1 Healthy Relationships, Better ChildhoodA five year cross sector strategy to catalyse relational systems change and enable healthier couple and family relationships in Hartlepool Initial – wonderful to be here today, and be contributing to such an important debate with you all; how we can enable children and families to live happier, healthier lives where people have the relational resources to thrive, and how we can support children to develop healthy models of relating (based on the model set by their parents) that will help them thrive and achieve in childhood, adolescence and beyond.

2 Who we are and how we try to helpThe relationships in our lives matter! Encouraging and supporting development of healthy relationships Systemic view; people seen in content of their relationships and relational needs Parental couple relationship Individual internal family relationships, and collective family functioning & ways of relating Peer & social relationships Inter and intra team and agency relationships Agency, practitioner and family relationships To briefly introduce who we are; Changing Futures North East is a Charity based in Hartlepool serving the North East of England that works on the belief that the relationships in our lives matter! We all know, at a very personal level, that the quality of our relationships has huge ramifications for our wellbeing, happiness and the extent to which we achieve in life. Poor relationships can bring misery, whereas having a variety of well functioning relationships, within and outside of the family, can bring immense joy, fuel our journey through life and enable us to touch in a very positive way the lives of others. Aside from this intuitively making sense, I know I’m not advising the committee of anything new when I say that this instinctively “right” argument is increasingly backed up by research and evidence. Driven by a determination to enable people to improve relationships, the organisation has developed new models of working with individuals and families: Piloting a 12 week programme with parents in long term entrenched conflict across the North East of England, supported by the Department for Work and Pensions, that's resulted in vast majority of those completing showing outcomes including improved shared awareness of children's needs, more collaborative parenting, and reduced parental conflict Started redeveloping a child focused mentoring model to take into account the family system and work with all appropriate family members, including the couple relationship(s) Working to embed support for relationships across all projects within the Company to help achieve our vision whereby people in the North East, and particularly Hartlepool, have healthier relationships than anywhere else in the country

3 Realising our vision through Family & Relationship Hub(s)Make Hartlepool a place where people have healthier relationships than anywhere else in the country Realising the vision Hartlepool will become a Family & Relationship Hub through delivery of the 5yr Healthy Relationship, Better Childhood strategy Three physical hubs in “hotspot areas” to become physical manifestations Hartlepool's commitment to relational working and focus on supporting couple and family relationships The experience of changing futures has been that, whilst relational services can enable good results for children and families, it can be hindered where systemic conditions aren't right. Within the organisation, some work has struggled to adapt to a family & relationship focus as assessment systems, professional backgrounds of staff, and a lack of adequate development of a shared understanding as to what relational work is and means, pulled against a desire for change. We’re embarking on a systems change project in Hartlepool to achieve our vision to make Hartlepool a place where people have healthier relationships than anywhere else in the country Our view is that existing services can and should be adapted to focus moreso on relationships and the couple relationship and building relational assets rather than deficits and “issues” , and that in order to do this major reshaping of strategies, assessment processes, retraining of the workforce and culture change is necessary. Our experience, even internally as we tried to mainstream a more relational approach, has been that the system can hinder progress if not worked with and reshaped from within. Our work in Hartlepool, with our partners, is to make Hartlepool itself a Family & Relationship hub. We do intent to establish three Family & Relationship hubs in the Town, and these will be through VCS and children's centres, but these physical, tangible “things” can only thrive if they are the manifestation of a relational focus, the realisation of work across systems to deliver a relational approach.

