SOCIAL IMPACT OF THE ABERLOUR FAMILY SERVICE SOUTH … · v i d u a l s e f f e c t i v e c o n t r i b u t o r s s u c c e s s f u l l l e a r n e r s a c d a i a aberlour child

SOCIAL IMPACT OF THE ABERLOUR FAMILY SERVICE SOUTH AYRSHIRE

A REPORT FOR ABERLOUR CHILD CARE TRUST

INDEX

EXECUTIVE SUMMARY 1

1: INTRODUCTION 6

2: STRATEGIC CONTEXT 8

3: THE FAMILY SUPPORT SERVICE 12

4: IMPACT ON SERVICE USERS 16

5: IMPACT ON THE SERVICE LANDSCAPE 32

6: PREVENTATIVE SAVINGS 36

7: CONCLUSIONS & RECOMMENDATIONS 40

APPENDIX A: CALCULATION COST SAVINGS 42

A B E R LO U R C H I L D C A R E T R U S TS O C I A L I M P A C T O F T H E A B E R L O U R F A M I L Y S E R V I C E S O U T H A Y R S H I R E

Our best estimate is that there are around 105-182 parents with learning disabilities in South Ayrshire, however, we believe that this figure is significantly understated because official data focuses solely on mothers and 63% of current clients are undiagnosed.

To date the Aberlour Family Service South Ayrshire has worked with 42 families (58 adults and 55 children).

PARENTS WITH LEARNING DISABILITIES

THE ABERLOUR FAMILY SERVICE

STRATEGIC CONTEXT

ABERLOUR CHILD CARE TRUST

EXECUTIVE SUMMARY

— Children and Young People (Scotland) Act 2014: Part 12: statutory duty to ensure relevant services are available to children and families at risk of becoming ‘looked after’.

— National Parenting Strategy: the need for prevention and to focus support on parents at risk of children being taken into care.

— The Keys to Life: Recommendation 38: parents with learning disabilities should have access to local supported parenting services.

— Better Health Better Care: vulnerable parents, including those with learning disabilities, require additional support.

— Getting It Right For Every Child: measuring and achieving SHANARRI wellbeing indicators.

— Scottish Good Practice Guidelines for Supporting Parents with Learning Disabilities: basis of Aberlour Family Service South Ayrshire.

— Academic Research: ample research evidences that parents with learning disabilities require specialist, bespoke support.

Operated in South Ayrshire since May 2013, providing Parenting Assessment (PAMS) and flexible support to families in which one or both parents have learning disabilities.

It focuses on increasing the parenting capacity in order to provide a safe and nurturing home environment and improved outcomes for children and their families.

A B E R L O U R C H I L D C A R E T R U S TS O C I A L I M P A C T O F T H E A B E R L O U R F A M I L Y S E R V I C E S O U T H A Y R S H I R E 1

RESPONSIBLE ACHIEVING

INCLUDED

RESPECTED

HEALTHY

NURTURED

SAFE

ACTIVE

IMPACT OF THE ABERLOUR FAMILY SERVICE SOUTH AYRSHIRE ON CHILDREN AND FAMILIES

FIGURE 4.2: SHANARRI OUTCOMES - CHILDREN

FIGURE 4.1: SHANARRI OUTCOMES - PARENTS


INCLUDED

RESPECTED

HEALTHY

NURTURED

SAFE

ACTIVE STAKEHOLDERS PERCEPTIONS

— Delivering early intervention

— Improving parenting skills

— Building confidence in families

— Connecting families to services and the community

— Healthier and happier children

— Preventing children from being taken into care

KEY

Before intervention After intervention

A B E R L O U R C H I L D C A R E T R U S TS O C I A L I M P A C T O F T H E A B E R L O U R F A M I L Y S E R V I C E S O U T H A Y R S H I R E2

IMPACT ON THE SERVICE LANDSCAPE

AN ESSENTIAL SERVICE

CHALLENGES

DELIVERING THE PREVENTION AGENDA

WORKING IN PARTNERSHIP

— Large unmet need: only worked with a maximum of 1/3 of potential parents with learning disabilities in South Ayrshire.

— Acknowledgement by multiple statutory providers that the service is an essential part of the service landscape.

— Lack of awareness of the service by both parents with learning disabilities and other statutory services (GPs).

— Working with 12-16 year old children.

— Offering support at evenings and weekends.

— Intervention before crisis-point.

— Reduced input required from statutory services at a later stage.

— Prevents children from being taken into care.

— Strong relationships with other service providers: cross-referral and joint delivery of services.

— Positive impact on the caseload of statutory services.

FILLING A GAP IN SERVICE PROVISION

— Only third sector organisation in South Ayrshire with a licence and training to undertake PAMS assessments.

— Varied and flexible assessment and support. Length, intensity and structure of support based on individual needs.

— Engaging families with a mistrust of and often difficult relationship with statutory services and working to improve trust and engagement with all services.


VALUING PREVENTION

WITHOUT THE ABERLOUR FAMILY SERVICE SOUTH AYRSHIRE

An assessment of what may have happened without the intervention of the Aberlour Family Service South Ayrshire - for the six case study families:

COST SAVINGS TO THE PUBLIC PURSE

— Over one year:

— Over a ten-year period:

children would have been at increased risk of involvement with the criminal justice system.

parents would have been unlikely to attend college.

children may have been taken into care.

parents would not have been able to access essential support services.

parents would have been likely to experience an increase in addiction related issues.

children may not have received essential health and other services (e.g. GP, physiotherapy, dentist etc.).

parents may have experienced seriously deteriorating health issues.

parent would have been at increased risk of a jail sentence.

children would have been likely to have continued poor school attendance.



1. INTRODUCTIONThis report describes the impact of the Aberlour Family Service South Ayrshire on the supported parents and children and the wider service landscape.

ABERLOUR CHILD CARE TRUST

Aberlour Child Care Trust aims to be Scotland’s leading children’s charity and a major force for change and provides services for children, young people and families across Scotland.

Since its inception as an orphanage in Speyside in 1875 and the formal establishment of Aberlour Child Care Trust in 1976, it has developed a significant reputation for delivering a range of services including residential care and fostering, dependency, early years, disability and early intervention youth work. They work with children, young people and families living with a disability, growing up in and leaving care, and dealing with the impact of drugs and alcohol on families.

THE ABERLOUR FAMILY SERVICE SOUTH AYRSHIRE

The Aberlour Family Service South Ayrshire is funded by the Big Lottery and South Ayrshire Council and has operated in South Ayrshire since May 2013. The service provides assessment and flexible support to families in which one or both parents have learning disabilities.

It focuses on increasing the parenting abilities of the parents in order to provide a safe and nurturing home environment and improved outcomes for children and their families.

The service is based in Girvan and delivers services across the whole of South Ayrshire.

The Family Service works with parents and their children on a one-to-one or group work basis and supports parents to connect and engage with the wider community.

One of the key services the Family Service offers is a parenting capacity assessment using the Parent Assessment Manual software (PAMS). This

assessment highlights any areas for development in terms of knowledge, skills and consistency. Following the assessment, a personalised teaching programme is developed to address these areas.

Big Lottery funding for the service ends in November 2017.

STUDY OBJECTIVES

The main objectives of the evaluation were:

— To assess whether the Aberlour Family Service South Ayrshire has had an impact on parents with learning disabilities and their children and, if so, to evidence this impact.

— To assess the impact of the Family Service on the service landscape in South Ayrshire.

— To establish whether there is a future need for the service.

— To make the case for further investment into the service.

— To suggest further improvements to the service.

STUDY METHOD

The study was carried out by Social Value Lab between July and September 2016. It was based on a mixed research design that involved a number of main stages:

— Desk-based review of Aberlour monitoring data.

— Desk-based review of strategic policy context.

— In-depth interviews with key workers of 6 families.

— Semi-structured telephone interviews with 14 key stakeholders.

The findings of the evaluation are set out in the following pages.



2: STRATEGIC CONTEXTThis Section details the strategy and policy documents in which the Aberlour Family Service South Ayrshire operates and why they are of strategic importance.

