The Local Authority Research Consortium (LARC) is a collaboration of local authorities (LAs) and national agencies that formed in 2007 to carry out joint research into the effectiveness of integrated working in children and young people’s services. An initial piece of research (LARC1), completed in 2008, showed significant variation in the ways and extent to which LAs accepted and implemented the CAF framework across councils, partners and individual services within their local areas.
A second research project (LARC2) has recently been completed that examines progress made over the past 18 months, and explores, in particular, the processes around the Common Assessment Framework (CAF). It seeks to find answers to the following 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?
To explore these issues, 24 authorities situated in a mix of urban and rural areas were involved in small-scale qualitative research projects involving more than 350 participants, including children and young people; lead professionals; school-based teaching and non-teaching staff; health practitioners and professionals in professions allied to health; youth offending teams; CAMHS professions; Connexions staff; family support; education welfare officers; housing officers; and drugs and alcohol teams. See below for information on the common findings across the 24 LAs in the study.
|Table 1: Common findings across the 24 LAs in the study|
|How does the CAF process support children and young people’s progress towards ECM outcomes?|
|Be healthy||LAs provided evidence that the CAF process supported improvements to the emotional and physical health of children, young people and families via interventions that included behavioural support and positive parenting programmes. Children and young people were also found to display better behaviour overall, a greater level of self-esteem and confidence, greater resilience and enhanced levels of wellbeing. An important outcome from the CAF process that many LAs in the study cited was that it supported and facilitated parents in understanding their children’s own needs more fully, and this enhanced understanding and led to more appropriate behaviour interventions, parenting techniques and confidence in parenting. These in turn supported the development of more positive relationships within the home which had positive ramifications outside of the home too.|
|Stay safe||Approximately one quarter of LAs involved in the study found that through CAF-led interventions, children, young people and their families received a thorough needs assessment that helped professionals identify involvement in risky behaviours. Appropriate, targeted interventions and support mechanisms were implemented in these cases that helped the young people to feel safe and to avoid the risky behaviours.|
|Enjoy and achieve||LAs reported that CAF processes helped children, young people and parents to access appropriate multi-agency support, which improved engagement in school life and enhanced peer relationships.|
|Make a positive contribution||LAs reported that the CAF process helped children, young people and families enjoy enhanced relationships and participate in more positive activities.|
|Achieve economic wellbeing||A number of LAs reported that as a result of CAF processes, children, young people and families enjoyed improved economic wellbeing through addressing housing and welfare issues and raising aspirations for engagement in further education, employment or training.|
Key factors of the CAF process which support these improved outcomes
The research highlighted five key factors within the CAF process that were found to promote these positive outcomes:
- The CAF promotes the engagement of children, young people and families as equal partners within the process.
- The CAF facilitates a better understanding of the (at times complex and multi-faceted) needs of children and young people, at an early stage in the process, thus supporting early and targeted intervention.
- The CAF process ensures consistency of the lead professional support, which helps families and professionals work together more effectively. The role of the lead professional was found to be crucial in supporting the engagement of families in the CAF process, not only in building a positive and non-judgemental relationship with the family concerned and being a single point of contact for all queries and issues arising, but also ensuring that multi-agency service provision is delivered in a timely and coordinated manner where all involved in the process are empowered to deliver their role optimally.
- The CAF supports and promotes active multi-agency working and information-sharing, which in turn leads to improved understanding of needs and service provision.
- The CAF is supportive in providing a comprehensive, structured and solution-focused framework that integrates all of the elements of the process: this includes an initial ‘holistic’ assessment that considers a child or young person’s needs; engagement with families through proper and timely consultation; the lead professional role to draw services together in a coherent and timely manner and be a central liaison that helps ensure that the family needs tell its ‘story’ only once; implementation of the Team Around the Child (TAC) model that supports a multi-agency approach to the intervention programme and helps maintain an appropriate child-led focus to service provision; and a system of meetings, action planning and reviews to ensure joined-up planning and coordinated and timely interventions to promote maximum effectiveness of all services delivered to the child or young person.
What do these findings suggest?