4 Focal point for work to support couple and family relationships - HartlepoolFacing substantial challenges, yet with huge assets – area is innovating and moving forward with optimism and commitment ‘There is a strong child-centred value base which forms a golden thread throughout the organisation’ – speak of strong culture of support, trust in leaders, experienced and talented staff... Comment that ‘the service is well placed for innovation’ OFSTED 2012 Circa 92,000 population Unitary Authority Highest spending on Early Help in the sub-region of Tees Valley Outsourcing of various Early Help services to VCS – endemic of attitude of partnership and trust in sector Early Intervention strategy increased demand and special care spend – uncovered unmet need – CIN cases up 50%, CP cases down 16% LAC cases up 34%, Social Care spend up 10% (over spend). Children impacted by various social and economic realities Economic situation Poverty Substance use, debt Educational outcomes We have chosen Hartlepool as an area to focus our efforts, in part because of the good relationships with have with the local authority and other partners, but also because of the clear evidence of need for a more relational approach,, and the substantial assets within the town: Hartlepool is a unitary authority with population of 92,000 and the area has an already existing strong Early Action infrastructure that includes: Universal child and youth activity offer in the five most deprived wards delivered by a VCS consortium Troubled Families work that is being mainstreamed across the area Integrated social care and early help teams to help prevent constant escalation & de-escalation with FSW & health visitors co-located Parent Support Advisors (Schools) working to support families Support for separated parents in conflict (CFNE) Investment in innovation would be timely; the recent OFSTED survey of children’s services identified: ‘There is a strong child-centred value base which forms a golden thread throughout the organisation. There is a strong culture of support throughout the organisation... The service is now well placed for innovation because the workforce, social workers etc have confidence and trust in their leaders and there are some very talented and experienced staff’. The area has invested in Early Intervention biggest spender in TV; uncovered unmet need, increased costs... May be typical for start of EI work.... At least have “bottomed out” what is estimated to be most unmet need so can start turning the tide Its an area that has also demonstrated a need to better support couple and family relationships: Relationship quality in and between agencies and teams, families and the parenting couple is not formally measured in Hartlepool. However: Practitioners across the Children’s Workforce report dysfunctional relationships are present in the vast majority of cases they encounter where problems are entrenched and severe 24% of children are referred into social care in Hartlepool because of family dysfunction. Practitioners in Hartlepool observe that after separation, many children become withdrawn and disruptive at school, get worse results, use alcohol, suffered mental health problems (75%) and see children get physically sick more (61%). Other agencies surveyed and interviewed 175 separating or separated family members; corroborating the PSP consultation, with most reporting separation was un-amicable. For couples whose relationship was not healthy, separation can set in motion a way of relating that is harmful for children.

5 Healthy Relationships, Better Childhood Strategy, 2015-2020Changing Futures North East & Hartlepool Borough Council led cross sector partnership to ensure: Hartlepool not only “Thinks Family”, but Thinks Child, Thinks Couple, Thinks Family; proper recognition and attention is given to relationships and the interrelatedness of human systems. Families who work with services see healthy relationships within services, and healthy ways of relating are modelled by staff who work with them Spending on acute children’s services is reduced by 5%+ through a 10% reduction in demand, with increased investment and capacity in early help services Key outcomes & indicators we expect to both contribute to and arise from this work include: Less family breakdown, less social care demand Improved family relationships Improved school attendance Supported by £1.52mill investment from Comic Relief, Big Lottery Fund, Esmee Fairbairn and also in year one through HBC secured finance So clearly, given the assets in Hartlepool as well as the needs discussed, it’s a great place to work in to try to enable better outcomes for children though strengthening couple and family relationships. However, it’s not a task we can take on alone; making Hartlepool a Family & Relationship hub where prevention and early help reduce wasted human potential and reduce acute spending requires the concerted efforts of partners across sectors, teams and agencies, and requires investment to enable change. Partners in Hartlepool, led by CFNE and HBC, have brought together their resources and thinking and created a single strategy, Healthy Relationships, Better Childhood, to deliver substantial change in Hartlepool, aiming to ensure that through focusing on couple and family relationships Hartlepool comes into line with statistical neighbours for looked after children numbers.

