The Wight Stuff

Emotionally or psychologically damaged young people with
resultant testing behaviours and characteristics can all too often
end up in specialised residential care units rather than receiving
services where they already live.

Not only do such placements take them away from their homes, peers
and communities, which risks adding an extra layer of rejection and
isolation on to their vulnerability, but even such “specialised”
units can end up simply providing a place to deposit
“problems”.

And neither is it a cheap option – units with therapeutic or
educational input can easily cost about £75,000 a year, more
than three times the annual fee for a place at Eton College.

It was such thinking that spurred the Isle of Wight into making
services available locally. In September, the merging of education
and social care services on the island into the children’s services
directorate, also gave an impetus to find new ways of joint
working.

Kath Smith, manager of the intensive support service, believes the
process of coming together has been a significant learning
experience. She says: “My brief was to set up a service with four
agencies – health, education, social services and substance misuse
– for children who are at the extreme end of disaffection and whose
next port of call would be an expensive mainland residential
placement, where they may or may not have a therapeutic
input.

“It was important that we could all feel comfortable with the
service, own the process and not lose our specific professional
identities.”

Working closely with other agencies “didn’t prepare anyone for the
challenge of working together as a multi-agency team”, says
therapeutic liaison Maria Cook. Education liaison Jacki Hayes adds:
“At first I found it hard to let go of ownership, not only
decision-making but the bits of paper that go with that.”

But being with each other daily fostered a mutual respect and a
confidence that bolstered a sense of belonging. “We’re employed by
our own agencies but I feel employed by the team,” says social work
liaison Carol Behenna who feels enlightened by the experience. “We
are always asking or expecting our clients and families to change
and develop, and this has helped me appreciate how hard it is for
them.”

The matter-of-fact honesty about the difficulties faced, but
ultimately overcome, in becoming a team is striking and is the
touchstone of its success. Cook says: “We are with each other day
after day – we plan together and we recognise each other’s places
within children’s lives. Even if we are not directly involved with
a child we are all involved in planning their services.

“The most exciting part for me is that people are now speaking to
each other with confidence – they understand each other’s language
and are not having to defend their corner or profession,” says
Smith. Behenna agrees: “The biggest thing I’ve taken from this team
is knowledge and understanding of each other.”

Having been given time to set up the team, time is crucially
allotted in case work and care planning. This is no quick-fix team,
although clients are prepared with skills for managing their
difficult circumstances.

Cook says: “Treating these children is a very complex business.
It’s a long haul. You can’t do brief intervention with this client
group which often has placement breakdowns. Children are used to
seeing professionals – as well as carers – come and go. They say
that they see us as something stable in their lives – so it’s
crucial for us to be able to stick in there.”

Because of the range of services offered, the team’s individual
involvement with young people can increase or reduce as needed.
There are five phases of service – referral, assessment,
intervention, transition and maintenance.

Smith says: “We expect that children who come to us will always be
in the maintenance phase and will dip in and out of the transition
phase. We’ve found that children emotionally might be stuck in the
intervention phase but we could put them into the transition phase
for education. And that’s something I hadn’t thought about when we
set the service up, which means we can support more children
through the system as each phase requires a different intensity of
input.” CC

Lessons Learned

• Make sure that individual and team supervision, and weekly team
  meetings, are participative.
• Learn the language, acronyms and so on of partner
  agencies.
• Develop shared and inclusive recording systems and
  assessments.
• To overcome difficulties together you need let go of ownership
  of ideas and decisions. 
• Being co-located has helped team spirit. “It means advice and
  support is on tap – instead of making phone calls all day or
  waiting three days for someone to get back to you,” says social
  work liaison Carol Behenna.
• Invest time in planning.