PARENTS WITH LEARNING DISABILITIES

It is unclear how many parents with learning disabilities there are in Scotland. Estimates for the UK vary from 23,000 to 250,000, which would equate to 40-439 parents with learning disabilities in South Ayrshire.

Almost all available data on parents with learning disabilities concerns those who are in contact with social work services, and focuses mainly on mothers1, and is therefore significantly understated.

In 2012 Aberlour commissioned the Scottish Commission for Learning Disabilities (SCLD) and the University of Bristol to undertake a feasibility study that estimated the number of parents with learning disabilities in South Ayrshire at 182.

The latest credible estimate of the number of parents with learning disabilities comes from research conducted by Strathclyde University2 on behalf of SCLD. This research report estimates that there are around 5,000 parents with learning disabilities in Scotland, which equates to 105 in South Ayrshire.

Aberlour’s experience with running the Family Support Service indicates that 63% of the parents it has supported have an undiagnosed learning disability so the prevalence of families with learning disabilities that require support may be much higher than previously thought.

STRATEGIC CONTEXT

There are a number of policies and strategies that guide the Family Support Service.

GETTING IT RIGHT FOR EVERY CHILD

Getting It Right For Every Child (GIRFEC) is the Scottish Government’s overarching strategy to ensure that every child in Scotland is fully supported to develop into successful learners, confident individuals, effective contributors and responsible citizens.

The GIRFEC approach arose from the Review of the Children’s Hearing System in 2004, was piloted in 2006 and introduced in phases from 2008 onwards.GIRFEC puts the rights and wellbeing of children and young people at the heart of the services that support them and defines wellbeing through the introduction of eight wellbeing indicators, better known as SHANARRI3. Like every service working with parents and children, the Aberlour Family Service South Ayrshire adheres to the GIRFEC approach and measures the success of its services through the SHANARRI wellbeing indicators.

1 Supported Parenting, Refreshed Scottish Good Practice Guidelines for Supporting Parents with learning disabilities, SCLD, 2015.2 Dr. A. Stewart, Dr. G. MacIntyre and S. McGregor, Supporting Parents with Learning Disabilities in Scotland: Challenges and Opportunities, SCLD, August 2016.3 SHANARRI = Safe, Healthy, Achieving, Nurtured, Active, Respected, Responsible and Included.


Being supported and guided in their learning and in the development of their skills, confidence and self-esteem at home, school and in the

community

Having opportunities to take part in

activities such as play, recreation and sport which contribute to healthy growth and development, both at home and in the

community

Having help to overcome socail, educational,

physical and economic inequalities and being

accepted as part of the community in which they

live and learn

Having opportunities and encouragement to play active and responsible roles in their

schools and communities where necessary, having

appropriate guidance and supervision and being

involved in decisions that affect them

Having a nurturing place to live, in a family setting with additional

help if needed or, where this is not possible, in a

suitable care setting

Having the opportunity, along with carers, to be heard and involved in decisions which affect

them

Protected from abuse, neglect or harm at home, at school and in the

community

Having the highest attainable standards of physical and mental health, access to suitable healthcare and

support in learning to make healthy and safe choices

NURTURED

RESPO

NSIBLE CITIZENS

CONFIDENT INDIVID

UA

LS

EFFECTIVE C

O

NTRIB

UTO

RS

SUCC

ESSFULL LEARNERS

AC

HIE

VIN

G

RESPECT

ED

ACTIVE

INCLUDED

RESPO

NSI

BLEH

EALT

HY

SAFE

BEST START IN LIFE:

READY TO SUCCEED

SHANARRI WELLBEING INDICATORS


CHILDREN AND YOUNG PEOPLE (SCOTLAND) ACT 2014

This Act was designed to bring about changes in the way the wellbeing of children and young people in Scotland are supported. The Act provides a legislative underpinning of the GIRFEC approach and values and embeds the SHANARRI wellbeing indicators as the legal definition of wellbeing for children and young people.

Part 12 of the Act, which came into force in August 2016, places a statutory duty on Local Authorities to ensure that a range of relevant services is available to children and their families that are at risk of becoming ‘looked after’.

PART 12Services in relation to children at risk of becoming looked after, etc.

Section 68 - Provision of relevant services to parents and others.

(1) A local authority must make arrangements to secure that relevant services of such description as the Scottish Ministers may by order specify are made available for –

(a) each eligible child residing in its area,(b) a qualifying person in relation to such a

child,(c) each eligible pregnant woman residing in its

area,(d) a qualifying person in relation to such a

woman.

(2) A “relevant service” is a service comprising, or comprising any combination of –

(a) providing information about a matter,(b) advising or counselling about a matter,(c) taking other action to facilitate the

addressing of a matter by a person.

NATIONAL PARENTING STRATEGY

In 2014 the Scottish Government launched its National Parenting Strategy4. This strategy provides a framework to support parents to be the best parent they can be to give children and young people the best start in life.

The document stresses the importance of love and nurturing for children’s health and wellbeing in their early years as well as throughout their childhood5.

The Strategy highlights the need for support at an early stage to prevent things getting worse and the need to focus support on those parents that are at risk of their children being taken into care. The Strategy acknowledges that parents with learning disabilities require extra support.

THE KEYS TO LIFE

The Keys to Life6, published in 2013, is Scotland’s 10-year learning disability strategy and the successor to The Same as You?

The strategy specifically mentions parents with learning disabilities and states as one of its objectives:

Recommendation 38

That by 2014 parents with learning disabilities should have access to local supported parenting services based on the principles of Supported Parenting and that the Scottish Good Practice Guidelines for Supporting Parents with Learning Disabilities are being followed by professionals working with parents with learning disabilities to ensure better outcomes for families.

The Scottish Government has also published the accompanying Keys to Life Implementation Framework and Strategic Priorities 2015-17, which details four priorities, including: “Develop effective interventions for parents who have learning disabilities” (Strategic Outcome 1).

4 National Parenting Strategy, Making a positive difference to children and young people through parenting, Scottish Government, 20125 Geddes, R., Haw, S. and Frank, J. Interventions for Promoting Early Child Development for Health, MRC, SCPHRP, 2010; Shonkoff, P., Phillips, D.A (2000) From Neurons to

neighbourhoods: The Science of Early Childhood Development; and Steinberg, L. (2009), A Behavioural scientist looks at the science of adolescent brain development. Brain and Cognition, 72, 1, 160-164

6 The Keys to Life, Improving quality of life for people with learning disabilities, The Scottish Government, 2014


SCOTTISH GOOD PRACTICE GUIDELINES FOR SUPPORTING PARENTS WITH LEARNING DISABILITIES

In 2015 SCLD published Supported Parenting7 a guide for professionals to ensure parents with learning disabilities get the support they are entitled to. The Aberlour Family Service South Ayrshire is based on the Principles of Supportive Parenting as described in these guidelines.

BETTER HEALTH BETTER CARE

Better Health, Better Care8 is the Scottish Government’s Action Plan for health improvement, tackling health inequality and improving the quality of health care.

The Action Plan recognises that vulnerable parents, including those with learning disabilities, require additional support.

INTERNATIONAL LAW ON HUMAN RIGHTS

The duty to support parents with learning disabilities to be good parents is further enshrined in the European Convention on Human Rights (article 8 - the right to respect for private and family life) and the United Nations Convention on the Rights of Persons with Disabilities (article 23, para 4 - the right of a child not to be separated from its parents on the basis of disability of either the child or one of the parents.

