History and Current Drivers for Change And Innovation In Childrens' Social Care

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 trialing 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 social care 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 if sufficient time and attention are 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 after all their system to support their practitioners.

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

Lessons Learned

Sometimes the smallest changes can cause the biggest problems!

• Have a Change Authority at all times: The first and most important one is to have an established mechanism for managing your changes. There has to be a regular forum where Practice, IT and Business Reporting leads come together to review change proposals, investigate, authorise and sign them off when ready to deploy.  If this works well then it should significantly reduce the risk of the other lessons learned that follow here from ever happening. You can also ask them to double up as a project board for smaller-scale projects.

• Have the required knowledge and expertise: If you are going to embark on a project to redesign forms, do the people who will do this have current knowledge of the product to really know how to make forms work best for the end-user and the system capabilities? A badly designed form can make things worse for the end user not better but a well-designed form can be truly transformational for the end-user. Practice leads might know what they want but a good form designer can often take their ideas one step further and deliver something that they might not even have realised can be done.

• Consider possible unintended consequences: Changing one part of the system without thinking through how that change might impact elsewhere.

• Tell your supplier if you think you might need them: Talk to your supplier at the very beginning. You might otherwise risk committing to timescales that they cannot meet.

• Be careful with what you remove: Depending on the age of your system, amending forms can lead to data loss at a statutory or local reporting level. Removal of statutory reporting fields in newer systems is not possible, as they are locked down by the supplier but in some older systems, this can cause issues. If you have data items in a form that are needed for local reporting, be careful not to remove them as you embark on redesigning a form – it’s all about having a change control process in place that involves your reporting leads.

• Engage End Users in Testing: If someone says they need something to be changed then they must be prepared to work with the people who will deliver the change. The person who requested the change should always test it properly before it is signed off. Nobody would be prepared to pay for a house to be built, without approving the drawings or visiting during the build!

• Prepare your End Users: On the day you go live with a change will they know this is happening and what to do? Do you need to train them or will written communication suffice? Have Practitioner representation on your Change Control Authority who can represent all the business areas and help you engage who you need to when you need to.

• Learn from others: Take part in supplier user groups and any customer forums to find out who else might have done what you are thinking of doing and learn from them. Some may even invite you to go and see what they did so you can see what a similar change might look like before you start your project.  You should also talk to your supplier - they have seen changes implemented time and time again.

• Get Feedback from your Users: Have a mechanism in place to capture whether your changes have resulted in any unintended consequences. Authorities who manage their systems well have internal user consultation forums, which means there is an established mechanism for representatives across the business to bring their system issues to your attention.

[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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