6 Strands of work Relational Work Improved Outcomes for FamiliesCreate Culture Change - Talking Relationships Establishing Healthy Organisational Systems Practice Supports Couple and Other Relationships In order to bring about this change and achieve our vision, we have three interrelated areas of work: These areas of work are not strictly linear and have a range of activities underway at the same time, whilst working on any one of those strands may have limited impact on outcomes for families, we believe that by focussing on all three to create the conditions for effective relational work where professionals are confident and adept at assessing and supporting individuals to have healthy relationships, as well as having parents and families who want and can access that support Relational Work Improved Outcomes for Families

7 Enabling systems changeThe challenge: Establishing Healthy Organisational Systems Effective and healthy ways of relating within teams, between teams and between services; Systems create and encourage this – Leadership, Strategies, Systems, Structures, Skills, Knowledge and Culture Our Work: Internal Development – embedding relational work at CFNE; Multi-agency engagement – frontline to strategic (and more); Fluid project team – people promoting change from within existing teams; Substantial engagement and support of senior and mid managers to create and embed change; Establish measures and ways of understanding team functioning and those relationships external to the team; Sharing learning with commissioners. Establishing healthy organisational systems: Important in our first year of work, is the need to successfully embed relational work in our own organisation – we expect that whilst challenging, doing so will provide lots of learning about managing change towards this way of work when thinking about the various systems of the organisation, families and the wider world. We are currently working with all levels within our organisation to establish this work internally, and have already learned much about some of the challenges but also the solutions to those challenges. That said, our experience of change management won’t be a common experience for all organisations looking to develop in this way, their own particular context will provide a unique set of conditions for an organisation introducing this work, but we hope that through our work we can enable other teams and services to develop healthy ways of relating – we plan to do this by engaging strategic senior and mid managers in a programme of training and support that will enable them to bring about change in their own team – we want them to work with their teams the same way we want to work with families, - thinking about the interconnected relationships, starting from where they are at, building on strengths and helping them to plan how a desired change is brought about. We know the work requires commitment from partners, and we have made some progress with this by creating a strategic group that has representation including up to director level from health, (CCG, public Health and Local NHS Trust) social care, education, economic development, community safety, youth and youth offending services and police. There is work to be done on developing understanding about why the couple and family relationships might be so important to their own priorities.

8 Enabling systems changeThe Challenge – High levels of need yet low take up of services Fear – making things worse, having children removed, what other people think; Awareness – Don’t know where or how to access support. Our Work – Normalising seeking help for relationships Develop local knowledge – volunteers and services; Marketing campaign – client input - with real local people stories; Web resources; Family Hub / Relationship Centres; Media strategy – local press, features and comment; Offer universal services – Parents as Partners Programme; Workforce development – Creating Culture Change We know there is demand and need in Hartlepool for early intervention couple relationship and other relationship support – We know this partly at least as demand for late intervention couple work is high –estimates from social care managers note separation and couple relationship dysfunction present in 80-90% of social care cases. Despite high need, the take up of services that provide help, such as mediation and relationship counselling is disproportionately low for the area’s population. We explored this with focus groups of parents, we found that many involved would find it difficult to seek help for their intimate relationships. The reasons for this were broadly based around two things: Fear of seeking and receiving help and secondly knowing where help is available. Reasons for fear included: that social services would be informed and children would be removed, that it would make the relationship worse and fear of others finding out. In terms of knowing about help, parents who had previously been involved with social care suggested that they only found out about available services once they had entered social care. As part of our work, we’re trying to bring about a change in attitudes and culture firstly ‘normalising’ the notion of seeking help for intimate relationships and secondly increasing awareness of that help and people’s confidence in accessing it. We’ll be building local knowledge of services available , with communities and the public and with either agencies in Hartlepool for example working with volunteers and universal services who are already active in communities so that they know about services and are can help to signpost encourage their use. We also need to shift the feared stigma of seeking help. We’ll be using real life stories of those who have accessed support in a variety of media to shift thinking- Parents have told us that they’d be more confident seeking help and going to access a service if they heard success stories from real local people. We’ve seen success using this approach by increasing take-up into one of our late intervention separation services. Using 2 different family testimonies in radio adverts increased self referrals to a late intervention separated couple conflict resolution service by over 400% compared with the previous quarter. We also believe this campaign which included flyers, adshells, billboards and beer mats helped to boost awareness of the service with other professionals which led to further referrals.