7 Supported Parenting , Refreshed Scottish Good Practice Guidelines for Supporting Parents with learning disabilities, SCLD, 20158 Better Health, Better Care: Action Plan, The Scottish Government, Edinburgh 20079 The Keys to Life, Improving quality of life for people with learning disabilities, The Scottish Government, 201410 Supported Parenting, Refreshed Scottish Good Practice Guidelines for Supporting Parents with learning disabilities, SCLD, 201511 Ibid.12 Moran, P, Ghate, D, and van de Merwe, A., What works in parenting support? A review of the international evidence, London: Department for Education and Skills, 200413 Supporting Parents with Learning Disabilities in Scotland: Challenges and Opportunities, SCLD August 201614 McGaw, S. and Newman, T., What Works for Parents with Learning Disabilities? Ilford: Barnardos, 200515 Ibid.16 Moran, P, Ghate, D, and van de Merwe, A., What works in parenting support? A review of the international evidence, London: Department for Education and Skills, 200417 Culley, L. and Genders, N., ‘Parenting by people with learning disabilities: the educational needs of the community nurse’, Nurse Education Today, 19(6), pp. 502-508,

199918 Tarleton, B, Ward, L. and Howard, J., Finding the Right Support: A review of issues and positive practice in supporting parents with learning difficulties and their children,

Bristol: University of Bristol, 200619 Supported Parenting, Refreshed Scottish Good Practice Guidelines for Supporting Parents with learning disabilities, SCLD, 2015

SUPPORT FOR PARENTS WITH LEARNING DISABILITIES

Although many policy documents acknowledge the need for early intervention and appropriate support for parents with learning disabilities, the reality is that this is not always the case9.

SCLD estimates based on a national survey of people with learning disabilities that about 40% of parents are not living with their children10.

There is no strong causal relationship between IQ and parenting ability and abuse11, although cognitive impairment does bring its challenges to parents (e.g. remembering, understanding, decision making and problem solving).

Research indicates that universal parenting programmes are less effective with disadvantaged families12, 13, 14.

There is also ample evidence that more complex parenting issues require specific, targeted support15, 16.

While general parenting services are not suitable for parents with learning disabilities, general learning disability services are not equipped to deal with complex parenting issues17, 18.

The conclusion of the Supported Parenting guidance sums up the need for specialist services such as the Aberlour Family Service South Ayrshire:

While there is evidence that families affected by parental learning disability experience a range of difficulties, it is also clear that most parents with learning disabilities are not receiving the type of support which is known to bring about improved outcomes for children19.


3: THE FAMILY SUPPORTSERVICEThis Section describes the Aberlour Family Service South Ayrshire and its activities.

This evaluation covers the period from May 2013, the start of the service’s first activity, until February 2016.

THE FAMILY SUPPORT SERVICE

The Aberlour Family Service South Ayrshire provides a holistic service, based on the needs of children and families. Working collaboratively the service offers a broad range of activities with a view to improving outcomes for parents, carers and children.

FOR PARENTS:

Initial Assessment – the service uses the Parent Assessment Manual software (PAMS) to assess parents’ knowledge, skills and practice, covering a wide range of areas including childcare and development, independent living skills and behaviour management.

Mellow Futures - an early intervention programme, adapted for parents with learning disabilities with the aim to build secure attachments promoting early brain development while building self-esteem and confidence of new parents.

Mellow Parenting - an intensive 6 weeks’ perinatal and 14 weeks’ postnatal programme delivered to a maximum of 4 parents in a group aimed to support and develop confidence, self-esteem, team work, communication and socialisation with peers.

Home Support – staff work with parents in their homes on areas identified from their PAMS assessment, including cookery skills, and household routines (using a washing machine,

storing important documents, recycling household waste, health & hygiene, time-telling, health & safety, guidance & control, budgeting, and saving).

Bookbug and Bookbug@Home – a programme of songs, stories and rhymes in a relaxed environment aimed to encourage parents and children to spend some quality time together, learning and having fun.

Signposting - to appropriate community based supports including Citizen’s Advice Bureau and SAC services for debt and welfare advice or local libraries for I.T. courses.

Support to Access Universal Services - support and advocacy for families in relation to essential appointments such as welfare, education, medical and dental.

FOR CHILDREN:

Incredible Years Dina Dinosaur Programme (DDP) [4 – 8 Years] – a programme for children who require support to build positive relationships and regulate their emotions, while promoting positive behaviour. The programme aims to prevent, reduce and address conduct problems in young children and increase social competence and the communication of feelings.

Homework support [5+ years] – support for children on a 1-1 and group basis to help children improve areas of difficulty and to support children to become confident and successful learners.


Arts and Crafts [3+ years] – activities to help children to socialise as part of group work, enabling creativity, expressing their thoughts and emotions, aiding dexterity and problem solving and growing confidence.

Play development sessions [Under 5’s] – sessions with parents and children in response to need (e.g. school holidays).

Basic cookery skills [5+ years] – cooking classes to help increase awareness of the variety of produce available and basic nutrition, developing a range of skills, including reading skills, improving vocabulary, maths skills, science and geography.

The service also encourages and supports children and parents to engage in community activities and take advantage of statutory and voluntary services.

In total the Aberlour Family Service South Ayrshire has delivered 3,705 hours of support in the period until February 2016. Figure 2.1 shows the type of support provided.

Figure 2.2 (page 12) provides an overview of the activities that have been delivered.

0

Family focus 1,757

Incident / concern 33

Professional 509

Third party 8

Daily / session log 872

Health focus 18

Educational focus 206

Parenting focus 301

Behaviour focus 1

1,500 2,000500

HOURS

1,000

FIGURE 2.1: TYPE OF SUPPORT


Groupwork session 778

Family session 1,380

0 200 400 600 800 1,000 1,200 1,400

1:1 session (parent) 146

General care 18

Family contact (supervised) 517

1:1 session (child) 41

Family contact (unsupervised) 14

Telephone call / text 314

Email / correspondence 74

Groupwork session Ab Fab Foods 15

Meeting 343

Social clubs and activities 22

Accompany to appointment 36

Other 7

FIGURE 2.2: ACTIVITIES

HOURS

ELIGIBILITY

The Aberlour Family Service South Ayrshire is available for parents with learning disabilities with children up to 12 years old.

For diagnostic purposes, a learning disability is defined as having an IQ of less than 70. However, to be eligible for the Aberlour Family Service South Ayrshire a formal diagnosis is not required. The service has the flexibility to support parents who do not have a diagnosed learning disability, working with the definition from the national guidance - 'lower intellectual ability, significant impairment of social or adaptive functioning, and onset in childhood.'

THE SERVICE USERS

The service supports families where one of the parents has learning disabilities. The service is aimed at families with children from pre-birth to twelve. During the time period covered by this evaluation, the Aberlour Family Service South Ayrshire dealt with 42 families20, consisting of 58 adults and 55 children.

In some cases, the service worked with both mother and father, in other cases just with one of the parents, and in other cases the parent was a single parent. In total the service supported 18 male parents and 40 female parents. The parents were between 19-49 years of age, with an average age of 30. The average age of a child was 6 years.

20 Of these there are 6 families who have disengaged from the service before any meaningful intervention. In some cases, there were valid reasons for disengagement, such as moving out of the area or death of the child, in other cases parents just refused to engage. These 6 families have not been counted in the number of adults and children worked with.


REFERRALS

The team responds to referrals that are generated through the linkages and partnerships within the community and a range of providers. Referrals to the service come predominantly from Social Workers, Health Visitors and Midwives.

People can also self-refer, or be referred by a family member.

LOCATION

The Aberlour Family Service South Ayrshire is based in Girvan, but delivers services across the whole of South Ayrshire.

STAFFING

The activities and interventions are delivered by a staff team comprising a Service Manager, four Children and Family workers and a part-time Administrator.

COST

The cost to run the Aberlour Family Service South Ayrshire is £197k per year. The costs consist of staffing, travel, other operating costs and overheads. The service is funded by a grant from the Big Lottery Fund (95%) and the remainder by South Ayrshire Council.


4: IMPACT ON SERVICE USERSThis Section explores the impact of the service on the parents with learning disabilities and their children who are supported by the Aberlour Family Service South Ayrshire.

SHANARRI WELLBEING INDICATORS

The Aberlour Family Service South Ayrshire uses the SHANARRI outcomes framework to report on the impact of its interventions on adults and children. The SHANARRI framework consists of eight indicators of wellbeing:

Safe - Protected from abuse, neglect or harm at home, at school and in the community.

Healthy - Having the highest attainable standards of physical and mental health, access to suitable healthcare and support in learning to make healthy, safe choices.

Achieving - Being supported and guided in learning and in the development of skills, confidence and self-esteem, at home, in school and in the community.

