Multi-agency working: guidance for professionals …

1 Multi-agency working : guidance for professionalsworking with problem drinking parentsThe Parenting & Alcohol Project Also in the seriesFUnderstanding alcohol issues forprofessionals working with parentsFUnderstanding parenting issues foralcohol professionalsFParenting, alcohol misuse andtreatmentservice provisionFChild protectionFCommon assessment frameworkFProtective parenting and children sresilienceFHidden harmDuring November 2005 several consultationevents were held withprofessionals from both the alcohol and children and families fields. One of the main issues that arose, whereprofessionals wanted further guidance ,was Multi-agency work has already been carriedout on Multi-agency working , especiallywithin the Every Child paper therefore incorporates muchof the available guidance , but inresponse to requests from professionals ,uses specific examples of multi-agencyworking around the issues of parentalalcohol misuse to illustrate its AAbout tthis gguidanceThis document will guide the alcoholand children and families fields indetermininghow best to developmulti-agency working protocols.

2 Itoutlinesprinciples of good practice,using examples of current practicewhere Multi-agency working hasenhanced and facilitated the process oftackling parental alcohol misuse and itsimpact on WWho iit iis fforThe guidance is primarily aimed at: Alcohol service managers and staff Parenting support and educationmanagers and staff Health and social care managersand staffIt will also be of value to: professionals who are responsiblefor developing and co-ordinatingmulti-agency working locally NNote oon tterminologyWhere the word parent is used, this istaken to mean anyone with a primaryresponsibility for caring for a WWhat iis mmulti-aagency wworking?Existing models of integrated workingare diverse and varied, ranging frommulti- professional teams based in onesite to Multi-agency working practicesinvolving joint commissioning and serviceplanning by health and local authorities,the private and voluntary Department for Education andSkills (DfES, 2006, ) have definedthree main ways of structuring frontlinemulti-agency services: Multi-agency panel:Membersremain with their agency but meetregularly to discuss children withadditional needs who would benefitfrom Multi-agency input.

3 Panelmembers might do case work ortake a more strategic MMuullttii-aaggeennccyy wwoorrkkiinngg:: gguuiiddaannccee ffoorr pprrooffeessssiioonnaallss wwoorrkkiinngg wwiitthhpprroobblleemm ddrriinnkkiinngg IInnttrroodduuccttiioonn3 Multi-agency working : guidance for professionalsworking with problem drinking parentsThe Parenting and Alcohol Project Multi-agency team:Members areseconded or recruited into the teamwith a leader and common purposeand goals. They may still getsupervision and training from theirhome agency, but have theopportunity to work with a range ofdifferent services. Integrated service:Different servicessuch as health and education areco-located to form a highly visiblehub in the community.

4 Funded by thepartner organisations and managedto ensure integrated working , they areoften based in schools or early yearssettings, Sure Start children'scentres and extended WWhy hhave mmulti-aagency wworking?Policy documents at local, national andinternational level continue to call forgreater integrated working . This stemsfrom research into Multi-agency working ,which has identified the followingoutcomesfor children and families(Atkinson et al, 2002): Access to services not previouslyavailable, and a wider range ofservices Easier or quicker access to servicesor expertise Improved educational attainmentand better engagement in education Early identification and intervention Better support for parents Children's needs addressed moreappropriately Better quality services Reduced need for more specialistservicesOutcomes for professionals include(Atkinson et al, 2003).

5 Less replication between differentservice providers Better links between serviceproviders, including a greaterunderstanding of their practices professional development andcareer progression opportunities More involvement in communitydevelopment Improved awareness of differentservices and changed public perceptions of service providersPolicy is beginning to recognise theimpact of parental alcohol misuse onchildren and families and the importanceof agencies working together to tacklethis issue. However, this policy iscurrentlyfragmented across of the current Multi-agency workingdrive stems from the Every ChildMattersagenda (DfES, 2003a; b). Thisplaces a duty on all professionals whocome into contact with families to'safeguardchildren, promote theirwell-beingand work together throughpartnership arrangements' and to ' PPoolliiccyy ccoonntteexxtt4 secure a consistent response to childrenand families' needs'.