9 Enabling systems changeThe Challenge: Getting Services thinking and working relationally Assessment, planning and practice – thinking couple and thinking relationships, thinking family. Developing systems around practice to enable working this. Our work: Multi-agency partners – engagement at all levels Revision of Common Assessment / Early Help Assessment and training in it’s use; Collocation specialist relationship and other services – Family Hubs / Relationships centres; Coaching and support for supervisors and managers; Coaching and support for teams –coaches embedded within; Training workforce in working relationally; Introduce Parents as Partners programme; Preventative services for children and adolescents Support the couple and family relationships: In our own services, we’ve seen strong outcomes for the whole family by directing intervention at the parenting couple and couple relationship. This work requires meaningful engage with from partners and at various levels within their own areas, our work is overseen by a multi-agency strategic group with partners from health, education, social care, economic development involved, the project is managed jointly between Hartlepool Borough Council We want to get practitioners from across the needs spectrum - universal to acute incorporating systemic and relational thinking within their practice and doing so with confidence and support from the systems in which they work. We’re currently establishing some accurate baseline data but suspect the % of assessments completed in early help that make reference or give consideration to the couple relationship and other family relationships will be very low. A recent audit of common assessments completed between December 13 and November 14, in Hartlepool illustrated some concerns, 72% of assessments had a complete absence of father’s voice and in many cases, completely absent from all discussion or information in the assessment. Suggesting that if the family isn’t mapped fully, practitioner’s ability to think about the relationships within is immediately hampered. Together with representatives from a variety of teams and services, we’ll be revising the early help assessment (and training in it) to encourage more consideration and assessment of relationship quality We’re working with a variety of statutory and voluntary sector services to catalyse this change, we believe the change needs to come from within teams gently and to reflect this, developing practice with a relational focus won’t be based around training alone, there will be substantial support for managers of teams to enable them to help their own teams work in this way. Including providing safe spaces for reflection and discussion on the challenges of change management which also supports development of healthy ways of relating between teams and between organisations. Collocation of some services and the development of integrated working systems supports this and will be developed in a Family Relationship Centre first with learning shared with partners in the Local Authority and Health. Direct training in higher level couple work for suitably experienced practitioners will be offered through the Parents as Partners programme and thus building local capacity to deliver services to support the couple relationship.

10 Initial Work (years one and two)Revision of Early Help Assessments (CAF) to enable relational assessment Training of 40 multi-agency staff in use of Early Help Assessment and relational focus. Begin Early Help Strategy for Hartlepool; Establish Parents as Partners Programme, to be delivered each year; Establishing relational working at Changing Futures North East; Enabling learning and evaluation Establishing baselines Identifying indicators and adapting systems Working with Sheffield Hallam university (EAFA appointed to measure overall impact of national programme and overall project level impact) Identifying partnerships and investment opportunities to help build the evidence base as to effectiveness of specific elements of relational systems change rather than relationship programmes Linking up with early action agencies nationally to learn from and share good practice Year 2 Campaigns to normalise seeking help; Work with volunteers to promote relationship services and support within own communities; Project team working with two ‘teams’ to embed relational working and systems; 40 staff trained in relational working Engagement of team managers to support relational working Complete Early Help Strategy

11 Some Indicators of ProgressAssessment 50% of all Common Assessments in Hartlepool contain detail on the couple and family relationships (baseline est 5-10%) VCS completion of CAF rises from 10 per year to 100 Service Demand & Utilisation Reduction in CIN and CP caseload size Looked after children rates reduce form 194 to 154 (in line with statistical neighbours) Mediation access increases from est. 50 to 120 per year Counselling – 89 to 150 per annum Outcomes 37% reduction in number of children with attendance of <85% Improved family & couple relationships

12 To conclude Has to be systemic; Has to be collaborative;Requires investment – not just financial but time, space for reflection and learning; National policy and measurements have a role to play in creating the conditions.

13 For further information, contactGraham Alton, CEO – Martin Todd, Deputy CEO & Project Lead – Telephone: Welcome further discussions with interested parties.