Nurtured - Having a nurturing place to live in a family setting, with additional help if needed, or, where this is not possible, in a suitable care setting.

Active - Having opportunities to take part in activities such as play, recreation and sport, which contribute to healthy growth and development, at home, in school and in the community.

Respected - Having the opportunity, along with carers, to be heard and involved in decisions that affect them.

Responsible - Having opportunities and encouragement to play active and responsible roles at home, in school and in the community, and where necessary, having appropriate guidance and supervision, and being involved in decisions that affect them.

Included - Having help to overcome social, educational, physical and economic inequalities, and being accepted as part of the community in which they live and learn.

The Aberlour Family Service South Ayrshire measures each of the relevant wellbeing indicators on a scale from 1-5, whereby 1 represents an acute crisis and 5 a situation whereby no support is required anymore. The measurements are taken at the start of the intervention and at the end of their involvement with the family, with one or more intermediate measures in between.

Figure 4.121 shows the composite change in SHANARRI outcomes of the Aberlour Family Service South Ayrshire interventions for the parents.

Figure 4.1 shows that on average the Aberlour Family Service South Ayrshire has made a positive impact on all wellbeing indicators, except ‘Achieving’.

Figure 4.2 provides the composite SHANARRI outcomes for the children.

This shows that on average the Aberlour Family Service South Ayrshire has helped children that received support to improve on all wellbeing indicators.

21 Throughout this Section the blue line represents the situation at the start of the Aberlour Family Service South Ayrshireinterventions and the pink line after the interventions.


FIGURE 4.1: SHANARRI OUTCOMES PARENTS


INCLUDED

RESPECTED

HEALTHY

NURTURED

SAFE

ACTIVE


INCLUDED

RESPECTED

HEALTHY

NURTURED

SAFE

ACTIVE

FIGURE 4.2: SHANARRI OUTCOMES CHILDREN

KEY



CASE STUDIES

To illustrate the impact of the services on adults and children, we have looked in-depth at a sample of six ‘typical’ families.

FAMILY A

BACKGROUND

A young woman with cerebral palsy and mental health issues with a history of Social Work involvement gave birth to a boy. This family was referred to the Aberlour Family Service South Ayrshire by the Midwife and the mother of the young woman.

ISSUES

— Emotional attachment with son.

— Inappropriate language.

— Depression and inappropriate self-medication.

— Unsuitable living space for a child.

— Baby not reaching his developmental milestones.

— No social contacts.

SERVICE INTERVENTIONS

— Coping strategies for depression.

— Referrals to GP, health visitor and physiotherapy for mother and son.

— Teaching about child development and responding to needs.

— Liaised with other services to get the home adapted.

IMPACT ON PARENT

— Improved parenting skills: appropriate language, praise, empathy with son.

— Improved mental health: coping strategies for depression, appropriate medication.

— Better relationship with family and other service providers.

— Safe home: home adapted to the family’s needs.

— Increased employability: planning to go to college and find a job.

— Improved social skills: willing to participate in community activities.

IMPACT ON CHILD

— Improved physical and mental health: mother has an improved understanding of his needs and is better able to meet them.

— Improved physical health: regular physiotherapy appointments.

— Reaching developmental milestones.

WITHOUT THE SERVICE

The mother would not have been able to cope independently, and may not have asked for help.

There would have been a reasonable chance that the child would have been taken into care.

RESPONSIBLE

ACHIEVINGINCLUDED

NURTURED

HEALTHY

ACHIEVING

RESPECTED

NURTURED

ACTIVE

HEALTHY

SAFE

FAMILY A: ADULT FAMILY A: CHILD

KEY



FAMILY B

BACKGROUND

This family consists of mum, dad and four children aged 2-16 years. The mother suffers from rheumatoid arthritis and has a learning disability. The father has alcohol addiction issues and is separated from the mother. The children were placed on the Child Protection Register and eventually the three youngest children were taken into foster care. This family was referred to the Aberlour Family Service South Ayrshire by the Health visitor.

ISSUES

— Lack of routine in the children’s lives: erratic school attendance.

— Unsafe home: the two year old got severe burns from an unsupervised iron.

— Lack of hygiene in the home and the personal appearance of the children.


— Supervised contact between the father and children.

— Provided Mellow Parenting sessions for the mother for 14 weeks.

— Supported the mother and youngest child to attend Book Bug sessions.

— Supported implementation of boundaries for managing the children’s behaviour.

— Arranged a befriender for the older boys.

— Weekly visits to the family home.

— Help with benefits forms.

IMPACT ON PARENT

— Improved parenting skills of the mother: initial charges of neglect were dropped, excellent school attendance, clear boundaries (e.g. computer time, time outs).

— Improved physical and mental health (looking after herself, improved appearance, appointments with dentist).

— Increased employability: mother started College course.

— Increased attachment to children.

— Improved relationship with children.

— Improved social skills (picks her friends more wisely).

FAMILY B: ADULT 1

SAFE

NURTURED HEALTHY

FAMILY B: CHILD 1


INCLUDED HEALTHY

NURTUREDACTIVE

SAFE


IMPACT ON CHILDREN

— Improved physical and mental health: hygiene, attendance at doctor and dentist appointments.

— Safe home: warmer, more hygienic.

— Improved social skills.

— Improved behaviour at school.

— Improved attachment.

— Children removed from Child Protection Register, only Supervision Order left for youngest child (due to alcohol issues (father)).

WITHOUT THE SERVICE

— Other service providers would unlikely to have been able to put in the resources required.

— Children likely to have been in foster care longer and may have remained in care.

— Additional social work intervention is likely to have been required.

FAMILY B: CHILD 2

FAMILY B: CHILD 3

RESPONSIBLE

INCLUDED

RESPECTED

SAFE

ACTIVE

ACHIEVING

HEALTHY

NURTURED


INCLUDED HEALTHY

NURTURED

SAFE

ACTIVE


FAMILY C

BACKGROUND

This is a young woman on the Autistic Spectrum with a young child. Initially she lived with her parents, but issues increased when she moved into her own flat. Although not living together, the father is involved and very supportive. This family was referred to the Aberlour Family Service South Ayrshire by the mother of the young woman.

ISSUES

— Mother struggles to engage with her child.

— Bad timekeeping at drop-off and pick-up from nursery.

— Personal hygiene of the child.

— Unsafe and unclean home (after moving into her own flat).

— Legal High issues of the mother.

— The child was placed on the Child Protection Register.


— Ensured the home was safe: safety gates, clutter, and food safety.

— Taught mother age-appropriate games and activities to do with her child.

— Supported mother and child to engage with the community.

— Helped to improve the child’s language skills and social interaction at nursery.

IMPACT ON PARENT

— Improved parenting skills: supported toilet training, appropriate clothing.

— Improved social skills: increased confidence visiting library, attending Book Bug sessions.

— Improved mental health: recognising when to seek help, involved with the CAMHS team.

— Improved physical health: attends the gym regularly, reduced substance use.

— Mother realised she has a lot to learn and needs support.

IMPACT ON CHILD

— Appropriate, safe and clean home environment.

— Child meeting his developmental milestones: improved language skills, interacts with others at nursery and became inquisitive.

— Good attendance at nursery.

— Clearer boundaries.

— Child removed from the Child Protection Register.

— Child is now living with grandparents and awaiting outcome of full custody request by father.

WITHOUT THE SERVICE

— Statutory providers unlikely to have been able to offer the same level of support and therefore outcomes for parents and children unlikely to have been achieved.

— Increased risk of the need for further social work intervention through increased risk to child.

FAMILY C: ADULT

FAMILY C: CHILD

NURTURED

HEALTHYACTIVE

ACHIEVING

SAFE

ACTIVEACHIEVING

RESPECTED

NURTURED

HEALTHY

SAFE


FAMILY D

BACKGROUND

This family consist of two adults and seven children. the father has a learning disability and mum's life experience and education have been impacted on as a result of becoming pregnant when very young. This family was referred to the Aberlour Family Service South Ayrshire by the Head Teacher of the children.

ISSUES

— Lack of rules and boundaries for the children.

— Inconsistent parenting.