The findings of the local studies suggest that significant strides forward in integrated working have been taken in many LAs since the initial research was carried out in 2007 (LARC1).
However, implementation of the CAF is not straightforward and a number of issues remain to be resolved. There is still inconsistent implementation of a system of identification and early support for children, young people and families, with significant differences in the approaches taken by different areas in terms of levels of strategic support given to achieving integrated frontline working. This was felt to stem not only from differences in strategic management at local levels, but also at a national level with differing views expressed by Lord Laming questioning the impact of CAF on referrals, and Ofsted using CAF as an indicator of integration.
In some areas, LAs also reported issues over a perceived lack of shared accountability and commitment to the CAF process across and between services. It was felt that more needs to be done to promote and support the CAF as a tool to support early intervention and prevention.
Schools also varied in terms of their engagement in CAF episodes, varying from partial to full engagement. Where schools were fully engaged in the process, benefits included the following:
- Staff having an increased focus on early intervention and prevention, and were more knowledgeable about multi-agency involvement. They were more likely to flag up early on concerns around behaviour, attendance and so on.
- Staff were more aware of families’ individual needs, and knew more about a child or young person’s home context.
- An important implication of this was that they could more readily recognise the ways in which a home environment was potentially affecting a child or young person’s performance at school, and provide appropriate support.
- At times, a member of staff took the lead professional role, which was found to be highly effective in terms of coordinating services and regular contact with the family.
- Staff reported improved levels of engagement with parents, which helped boost levels of trust and engagement.
- Staff were able to provide support for each other and across agencies.
Schools that were partially engaged in the CAF process were those schools that were more likely to see the CAF framework as an ‘add on’ to the daily workload of the school, rather than an intrinsic part of it. Time, capacity and resource issues were sometimes identified as barriers to full engagement. At the time that the research was carried out, LAs were at different stages in terms of the extent to which the CAF was embedded within their processes, and none of the LAs involved demonstrated complete embedding of the CAF across all agencies and with all personnel working in an integrated work setting.
The evidence to date appears to suggest that the CAF is an effective tool in supporting improved outcomes for children, young people and their families in the form of providing appropriate and timely support, and that more needs to be done to embed the CAF as a tool to support early intervention and prevention more consistently at local and national levels. A number of LAs involved in the research also reported some confusion about implementation of aspects of the CAF process (eg the use of the pre-CAF assessment, the information recorded on CAF forms, the format of TAC meetings, and the role of the lead professional) that need to be resolved in order for the uniform implementation of CAF across LAs.
Further research is planned (LARC3), commencing later this year, that will continue to explore the CAF process, focusing particularly upon issues around cost effectiveness and specifically addressing the concept of ‘invest-to-save’. Questions that remain to be answered in the future will need to address whether the CAF supports sustained improvements to outcomes for children, young people and families.
A number of specific recommendations arising from these research findings involve ways of further embedding the CAF as a tool to support early intervention and prevention, and to improve integrated working. These suggestions include:
- Creating better links between monitoring and evaluation of the CAF data and strategic planning. Providing clear monitoring and evaluation procedures will help assess the longer-term impact of the CAF.
- Sharing the positive outcomes from the CAF process with universal services, and clarifying the role of the CAF for children and young people moving between universal, targeted and specialist services (at local and national levels).
- Promoting the CAF, the lead professional role and integrated working as tools and levers that support early identification and intervention of needs. This should help promote multi-agency accountability and commitment to the CAF process.
- Ensuring that policies locally and nationally support the use of CAF and integrated working.
- Funding local/national roles to promote, manage and support the use of the CAF.
- Reviewing the referral procedures used to support intervention services to ensure that they tie in clearly with the CAF framework, and to avoid any duplication of resources.
- Acknowledging and helping frontline practitioners to implement and drive through CAF-led episodes of care, supported by rolling training programmes and formal/informal support networks.
- Making sure that families are aware of the support available to them from multi-agency professionals via the CAF framework, to support early intervention and empowering families to seek out help as needed.
To download a copy of the full report, go to www.larc-research.org.uk.
Easton, C, Morris, M and Gee, G (2010). LARC2: Integrated Children’s Services and the CAF Process. Slough, NFER