practitioners, parents and carers or even the child or young person in question can make a referral for a multi agency panel. If a practitioner/ teacher or other member of staff is making the referral, full consent of the parent/carer and or child or young person must be obtained. It is vital to use sensitive language and be completely clear on the situation, this includes taking into account cultural and religious differences and opinions towards health and mental issues.
A multi agency referral form is used if the Common Assessment Framework (CAF) form is not being used to support the case. Detailed notes regarding the child’s needs and issues should be made along with any actions that have already been put into place.
1.6 Explain the assessment frameworks that are used in own UK Home Nation:
There are 3 main frameworks that are used within the UK early years sector, they are the Common Assessment Framework, (CAF), The Early Years Foundation Stage Framework (EYFS) and the Every Child Matters Framework (ECM).
The Common Assessment Framework (CAF) is a four-step process that enables practitioners and teachers to early on identify a child or young person’s needs, complete an overall assessment and begin to assemble a coordinated team to offer support and review progress.
The CAF is designed to be used in the following situations:
There is concern, (from a practitioner), about the progression of a child or young person’s health, development, welfare, behavior, learning progression or any other area of their wellbeing. A child or young person or their parent/carer raises a concern. The needs of a child or young person and complicated and beyond the capability of the practitioner.
The CAF process is voluntary and can only be put into place with consent from the child/young person and their parent/carer and the child and their family have complete control over what information is shared and with whom.
The CAF should be offered to children who have additional needs to those being met by universal services. Unless a child is presenting a need, it is unlikely the CAF will be offered.
The CAF process is not a referral process but a “request for services”. Department for Education, (2012) The CAF process, (Online).
The Early Years Foundation Stage Framework (EYFS) Is mandatory for all early years providers including schools, child-minders, nursery’s and pre schools. All early years providers have a legal duty to work with the EYFS and can be subject to an OFSTED inspection at any time to assess their capabilities and standards. The EYFS Framework refers to the following legislation:
The learning and development requirements are given legal force by an order made under section 39(1)(a) of the Childcare Act 2006. The safeguarding and welfare requirements are given legal force by Regulations made under section 39(1)(b) of the Childcare Act 2006. Department for Education, Statutory Framework for the Early Years Foundation Stage, Published March 2014, Pg. 4. (Online).
The Every Child Matters Framework (ECM)
The Every Child Matters Framework sets out the five outcomes that are key to well being in children, they are that children should stay safe, be healthy, enjoy and achieve, make a positive contribution to society achieve economic well being. These five outcomes are central to the programme of change and are at the heart of the Children Act 2004, which provides the legislative foundation for the programme. The 2003 Green Paper Every child matters recognised that, in order to realise the ambition to improve outcomes, there needed to be a radical change in the whole system of children’s services including shifting from intervention to prevention and services working together more effectively. Every Child Matters: Change for Children sets out a national framework for 150 local programmes of change to be led by Local Authorities and their partners. Every Child Matters: Change for Children, A Summary, (Online).
BBC News, (2003), Victoria Climbie, (Online), available from www.news.bbc.co.uk, (accessed on 23/05/2014)
BBC News, (2013), Daniel Pelka, (Online), available from www.news.co.uk/news, (accessed on 23/05/2014)
Bruce, T., Meggitt, C. and Grenier, J. (2011). Cache level 3 Children and Young People’s Workforce Diploma. London: Hodder Education.
Department for Education, Statutory Framework for the Early Years Foundation Stage, Published March 2014, page 4. (Online), available from www.gov.uk, (accessed on 24/05/14).
Department for Education, web archive, (2012) The CAF process, (Online). Available from www.webarchive.nationalarchives.gov.uk, (accessed on 24/05/14). Every Child Matters: Change for Children, A Summary, (Online), available from www.hertsdirect.org (accessed on 24/05/14) Tassoni, P. (2010). Level 3 Diploma Children and Young People’s Worksforce (Early Learning and Childcare) Candidate Handbook. Oxford: Heinemann.