— Lack of one-to-one time for the children with their parents.

— Poor performance at school: truancy issues, not completing homework.

— Oldest child had emotional issues: violent behaviour.

— Child Protection referral was made for oldest child.


— Delivered sessions about boundaries.

— Supported family activities.

— Group work with the children: e.g. on house rules.

— Facilitating one-to-one bonding sessions between the parents and children.

— Arranged befriender for oldest child.

IMPACT ON PARENTS

— Improved parenting skills: more active role for the parents, more parental responsibility of the father, knowing where the children are at all times.

— Improved mental health: mother feeling supported, working as a team, confidence to sort out issues (e.g. dampness in the home).

— Better understanding of developmental milestones of the children.

— Improved social skills: going out as a family, attending community events.

IMPACT ON CHILDREN

— Improved mental health: closer bond with their parents, emotional stability, anger management.

— Improved social skills: better attitude at school, reduced violent behaviour, attending youth clubs.

— Improved achievements at school.

FAMILY D: ADULT 1

FAMILY D: ADULT 2


INCLUDED HEALTHY

NURTURED

SAFE

ACTIVE


INCLUDED

RESPECTED

HEALTHY

NURTURED

SAFE

ACTIVE


FAMILY D: CHILD 1 FAMILY D: CHILD 4



ACTIVE

ACHIEVINGINCLUDED

SAFE

NURTURED

RESPONSIBLE

INCLUDED

SAFE

ACHIEVING

HEALTHY

NURTUREDACTIVE

RESPONSIBLE

INCLUDED

RESPECTED

SAFE

ACTIVE

ACHIEVING

HEALTHY

NURTURED

ACTIVEACHIEVING

RESPECTED

NURTURED

HEALTHY

SAFE

SAFE

ACHIEVING

RESPECTED

NURTURED

HEALTHY

ACTIVE


INCLUDED

RESPECTED

HEALTHY

NURTURED

SAFE

ACTIVE


FAMILY D: CHILD 7

WITHOUT THE SERVICE

— Without support for parents the outcomes for children are likely to have been poorer.

— Eldest child would have been at risk of escalating involvement with the criminal justice system.

— The relationship between the parents would have become very strained with risk of separation or breakdown.

FAMILY E

BACKGROUND

This family consist of a married couple and two children aged 5 and 3. Both parents have a learning disability and a long history of Social Work involvement. This family was referred to the Aberlour Family Service South Ayrshire by the Health Visitor.

ISSUES

— Poor and inconsistent parenting.

— Cleanliness, safety and warmth of the home (no electricity, suspended benefits, no bed for oldest child).

— Issues of personal hygiene\appearance for the children.

— Poor attendance at nursery.

— Struggling to maintain daily routines.

— Children’s Hearing set with the aim to obtain a Supervision Order.


— Delivered one-to-one sessions with the parents.

— Support to implement boundaries and routine in the children’s lives.

— Support parents to interact with their children (games, activities).

— Advised on cleanliness and practical help to keep the home clean.

— Organised and supervised family outings.

— Helped family apply for grants (clothes, Christmas presents).

— Advised on affordable and healthy cooking.

IMPACT ON PARENTS

— Improved parenting skills.

— Improved mental and physical health.


INCLUDED

RESPECTED

HEALTHY

NURTURED

SAFE

ACTIVE


IMPACT ON CHILDREN

— Improved safety and cleanliness of the home (carbon monoxide detector, safety gates).

— Improved attendance at nursery.

— Improved health (immunisations).

WITHOUT THE SERVICE

— The children may have been taken into care.

— The home environment would have been unstructured and unsafe.

— Attendance at nursery/school would continue to be an issue.

FAMILY E: ADULT 1 FAMILY E: CHILD 1

FAMILY E: ADULT 2

ACTIVE

INCLUDED

NURTURED

ACHIEVING

HEALTHY

SAFE

ACHIEVING

HEALTHYNURTURED

SAFE


INCLUDED HEALTHY

NURTURED

SAFE

ACTIVE


FAMILY F

BACKGROUND

This family consists of two adults and one child. The mother is pregnant again and the couple has recently separated. The father has physical and mild to moderate learning disabilities and the mother severe health issues and a learning disability. Both have been brought up in the care system with experience of abuse and domestic violence. The mother has addiction issues (alcohol and legal highs). The father was in an unhealthy relationship with another man (criminal behaviour). This family was referred to the Aberlour Family Service South Ayrshire by a Social Worker.

ISSUES

— Blaming culture between mother and father.

— Concerns about the child’s health and developmental issues.

— No concept of dangerous behaviour.

— Volatile relationship of the parents.

— Mother lethargic, father cannot cope with caring for a baby (not picking up cues, not coping with unexpected events).

— Home not suitable environment for a baby.

— Health information provided by the Midwife was not applied by the parents (bottle sterilisation, bathing).

— Social work planning to remove child. Child placed on the Child Protection Register.


— Repeating practical skills until they stick.

— Observation of basic household and caring tasks and provision of guidance and advice.

— Building confidence of parents.

— Supported engagement with community activities.

IMPACT ON PARENTS

— Improved mental health (better able to deal with emotions, improved morale, understanding the effect of their mental health on the baby).

— Improved interaction with the baby (swimming, play park, Book Bug).

— No more signs of substance abuse.

— Parents coping.

— Mother has moved into a Women’s Aid refuge.

IMPACT ON CHILD

— Basic physical and emotional needs are met.

— Increased physical activity.

— Child still on Child Protection Register.

WITHOUT THE SERVICE

— Child likely to have been taken into care at birth.

— Addiction issues of the mother likely to have continued.

— Father's continued association with criminal activity is likely have increased risk in the home.


STAKEHOLDERS PERCEPTIONS

We have interviewed 14 key stakeholders from NHS Ayrshire and Arran22 and South Ayrshire Council23 and asked them about their experiences with the service and the impact of the service on parents with learning disabilities and their children.

They reported a number of impacts of the service.

INTERVENING EARLY

Previously interventions were made when crises occurred, when only drastic and intensive measures where possible. The Aberlour Family Service South Ayrshire is intervening at a much earlier stage before problems get out of hand, and thus significantly improving the chances of positive outcomes for parents and children.

BECOMING A BETTER PARENT

The Family Service has a positive impact on parenting skills, building confidence and competence.

Aberlour staff provide parents with both practical and emotional support. The Child and Family Workers offer flexible personalised support. The length, content and structure of sessions is determined in consultation with parents and other service providers to meet individual need.

“They help parents come up with their own solutions.” Social Work Services

“Predominantly there is a better understanding by parents about how to parent.” Health Services

“With regard to the health and wellbeing of the child, nothing is left to chance. Teaching parents is so important.” Social Work Services

BUILDING CONFIDENCE

Rather than focusing on what parents with learning disabilities are not able to do, the Aberlour Family Service South Ayrshire assesses the strengths of the parents and builds on these. This builds the confidence of parents in their parenting ability and improves their self-esteem and helps them to be the best parent they can be.

“Parents know that they can look after their child appropriately”. Social Work Services

MORE CONNECTED TO SERVICES AND THE COMMUNITY

The Aberlour Family Service South Ayrshire helps parents improve their social skills and supports them to access activities and services in their community. If required, they accompany the parents and children for a limited number of times, until parents are confident to attend independently.

“One mum wouldn’t come along at first because of discipline issues but slowly it got her out of the house into the library. She benefited from the socialisation and felt less isolated and the child’s behaviour improved.” Library Services

“A key element of the service is helping them to connect with the community and services.” Social Work Services

HEALTHIER AND HAPPIER CHILDREN

Although the initial focus of the Aberlour Family Service South Ayrshire is on parents with learning disabilities, the service also works with the children directly towards achieving the SHANARRI outcomes.

Also, improving parenting skills and the health and wellbeing of parents, has a positive impact on the development and health and wellbeing of their children.

