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Innovation in Children’s Social Care: Making Your Case Management System Work for You.

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History and Current Drivers for Change

In her Review of Child Protection in 2011 (p.11)[i], Professor Eileen Munro recommended: “[The] removal of constraints to local innovation and professional judgment that are created by prescribing or endorsing particular approaches, for example, nationally designed assessment forms, national performance indicators associated with assessment or nationally prescribed approaches to IT systems.”  Before that time, children’s social care services had been struggling with workflows and forms of the nationally mandated Integrated Children’s System (or ICS as it was more commonly known).

The mantra in the London Borough where I worked until recently as a Service Manager was: “Practice should drive IT, not the other way around!”   

When family working was delivered in our case management solution, the social workers were so relieved. Filling in a form once for a group of siblings without any copying and pasting was truly exhilarating.  The new form design tool opened up huge possibilities - finally each business area could redesign their forms so that they recorded information in the way they wanted to.  Councils started to have some choices about which areas of workflow they wanted or even to skip certain elements (such as pre-meeting reports).  As long as the underlying statutory reporting rules and core regulatory pathways were not affected, anything became possible.

The launch of the Department for Education’s Social Care Innovation Programme[ii] in 2013 saw Authorities being invited to apply for funding to bring innovation into the sector.  Today lots of Authorities are trialling a wealth of initiatives across the country.

Hertfordshire County Council was the recipient of one of the largest sums of Innovation Funding and made significant changes to the way in which Family Safeguarding Intervention[iii] was recorded.  The Council opted to create a multi-agency collaborative workspace for their new style teams to record into. Whilst this process was separate from the core statutory pathways for children, it still linked very clearly to them.

But delivering change in a social care IT environment is not easy and if not managed well it can create a host of problems and make the lives of busy practitioners worse not better.  In this blog I will share some of my personal lessons learned from delivering changes whilst working for an Inner London Authority, as well as those I have witnessed across the country from some who manage it well and those that have struggled.  I hope it offers some helpful insights and guidance to those who are embarking on changes today whether they be small or large.

Managing Change

Before the days of electronic social care records, if you wanted to change how social workers worked, you might use a set of new policies and procedures to inform staff of a change. You might give them some new workflow diagrams to stick on the wall or embed them in an electronic procedures manual.  You might have re-indexed the layout of your organisation’s paper files to capture a new requirement or introduce new forms to go in them.  Who can forget the introduction of the Department of Health’s Looked after Children Materials?  As a social worker I remember a host of new forms arriving (or should I say booklets?).

Today social workers are able to make use of mobile apps which allow users to complete forms on site, capture signatures and photographs which are instantly linked to the child’s record.  It is also possible to share this information with some case management systems via user portals. This means that there is no need to print or post documentation - portals can even be used to communicate with service users and the messages appear in the child’s case notes.    Service users can access their information online, much like they can access their bank account.

Innovation never ends in IT nor in Practice.  No sooner does the Council’s IT support team head off for lunch, happy that they have delivered the latest release from the supplier, than the phone rings from the Head of Safeguarding and Quality Assurance.  She asks if they can come to a meeting as they want to consider implementing this approach called Signs of Safety and it may mean some system changes…

Today, if Councils change any elements of Business Process, they have to make sure that the systems which support it are adapted in tandem, otherwise there is a risk of creating an environment where people’s experience of their system is at odds with how they want to or are expected to work.  Councils can’t just throw new technology to users and expect everyone to pick it up no matter how intuitive the software. Therefore thought needs to go into how to maximise user buy-in and take up of IT changes. 

In the context of safeguarding vulnerable children, changing the IT system can introduce risks, often through unintended consequences. These can be mitigated against if sufficient time and attention is given to planning and delivering changes well and by ensuring there is sign up across the 3 key disciplines (Practice, IT and Business Intelligence/Reporting).    

Newer case management systems are no longer simply files for recording information about a child or family.  The information gathered flows between areas as children progress through statutory case pathways. From the section 47 investigation to the administrator organising the CP Conference and from the Social Worker who accommodates a young girl to the Independent Reviewing Officer who will be chairing her first Looked After Review.  There are vast numbers of interdependencies across the business as everyone relies on the information being there, in the right place and at the right time.  Business Intelligence or Reporting Teams also rely on this information for statutory reporting, local reporting and to support commissioning processes like the Looked After Children’s Placement Sufficiency Strategy. The information is also used to carry out outcome focused evaluations of particular interventions.

Being able to identify the scope and the nature of a proposed change is essential to determining your approach and ensuring that you can deliver system changes well. 

Balogun and Hope-Hailey (1999)[iv] offer a helpful matrix against which to map intended change in order to get a sense of potential scope and nature in order to help think about how you might best deliver the change.   

 

Realignment

Transformation

Incremental

Adaptation

Evolution

Big Bang

Reconstruction

Revolution

Here are examples of how changes can be mapped using this model:

Adaptation

(Realignment & Incremental)

  • Some small form changes in  confined business areas (e.g. Child Protection Conferencing).
  • Working from business area to business area to deliver simple changes along a particular theme (e.g. reducing bureaucracy by mopping up word docs and building them into the system. Reviewing existing forms to see which elements could be removed).
  • Changing a task to flow to someone else in a team.
  • Tweaking workflows so that an authorisation step is built into a process or a step in a workflow is removed in a particular business area.

Reconstruction

(Realignment & Big Bang)

  • Changing the layout of Plans across Social Care
  • Changing the ‘front door’ processes for Contacts/Referrals and MASH
  • Taking an upgrade that contains new regulatory workflows for fostering recruitment.

Evolution

(Transformation & Incremental)

  • Introducing a Portal or Mobile App in a phased approach into different business areas.
  • Implementing a Customer Defined Workflow for a specific area of the business. 

Revolution

(Transformation & Big Bang)

  • Implementing new cross functional changes Complete system redesign to accommodate a new model of practice (e.g. Family Safeguarding, Signs of Safety or Restorative Practice).

Additional staff may not be required to deliver the kinds of changes illustrated, this should be evaluated on a case by case basis. The level of risk around delivery in terms of the time, cost and impact on practitioners are often driving factors to advocate for a more formal project approach with a project sponsor and a project board.  A formal project in itself does not however need to result in lots of additional work, but it does mean the work has a more visible layer of accountability by ensuring key stakeholders oversee that the project will deliver to timescale, cost and quality.

Sometimes the key stakeholders appointed to oversee a project can be a new group of people but often it can be an existing group of people such as a senior management team or an IT strategy board for example.  Ensure that all change initiatives no matter how small or large are sponsored by the Business AND signed off by the Business before they are made in the live environment.  It is afterall their system to support their practitioners.

You may need your supplier to make the change which would need to be factored in to the timescales.

Lessons Learned

Sometimes the smallest changes can cause the biggest problems!

[i] Access via: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/175391/Munro-Review.pdf

[ii] Access via: http://springconsortium.com/launch-of-an-innovation-programme-targeted-opportunity/

[iii] Access via: https://www.hertfordshire.gov.uk/about-the-council/jobs/working-in-care/work-with-children-and-families/safeguarding-in-hertfordshire.aspx

[iv] Source: Adapted from J. Balogun and V. Hope Hailey, Exploring Strategic Change, Prentice Hall, 1999

 

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