As integrated services for children become the norm, key workers, or lead professionals, are likely to play an increasingly important role in coordinating support for children and young people with SEN or disabilities. Recently published research identifies what effective key worker support looks like in practice and what should be done to ensure that it is effective. These findings and their implications are likely to be of particular interest to SENCOs who may take on key worker roles in the future.
Introduction The value of key workers in providing ‘named person’ support for disabled children and their families has long been regarded as worthwhile, and has recently been recommended as a key component of the Children’s National Service Framework. Although research has shown that severely disabled children and their families do benefit from key work support, both in terms of relationships and access to services, and overall quality of life, when compared to those who do not have a key worker, much less is known about models of key worker practice.
With this in mind, researchers based at the University of York and the University of Kent at Canterbury were commissioned by the DfES to explore the nature of current practice and to make recommendations about the development of effective and cost effective practice.1 The aims of the research were:
- to compare the implementation and operation of different models of key worker services
- to assess the outcomes for parents and children of the provision of different models of key worker services
- to investigate sources of funding and costs of different models of key worker services
- to identify the features of the services that contribute to improved care for disabled children and their families
- to inform standards of good practice in services for disabled children and their families.
The researchers carried out a UK-wide survey of care coordination schemes (in 2002) and identified 30 services providing key worker services for disabled children. Seven of these services were selected for more detailed study. This more in-depth research involved seeking the views of key workers, members of steering groups, managers of services and staff working in schools. Two hundred and five parents and 30 children completed questionnaires on their experiences of the services. Sixty-eight parents/guardians and nine children/young people were also interviewed.
The study concluded positively that:
- key workers provided a valuable service for families and had positive impacts on many families’ lives
- key workers’ collaborative work with other agencies and professionals and with schools facilitated access to appropriate support for disabled children and their families.
More negatively, variations in practice in different areas were highlighted. Factors relating to better outcomes included:
- the management of the service
- definition and understanding of the key worker role
- the provision of training and supervision for key workers.
The research showed that key worker services are most beneficial to families when they are effectively managed, and when all service partners involved are committed to the service and provide adequate funding, staffing and managerial support. It also showed that the role of the manager of the key worker service was crucial, as were key features of it (eg multi-agency care planning and review meetings). Good provision of this kind also enabled parents to participate fully, and helped the service to ensure that a clear focus was kept on the needs of disabled children and their families.
Key worker role
The research found that in some areas the role of the key worker was not always understood, either by families, or the key workers themselves. The most effective services had clearly defined key worker roles and ensured that families, other services and key workers understood what it covered. Outcomes for families were strongly related to the extent to which key workers carried out the different aspects of their role. Agreement between key workers and families on frequency of contact was also important; those families, for example, who felt that they needed more contact, experienced poorer outcomes.
Key worker training and supervision
The research indicated that key workers who received regular training, supervision and peer support were likely to carry out more aspects of the key working and had more positive impacts for families. The implications, for policy and practice, of these findings are outlined the panel opposite.
Effective service provision The research, in noting that more intensive key work contact with families, which was associated with greater levels of parental satisfaction and a positive impact on quality of life, highlighted the need for adequate financial investment in key worker services. It also provided evidence that employing designated key workers was not necessarily more expensive than employing non-designated staff. Funding, however, is not the only factor that contributed to effective key working:
‘[W]hen controlled for other aspects of the service, costs were not directly related to better outcomes for families suggesting that the way key workers provide support may be more important than overall levels of contact.’ (Research Brief RB 656, p.4)
Conclusion The findings and implications of the research outlined in this article are particularly timely and important (see for example, this month’s lead news article ‘Consultation on information sharing’, p.1 and p.3 which emphasises the importance of inter-service information sharing). They warrant close scrutiny by everyone involved in developing new and/or rationalised support services for disabled children, young people and their families.
As noted at the beginning of this article, key working is central to the Children’s National Service Framework. It is also likely to be a crucial factor in ensuring that the implementation of the Common Assessment Framework (CAF) brings real benefits to families. To date, the key worker role has often been associated with health and social-service-based support services for families.