22 These included: Health Visitors (3), Learning Disability Services (2), Midwife and Early Years and Childcare Services23 These included: Social Work (4), GIRFEC, Education and Library Services


“The children benefit indirectly from the support provided to parents.” Health Services

“I certainly noticed it, children were more settled.” Education Services

“Better behaviour at home as well as a range of other developmental improvements.” Library Services

AVOIDING THE CARE SYSTEM

One of the main results of the service for parents and children is the reduced risk of children being taken out of the custody of parents with learning disabilities and into the care system.

Many stakeholders interviewed acknowledged that, where children are on the Child Protection Register, in many cases the support leads to the child being removed from the register. When the child is not on the register, the service significantly reduces the risk of children being taken out of parental care.

Stakeholders acknowledged that before the Aberlour Family Service South Ayrshire existed, interventions were made at a later stage and mainly focused on taking children into care.

However, in some cases, despite the support, it is in the best interest of the child to be placed into care. In these rare cases, the parent is supported to come to terms with this and maintain contact whenever possible.

“There are some examples of children getting off the Risk register.” Social Work Services

“The Aberlour Family Service South Ayrshire gives parents the support to use every possibility to keep the child with the parents.” Health Service



5: IMPACT ON THE SERVICELANDSCAPEThis Section reports on the impact the Aberlour Family Service South Ayrshire has on other statutory services.

The Aberlour Family Service South Ayrshire has an impact on the mainstream services in South Ayrshire. From the project monitoring and evaluation data, the analyses of the case studies and the interviews with key stakeholders a consistent picture of the Aberlour Family Service South Ayrshire’s place in the South Ayrshire service landscape emerges.

ONGOING NEED FOR THE SERVICE

All interviewees agreed that there is an ongoing need for the Aberlour Family Service South Ayrshire. The service has over the period of this evaluation worked with 42 families and has a continuing stream of new service users.

It is unknown how many parents with learning disabilities are living in South Ayrshire. The most accurate and recent estimate is 105-182, but is likely to be significantly higher due to the large number of undiagnosed learning disabilities (see Section 2).

“There is a level of demand that is recognised across services. We did not have this before and it was difficult to meet the needs of parents with learning disabilities.” Social Work Services

“We can’t do everything and joint visits are really helpful for us and the parents”. Health Services

FILLING A GAP IN PROVISION

The Aberlour Family Service South Ayrshire fills a gap in service provision in South Ayrshire in a number of ways.

The Family Service is the only third sector organisation in South Ayrshire with a license and trained staff for the PAMS assessment tool, an acknowledged framework to assess the needs of families. Many interviewees indicated that they would not have the time to undertake the assessment, which requires multiple sessions over a period of at least twelve weeks. Perhaps more importantly, the Aberlour staff have developed a broad knowledge and experience of supporting parents with a learning disability.

“We don’t have the capacity or the in-depth understanding of learning disabilities.” Health Services

“The family assessments are very thorough and collect a lot of information on families we wouldn’t otherwise have.” Health Services

The Aberlour Family Service South Ayrshire is also unique in the South Ayrshire service landscape because of the varied and flexible support they can offer, ranging from practical support to emotional support and help to engage with the community and other services. Support can be delivered one-to-one or in group sessions, dependent on the needs of the families. Support can be as intensive and lengthy as required. Other service providers are limited to more specific tasks and commitment.


“We have a specific focus, the Aberlour Family Service South Ayrshire can afford to be broader.” Health Services

“They provide hands-on practical help which we don’t really have the time for.” Health Services

“The Family Service worked with children using the Dinosaur rules to learn appropriate behaviour and with the parents to do cooking skills.” Education Services

Finally, the Aberlour Family Service South Ayrshire plays an important role in engaging families. Many of the families have a difficult relationship with and a deep mistrust of statutory services. As a voluntary sector service with the clear aim to help the parents to look after their children, rather than implementing statutory interventions perceived to place children into care, they are quickly able to build up a trusting relationship. Once that relationship is established, the Family Service helps parents to link with statutory services, which makes their work easier and more effective.

“It was a difficult scenario with that client, but once involved the Family Service quickly figured out how to communicate with them.” Health Services

“We had other agencies working before, but the families opted out of everything.” Health Services

“Parents are more receptive and less defensive because it’s a community based service.” Health Services

AN ESSENTIAL SERVICE

When asked specifically to make a choice, all interviewees agreed that the Aberlour Family Service South Ayrshire is ‘an integral part of the service delivery’, rather than ‘a nice to have add-on’. This emphasises the critical part that the Aberlour Family Service South Ayrshire plays in the service delivery in South Ayrshire.

“It’s an integral part of the service, and it would be hugely missed by us and the families if it wasn’t there.” Social Work Services

“We need more of it.” Health Services

DELIVERING THE PREVENTION AGENDA

Statutory services generally are only involved when a situation reaches a crisis point. The Family Service can intervene at a much earlier stage, which prevents situations reaching crisis point.

“The Aberlour Family Service South Ayrshire can get in there early, unlike us who are predominantly dealing with crises and fire-fighting.” Social Work Services


IMPACT ON OTHER SERVICES

The Aberlour Family Service South Ayrshire is working in strong partnership with other service providers, including Social Workers, Health Visitors and Midwives. Other service providers refer to the service when they come across issues on parenting with learning disabilities and in some cases they deliver services together.

The early intervention offered by the Aberlour Family Service South Ayrshire helps by tackling issues before they become a crisis and helps reducing the pressure on statutory services. Statutory services also commented that the way in which the Aberlour Family Service South Ayrshire engages with families and builds up trusting relationships, makes their work with those families easier.

“It’s easier for me to do my job due to the improved skills and behaviour of the children.” Education Work Services

“It decreases my workload slightly, when you can rely on others such as the Aberlour Family Service South Ayrshire.” Social Work Services

The Aberlour Family Service South Ayrshire has led to a reduction of the caseload of other statutory providers.

“Referrals to us on parenting issues have virtually stopped”. Health Services

“In many cases there is no need for us to be involved anymore.” Health Services

BARRIERS AND CHALLENGES

Some respondents mentioned a lack of awareness of the Aberlour Family Service South Ayrshire by both parents with learning disabilities and other statutory services.

“I’ve been at meetings where I’ve mentioned the service and people didn’t know about it.” Education Services

Some also mentioned the location of the service in Girvan, away from the main population areas. However, most interviewees recognised that the Aberlour Family Service South Ayrshire staff work across the whole of South Ayrshire and found this less of an issue. The current service works only with families with children up to 12 years of age. Many interviewees mentioned the unmet needs of children aged 12-16 and expressed the opinion to extend the age range of the service to 16.

The service gets the majority of its referrals from community based health practitioners. It is suspected that the service is missing out an important segment of referrals from families in need that access GP services.


WITHOUT THE ABERLOUR FAMILY SERVICE SOUTH AYRSHIRE

We asked interviewees to reflect on what it would mean if the service was not there anymore. Interviewees reported that people with learning disabilities would lose an integral part of their services. There is no other organisation in the area that would be able to pick up the work. All current service providers, such as Social Work, would do whatever they can, but they lack the time, knowledge, skills and resources to fill the gap.

“If they weren’t there, there would be a huge gap in services, especially in the rural areas.” Education Services

This would have an effect on parents and children. Parents with learning disabilities would have reduced confidence to be parents and children would be more at risk of poor parenting.The interventions that statutory services would provide would be more focussed on crisis situations and lots of families would not get the support they need or it would be offered at a much later stage. Support would be shorter, less intense and parents with learning disabilities would be included within general parenting services, which would be less effective.

Some interviewees mentioned that without the support the Aberlour Family Service South Ayrshire provides, the total cost for learning disability services in the area would be much higher.

“Without the Aberlour Family Service South Ayrshire the services for parents with learning disabilities would cost a lot more.” Health Services

Finally, without the Aberlour Family Service South Ayrshire more children would be at risk and be placed in the care system, which has significant cost implications.

“You would see a rise in children accommodated on the At Risk register.” Health Services

“A lot more children would not live with their parents.” Social Work Services

An in-depth assessment of the counterfactual, what would have happened without the Aberlour Family Service South Ayrshire intervention, of the six case study families resulted in:

9 children may have been taken into care.

3 children would have been at increased risk of involvement with the criminal justice system.

