Does the common assessment framework lead to better outcomes for children who have additional needs? Susannah Bowyer describes a mixed picture
Authors: Claire Easton, Marian Morris and Geoff Gee
In May 2009 Research Realities reported on the first round of research by the Local Authorities’ Research Consortium (Larc), which carries out research aimed at improving integrated working. The second round of Larc research has just been published by the National Foundation for Educational Research (NFER).
The first report (Larc1) looked at the early impact of integrated children’s services while the second (Larc2) used the common assessment framework (CAF) process as a focus for identifying what enables effective integration between targeted and universal services.
The research projects undertaken by the 24 local authorities participating in Larc2 all looked at the engagement of schools in the CAF process and addressed two main questions:
● Does the CAF process support the achievement of better outcomes for children and young people?
● What are the key factors that promote the effectiveness of CAF in different contexts?
As Larc chair John Harris puts it, the consortium aims to provide an opportunity for authorities “to benchmark with and learn from others in a spirit of honest and collaborative enquiry”.
Such sharing of innovation and exchange of good practice was commended by the Chief Advisor on the Safety of Children in his first report to parliament earlier this year, while the Association of Directors of Children’s Services has also called for new service delivery models based on the principle of sector-led improvement (ADCS 2009).
The research involved 24 authorities from all nine government office regions in England and over 350 people participated in the research. Of these, 105 were lead professionals and 90 were parents.
Other participants included children and young people, staff from schools, children’s centres, youth offending teams, child and adolescent mental health services, Connexions, drug and alcohol teams, family support, housing, health visitors, midwives, paediatricians, educational psychologists, school nurses, and school improvement and attendance teams.
The participating authorities’ research projects were relatively small-scale and used mainly qualitative methods. All were designed within an overall project framework based on the concept of “realistic evaluation” (Pawson and Tilley 2004). This approach recognises that the effects of an intervention will vary in relation to the context in which it’s delivered and therefore focuses the evaluation not simply on the question “what works?” but “what works, for whom, in what circumstances?”
Each local team wrote a final report which NFER then collated to produce an overall analysis.
Challenges were raised by this practitioner-led research process. NFER found that some local projects ended up focusing on the outcomes of CAF episodes rather than testing their original research proposition about the processes at work, while other propositions proved “overly ambitious” for the scope of this project.
The report is rigorous in noting where outcomes can be linked directly to the CAF process, and where the research does not provide sufficient evidence to support this.
The CAF process is a core element in integrated working, and increasing emphasis is being placed on its role in managing demand for services. A recent report commissioned by the Local Government Association on the cost and capacity implications of implementing Lord Laming’s 2009 recommendations on child protection concluded with the suggestion that:
“It may be beneficial for authorities to consider whether they could make efficiency savings [by] promoting more effective use of the CAF to reduce the time [social] workers are spending on [‘front door’ services, contacts and referrals] thereby freeing up more time to respond to ‘appropriate’ referrals and undertaking necessary assessments.”
So, six years on from Every Child Matters, how is the CAF working in practice? Endorsing other research in this area, the overall picture LARC2 presents is of “a steadily improving but still somewhat inconsistent implementation” of the CAF with significant variations in approach in different authorities. The research found that the CAF process can be “a key mechanism for enhancing and embedding integrated working and can lead to improved ECM outcomes”.
In nine of the 24 authorities, the CAF was seen by staff as “a single, neutral and universally used system that is not ‘owned’ by one sector or service”, and seen to facilitate joined-up working in ways about which many practitioners were highly sceptical before its introduction.
Schools engaging fully with the CAF process were experiencing improved awareness of families’ needs and home environment and the impact of these on school life.
The report details positive outcomes achieved through the CAF process. These include improved school attendance, better engagement with education and raised aspirations (for example returning to school, taking GCSEs or applying for future education, employment or training opportunities), improved physical health and self-confidence and better family relationships.
Six authorities provided evidence of the CAF process enabling families to access benefits and financial and housing support, leading to a tangible reduction in the pressures on families.
Five key contributing factors to the effectiveness of the CAF were identified:
● Engaging children, young people and families as partners in the process.
● Developing a better understanding of children and young people’s needs at the earliest possible stage.
● Ensuring consistency of the lead professional support – which helped build the sustained relationships of trust at the heart of all successful human services delivery.
● Ensuring multi-agency working and information sharing.
● Integrating all elements of the CAF process – holistic assessment, engagement with families, lead professional role, the team around the child model and meetings, action planning and reviews.
Remaining challenges included “a lack of accountability and shared commitment to multi-agency collaboration” in about half of the participating authorities, and a need for children’s trust boards to provide clarity about what the CAF is, who it is for and how it relates to other assessment processes.
Where the CAF process was not fully embedded there could be “strong reluctance to engage with or support” the work, with social care appearing to be the service least engaged in the CAF process.
It was noted that staff may be reluctant to initiate a CAF for fear of becoming the lead professional by default and there is a clear need for ongoing training and informal support to build confidence and capacity in taking on the lead professional role.
For some practitioners there was a gap of over a year between the training and undertaking the lead professional role, indicating the need for refresher training. In the small number of authorities with CAF coordinators or mentors to offer support, this was “highly valued” by lead professionals.
Informed by good local needs mapping and monitoring data, some authorities are targeting the CAF at more specific groups, for instance with families in specific geographical areas, or in work with young runaways or children missing education.
However, few children’s trusts were using CAF data to inform planning and commissioning. Monitoring and evaluation of outcomes in relation to the CAF needs improving, particularly in relation to long-term outcomes to see whether short-term improvements are sustained.
One example is that these authorities were not accessing schools attainment data, which would have provided quantitative evidence for their studies, suggesting the need for more ‘joined-up’ thinking about evaluation.
The Larc collaborative research process itself was found to encourage reflection and local learning, to provide insights into frontline working for middle and senior managers, and to provide evidence of impact on outcomes of local service delivery. NFER’s input and the practitioners’ participation in the research built local capacity for evaluation and research.
Susannah Bowyer is a research officer at Research in Practice
● Larc3 begins new research in 2010 which will continue to explore the CAF process, focusing in on cost effectiveness and the concept of “invest-to-save”. There are currently 22 authorities participating. Those interested in joining the consortium should contact Jane Lewis, director of Research in Practice at firstname.lastname@example.org
Timely early intervention
Despite the aim of the CAF process being a tool for early identification of unmet needs, in many cases it is delivering earlier but not early intervention. This echoes a recent review by Statham and Smith which found that “children selected for CAF assessments were usually those whose behaviour caused agencies (typically schools) the most concern and who already had a relatively high level of problems”.
Seven authorities referred to examples where no improvement in outcomes was recorded. “In most cases, the reason for this lack of change in outcome appeared to be as a direct result of lack of family engagement in the CAF process”. Families with previous negative experiences with services could be hard to engage but “often changed their mind” when the CAF process was fully explained, underlining the critical importance of parents fully understanding the purpose of the CAF if they are to engage.
Links and resources
This article is published in the 3 June issue of Community Care magazine under the heading Identifying young people’s needs