6 Toolkits onmulti-agency working for practitionersand managers, guidance on informationsharing and on using a commonassessment framework have beenproduced to support professionals inachieving this and can be found Training materials tosupport integrated working can befound at Every Child Mattersagenda hasalso produced an updated version ofWorking together to safeguard children:a guide to inter-agency working tosafeguard and promote the welfare ofchildren, which can be found specific impact of parental alcohol(and drug) misuse on children andfamilies,the need to assess for thisimpact and to address this issuethrough coordinated interventions havebeen highlighted in Hidden Harm(Advisory Council on the Misuse ofDrugs, 2003), the Alcohol harm reductionstrategy for England(Cabinet Office,2004), and Models of care for alcoholmisusers(MoCAM; National TreatmentAgency, 2006).

7 However, no integratedcare pathways have been producedas has, however, produced severalguidance documents that tackle theissue of Multi-agency working aroundparental drug and alcohol misuse: Getting our priorities right: goodpractice guidance for working withchildren and families affected bysubstance misuse (ScottishExecutive, 2003) Lanarkshire protocols and operationalprocedures for inter-agency workingwith children and families affectedby substance misuse (NorthLanarkshire Council, 2004) Protecting children living in familieswith problem substance use:guidelinesfor agencies inEdinburgh and the Lothians (City ofEdinburgh Council, 2005)When developing local multi-agencyworking protocols, there are standardsfor work in the drug and alcohol andparenting fields to act as a guide thatinclude guidance and minimum standardsfor Multi-agency working : Drug andalcohol national occupational standards(DANOS) (Skills for Health, 2002) andNational occupational standards forwork with parents (Parenting UK, 2005).

8 (See Appendix 1 for specific standards)However, further action is needed toincrease the effectiveness of severalareas of Multi-agency working . Theseareas include assessment of drugand alcohol misusers with children,communicationbetween agencies,efforts to break down barriers to sharinginformation, more effective identificationof children at risk and re-training of staffin child protection (Scottish Executive,2006).5 Multi-agency working : guidance for professionalsworking with problem drinking parentsThe Parenting and Alcohol Project PPrraaccttiiccee eexxaammpplleess aanndd sseerrvviicceess'' ffiinnddiinnggssPractice eexample: AA mmulti- professional sservice bbased iin oonesiteBBAASSEE 1100is a tier 2 young persons'drug and alcohol service that works ona harm minimisation basis with youngpeople who are affected by substanceuse.

9 The UP Project at BASE 10 workswith young people who are affected byparental drug or alcohol use and thereis a Parenting Support Worker who canwork with their 10 has devised an informationsharing policy for situations wheredifferentpractitioners in the service areworking separately with the parent andtheir child. The policy allows workers todiscuss amongst themselves or withpartner agencies, but not other familymembers, their work with either theparents or the young person in order thatthe workers hold all of the appropriate,available information and so canengage most effectively with theirclients. This was created specifically toavoid alienating young people from theservice while being able to engage theparents with the aim of improving theoutcomes for those young members are shown this policywhen they first enter the service toallow them to engage with confidenceabout what will be done with theinformationthey eexample: AA fflexible mmulti-agency iinterventionDDoorrsseett YYoouutthh OOffffeennddiinngg TTeeaamm ((YYOOTT))has devised an intensive, one-dayintervention with young offenders andtheir parents to improve communicationwithin families (a known protective factoragainst offending) and so reduce conflictin the home: the Living with Parentsprogramme.

10 Many issues around misuseof alcohol within families come up duringthe workshops, as it is a significant riskfactor for young people programme is activity-based andadaptable to suit clients' differingneeds. Two YOT parenting workerscarry out each workshop in conjunctionwith two facilitators from partner agencies,which have so far included anti-socialbehaviour co-ordinators, Connexionspersonal advisors, CAMHS and thePolice. Facilitators are matched to theclient group according to their differentskills and areas of expertise. Groupinga range of specialists into a multi-agencyteam of facilitators is necessary toeffectively respond to families withcomplex needs, as it ensures that thesupport offered to the family is betterinformed by professionals who are ableto learn from each other.