5 children may not have received essential health and other services (e.g. GP, physiotherapy, dentist etc.).

12 children would have been likely to have continued poor school attendance.

2 parents would have been unlikely to attend college.

3 parents would not have been able to access essential support services.

3 parents may have experienced seriously deteriorating health issues.

2 parents would have been likely to experience an increase in addiction related issues.

1 parent would have been at increased risk of a jail sentence.


6: PREVENTATIVE SAVINGSThis Section calculates the monetary value of the impact of the Aberlour Family Service South Ayrshire on the public purse.

By addressing the issues of parents with learning disabilities the Aberlour Family Service South Ayrshire contributes to the Scottish Government’s National Outcomes and creates savings for the public purse of over £1.4 million in the year that the service is delivered. Table 6.1 provides an overview of the outcomes achieved and their respective cost savings to the public purse (more detailed information can be found in Appendix A).

For the values of the financial proxies we have used the Cabinet Office Unit Cost Database, which provides government endorsed fiscal and economic cost savings of certain interventions. Some values are UK-wide; others are based on average English and Welsh values. There is no reason to assume that costs in Scotland differ considerately from those in the rest of the UK.


TABLE 6.1: COST SAVINGS TO THE PUBLIC PURSE (YEAR 1)

OutcomeNo. of

IndividualsProxy Value

Total Cost Savings

Improved physical health parent 8 £375 £3,000

Improved mental health parent 21 £977 £20,517

Significantly reduced alcohol dependency parent 3 £2,015 £6,045

Significantly reduced drugs dependency parent 3 £3,727 £11,181

Avoided loss of tenancy 2 £7,276 £14,552

Avoided/reduced contact with criminal justice parent 5 £4,473 £22,365

Parent more work-ready 10 £1,089 £10,890

Parent become employed 3 £10,321 £30,963

Parent reduced/stopped using Social Work services 11 £3,068 £33,748

Parent likely avoided having to use Social Work services in the future

2 £3,068 £6,136

Total Value Parents £159,397

Effect of improved parenting 37 £799 £29,563

Improved physical health child 34 £375 £12,750

Improved mental health child 39 £271 £10,569

Child avoided being taken into care 17 £52,676 £895,492

Avoided/reduced contact with criminal justice child 11 £3,620 £39,820

Avoided exclusion from school 10 £11,473 £114,730

Child more school-ready 24 £1,878 £45,072

Avoided being not in employment, education or training child

3 £4,637 £13,911

Child removed from the Risk register 16 £1,476 £23,616

Child reduced/stopped using Social Work services 22 £3,256 £71,632

Child likely avoided having to use Social Work services in the future

3 £3,256 £9,768

Total Value Children £1,266,923

Total Family £1,426,320

The changes that the Aberlour Family Service South Ayrshire achieves in the lives of parents with learning disabilities and their children will have a much longer impact than one year. Potentially there is an impact during the whole life of the service

user. We have made an assessment of the potential savings to the public purse for the coming ten years, which indicates that the potential savings to the public purse over ten years could be estimated at just over £9.6m, which is shown in Table 6.2.


TABLE 6.2: TEN-YEAR COST SAVINGS TO THE PUBLIC PURSE

OutcomeNo. of

IndividualsNo.

YearsProxy Value

Total Cost Savings

Improved physical health parent 8 3 £375 £9,000

Improved mental health parent 21 3 £977 £61,551

Significantly reduced alcohol dependency parent 3 3 £2,015 £18,135

Significantly reduced drugs dependency parent 3 3 £3,727 £33,543

Avoided loss of tenancy 2 1 £7,276 £14,552

Avoided/reduced contact with criminal justice parent 1 N/A £33,790 £33,790

Parent more work-ready 3 10 £10,321 £309,630

Parent become employed 3 10 £10,321 £309,630

Parent reduced/stopped using Social Work services 11 10 £3,068 £337,480


2 10 £3,068 £61,360

Total Value Parents £1,188,671

Effect of improved parenting 37 3 £799 £88,689

Improved physical health child 34 3 £375 £38,250

Improved mental health child 39 3 £271 £31,707

Child avoided being taken into care 17 1-10 £52,676 £6,321,120

Avoided/reduced contact with criminal justice child 3 1-10 £33,790 £101,370

Avoided exclusion from school 10 1-10 £11,473 £562,177

Child more school-ready 24 1-10 £1,878 £354,942


3 1-10 £4,637 £125,199

Child removed from the Risk register 16 1 £1,476 £23,616

Child reduced/stopped using Social Work services 22 10 £3,256 £716,320


3 10 £3,256 £97,680

Total Value Children £8,461,070

Total Family £9,649,741

There are a number of outcomes that have an impact only in the year they occur (e.g. removal from the Risk Register). For other outcomes we have limited the potential cost savings to the public purse to three years. These outcomes are

also influenced by new events and experiences (e.g. health), therefore, there is no sufficient link to the Family Service support. Appendix A provides more detail about the calculations and the assumptions we have made.



7: CONCLUSIONS AND RECOMMENDATIONSThis Section draws conclusions from the research and makes recommendations for the improvement of the Aberlour Family Service South Ayrshire.

CONCLUSIONS

From this evaluation we can draw the following conclusions:

ONGOING NEED FOR THE SERVICE

1. Although there is no hard data on the number of parents with learning disabilities in South Ayrshire, existing data suggest that the Aberlour Family Service South Ayrshire has worked with only a third of potential service users. It is highly likely that the number of potential service users is significantly higher than our estimates.

2. Stakeholders agree that there is an ongoing need for the service and without it no other current service will be able to fill the gap.

3. There is ample evidence that a bespoke, specialised service is the most effective way of supporting parents with learning disabilities.

DELIVERING IMPORTANT OUTCOMES

4. The Aberlour Family Service South Ayrshire is delivering on national and local policies and strategies. It is also achieving the outcomes agreed with the Big Lottery Fund.

5. The Aberlour Family Service South Ayrshire delivers significant outcomes on the SHANARRI Framework.

6. Stakeholders overwhelmingly acknowledge the outcomes that the service is achieving for parents with learning disabilities and their children: improved parenting, building confidence, reducing social isolation, healthier, safer and happier children and keeping children out of the care system.

AN INTEGRAL AND ESSENTIAL PART OF THE SERVICE LANDSCAPE

7. The Aberlour Family Service South Ayrshire is an essential, critical service that fills a clear gap in service provision through: PAMS assessments, delivering support that is holistic, personalised, flexible in content, intensity and length and engaging unwilling and sometimes hostile parents.


DELIVERING ON THE SCOTTISH GOVERNMENT’S PREVENTION AGENDA

8. The Aberlour Family Service South Ayrshire delivers on the prevention agenda, generating significant cost savings to the public purse of around £1.4m in the first year and £9.6m over ten years. Compared to the cost of the service of £197k per year, this means that if the service was funded by public means, the public purse would save about £1.2million per year immediately and up to £9.4m over the next ten years.

9. There is evidence that without the Aberlour Family Service South Ayrshire more children would end up in care.

WORKING IN PARTNERSHIP

10. The Aberlour Family Service South Ayrshire works in partnership with other service providers, which makes the jobs of statutory services in the area easier and reduces their caseloads.

RECOMMENDATIONS

From this evaluation study the following recommendations for future development can be made:

1. Use this evaluation to make South Ayrshire Council and the South Ayrshire Health and Social Care Partnership aware of the service, its critical role in the service landscape and its contribution to prevention, with a view to justifying long-term core funding for the service in the future.

2. Increase the awareness of the service among parents and service providers by developing and resourcing a Communication Strategy and Plan for the service.