However, with the greater integration of children’s services the role of the key worker could very well become a school-, or education-based professional. Furthermore, as the extended schools initiative gathers momentum, and ideas about the nature of future schools lead to the development of innovative and more complex forms of personalised educational provision, key working may become the cornerstone of support that enables some children and young people to navigate the educational system.
In some school settings, SENCOs might be very well placed to take on the role of key worker for vulnerable children and young people. In other schools, where the SENCO role is poorly conceptualised or undervalued, taking on key worker responsibilities is less likely to be appropriate, and could overburden already overstretched professionals. A positive next step, for key policy and decision makers could be to review the National Standards for Special Educational Needs Coordinators in the light of the latest key worker-focused research and changes proposed to the general framework for the occupational and professional standards of teachers.2
1. Greco, V, Sloper, P, Webb, R and Beecham, J (2005) An Exploration of Different Models of Multi-Agency Partnerships in Key Worker Services for Disabled Children: Effectiveness and Costs [RR655] can be ordered from DfES publications, and costs £4.95. A Research Brief [RB656] can also be accessed online at: www.dfes.gov.uk/research.
DfES Publications: Tel: 0845 60 222 06 Email: [email protected] 2. The Training and Development Agency
for Schools (TDA) commenced a consultation and review of this framework in October 2005.
Developing effective key worker services
Implications for the management of services:
- A multi-agency steering group, involving senior managers from each agency who have the power to commit resources and parents, should oversee the service, facilitate information sharing and agree ways in which the service will gain families’ consent for information relating to them to be shared between professionals/agencies.
- Sustainable long-term funding is required to cover the time of a dedicated service manager and some dedicated administrative support. Such funding should be agreed on an ongoing basis.
- The service manager’s role should include inducting key workers, organising ongoing training and opportunities for key workers to meet together, ensuring they are provided with regular supervision, organising joint-care planning and review meetings, and drawing up information about the service and publicising it to families, other agencies/professionals.
- Non-designated key workers should have protected time to undertake the key worker role effectively.
- The manager and steering group should ensure line managers in agencies from which key workers are drawn understand their role and are committed to the service. Time commitments of the role should be recognised and agreed between the service and the agencies that provide key workers.
- Multi-agency care planning and review meetings should be part of the service and where possible be combined with other reviews, so that families are not required to attend multiple meetings. Meetings should enable information to be shared and the actions of different agencies/professionals to be agreed in collaboration with parents, and young people. Key workers should support families to prepare for and take part in these meetings.
Implications for key worker training and supervision:
- A definition of the role of key worker should be outlined in a job description and the service manager should ensure that every key worker understands the role. Written information for families should also make clear what is and is not within the key workers’ role and key workers should explain this to them. Other relevant services, including schools should receive information about the key workers’ role, and key workers and service managers should be proactive in ensuring that appropriate professionals are aware of, and understand the remit of the service.
- Best outcomes for families are achieved when the key worker role includes: providing information to families about local and national services and support, and how to access these; providing information about the child’s condition where needed; identifying and addressing the needs of all family members; coordinating care and supporting families with care planning and review; improving access to services; speaking on behalf of the family when dealing with services; providing emotional support; and providing help and support in a crisis. These aspects of the role will be carried out in a variety of ways, reflecting the particular needs of individual families.
- Key workers should be proactive in contacting families regularly at intervals agreed with the family.
- Key workers need training to support them in working with disabled children and young people, particularly those who have cognitive and/or communication impairments. Time is needed for key workers to ensure this aspect of their work can take place. Children and young people’s participation in decisions about their own care and about developing the service should also be promoted, and this will need time, resources and support for children.
- Key workers have an important role in improving children’s education and school experience. This may involve mediating between schools and families to tackle problems and to resolve sensitive or contentious issues. It is important that key workers introduce the service to schools when they are allocated to a child or when children start school. This facilitates relationships with schools and enables key workers to be proactive rather than reactive.
- Key workers require a broad range of skills and knowledge and the role is performed best when it is not an ‘add-on’ role without time and training allocated to it.
Adapted from DfES Research Brief RB656