3. Increase the awareness of the service and the number of referrals from GPs to meet some of the hidden unmet demand.

4. Review the age range of children eligible for the service up to 16 years in the future.

5. Consider the possibilities to open a (part-time) satellite base in the Kyle area.


APPENDIX A:CALCULATION COST SAVINGS

TABLE 6.1: COST SAVINGS TO THE PUBLIC PURSE (YEAR 1)

OutcomeNo. of


Total Cost Savings

Proxy Description Source

Improved physical health parent

8 £375 £3,000 3 hours less time commitment for GP: - cost per hour, General Medical Services activity

Cabinet Office Unit Cost Database

Improved mental health parent

21 £977 £20,517 Average cost of service provision for adults suffering from depression and/or anxiety disorders, per person per year - fiscal and economic costs


Significantly reduced alcohol dependency parent

3 £2,015 £6,045 Estimated annual cost to the NHS of alcohol dependency, per year per dependent drinker


Significantly reduced drugs dependency parent

3 £3,727 £11,181 Average annual savings resulting from reductions in drug-related offending and health and social care costs


Avoided loss of tenancy 2 £7,276 £14,552 Average fiscal cost of a complex eviction


Avoided/reduced contact with criminal justice parent

5 £4,473 £22,365 Average prosecution costs at Sherriff Court

Parent more work-ready 10 £1,089 £10,890 Work Programme (HISTORIC), Job outcome fee


Parent become employed

3 £10,321 £30,963 Fiscal benefit from a workless claimant entering work (Job Seeker’s Allowance)



OutcomeNo. of


Total Cost Savings


Parent reduced/stopped using Social Work services

11 £3,068 £33,748 1 hour per week reduced time commitment Social Work: Social worker - adult services: cost per hour, with qualification costs



2 £3,068 £6,136 1 hour per week reduced time commitment Social Work: Social worker - adult services: cost per hour, with qualification costs


Effect of improved parenting

37 £799 £29,563 Total economic savings from the delivery of school-based emotional learning programmes, per child over a 10 year period


Improved physical health child

34 £375 £12,750 3 hours less visits to GP: - cost per hour, General Medical Services activity


Improved mental health child

39 £271 £10,569 Average cost of service provision for children/ adolescents suffering from mental health disorders, per person per year - total fiscal cost (to the NHS)


Child avoided being taken into care

17 £52,676 £895,492 Child taken into care - average fiscal cost across different types of care setting, England, per year


Avoided/reduced contact with criminal justice child

11 £3,620 £39,820 Average cost of a first time entrant (under 18) to the Criminal Justice System in the first year following the offence


Avoided exclusion from school

10 £11,473 £114,730 Permanent exclusion from school - fiscal and economic cost of permanent exclusion from school, per individual per effective year



OutcomeNo. of


Total Cost Savings


Child more school-ready 24 £1,878 £45,072 Persistent truancy - total fiscal cost of persistent truancy (missing at least five weeks of school per year), per individual per effective year



3 £4,637 £13,911 Average cost per 18-24 year old Not in Employment Education or Training (NEET)


Child removed from the Risk register

16 £1,476 £23,616 Children in Need, case management processes - average cost of ongoing support, per month (standard cost)


Child reduced/stopped using Social Work services

22 £3,256 £71,632 Children in Need - average total cost of case management processes over a six month period (standard cost)



3 £3,256 £9,768 Children in Need - average total cost of case management processes over a six month period (standard cost)


For the establishment of these financial proxies we have made a number of assumptions:

— We do not have sufficient evidence of the implications of improved physical health to the parents and children. Therefore we have conservatively assumed this would lead to three hours less GP time per year. This does not include the time of other health practitioners or eventual hospital admissions, which would lead to much greater cost.

— For reduced use of Social Work services by parents we have assumed that on average, this would lead to 1 hour less Social Work involvement per week.


TABLE 6.2: TEN-YEAR COST SAVINGS TO THE PUBLIC PURSE

OutcomeNo. of

IndividualsNo.

YearsProxy Value

Total Cost Savings


Improved physical health parent

8 3 £375 £9,000 3 hours less visits to GP: cost p/hr, General Medical Services activity


Improved mental health parent

21 3 £977 £61,551 Average cost of service provision for adults suffering from depression and/or anxiety disorders, per person p/yr, fiscal and economic costs


Significantly reduced alcohol dependency parent

3 3 £2,015 £18,135 Estimated annual cost to the NHS of alcohol dependency, per year per dependent drinker


Significantly reduced drugs dependency parent

3 3 £3,727 £33,543 Average annual savings resulting from reductions in drug-related offending and health and social care costs


Avoided loss of tenancy

2 1 £7,276 £14,552 Average fiscal cost of a complex eviction


Avoided/reduced contact with criminal justice parent

1 10 £33,790 £33,790 Average cost across all prisons, including central costs


Parent more work-ready

3 10 £10,321 £309,630 Fiscal benefit from a workless claimant entering work (Job Seeker’s Allowance)


Parent become employed

3 10 £10,321 £309,630 Fiscal benefit from a workless claimant entering work (Job Seeker’s Allowance)



OutcomeNo. of

IndividualsNo.

YearsProxy Value

Total Cost Savings


Parent reduced/stopped using Social Work services

11 10 £3,068 £337,480 1 hour per week reduced time commitment Social Work: Social worker - adult services: cost per hour, with qualification costs



2 10 £3,068 £61,360 1 hour per week reduced time commitment Social Work: Social worker - adult services: cost per hour, with qualification costs


Effect of improved parenting

37 3 £799 £88,689 Total economic savings from the delivery of school-based emotional learning programmes, per child over a 10 year period


Improved physical health child

34 3 £375 £38,250 3 hours less visits to GP: cost p/hr, General Medical Services activity


Improved mental health child

39 3 £271 £31,707 Average cost of service provision for children/ adolescents suffering from mental health disorders, per person per year - total fiscal cost (to the NHS)


Child avoided being taken into care

17 10 £52,676 £6,321,120 Child taken into care - average fiscal cost across different types of care setting, England, per year


Avoided/reduced contact with criminal justice child

3 10 £33,790 £101,370 Cabinet Office Unit Cost Database


OutcomeNo. of

IndividualsNo.

YearsProxy Value

Total Cost Savings


Avoided exclusion from school

10 10 £11,473 £562,177 Permanent exclusion from school - fiscal and economic cost of permanent exclusion from school, per individual per effective year


Child more school-ready

24 10 £1,878 £354,942 Persistent truancy - total fiscal cost of persistent truancy (missing at least five weeks of school per year), per individual per effective year



3 10 £4,637 £125,199 Average cost per 18-24 year old Not in Employment Education or Training (NEET)


Child removed from the Risk register

16 1 £1,476 £23,616 Children in Need, case management processes - average cost of ongoing support, per month (standard cost)


Child reduced/stopped using Social Work services

22 10 £3,256 £716,320 Children in Need - average total cost of case management processes over a six month period (standard cost)



3 10 £3,256 £97,680 Children in Need - average total cost of case management processes over a six month period (standard cost)



For the establishment of these values we have made a number of assumptions:

— For the outcome “avoiding/reduced contact with criminal justice” for parents and children we have assumed that, without the Aberlour Family Service South Ayrshire intervention, 29.6% of children and parents (the official re-offending rate: http://www.gov.scot/Topics/Statistics/Browse/Crime-Justice/TrendReOffending) would have gone on to commit a serious crime. For the proxy value we have taken the average length of a prison sentence (354 days: Prison statistics and population projections Scotland: 2013-14) and multiplied that with the Average annual cost across of a prison sentence (Cabinet Office Unit Cost Database: average cost across all prisons, including central costs).

— We have assumed that 33% of all work-ready parents would get a job.

— For the outcome “Child avoided being taken into care” we have calculated the years of the concerning children in the next 10 years that they are under the age of 16, the legal age of leaving youth care.

— For the outcome “Child more school-ready” we have calculated the years of the concerning children in the next 10 years that they are under the age of 16, the legal school leaving age.

— For the outcome “Avoided exclusion from school” we have calculated the years of the concerning children in the next 10 years that they are under the age of 16, the legal school leaving age.

— For the outcome “Avoided being not in employment, education or training child” we have calculated the years of the concerning children in the next 10 years that they are under the age of 24, the definition of NEET.




A B E R LO U R C H I L D C A R E T R U S TS O C I A L I M P A C T O F T H E A B E R L O U R F A M I L Y S E R V I C E S O U T H A Y R S H I R E

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Documents

SOCIAL IMPACT OF THE ABERLOUR FAMILY SERVICE SOUTH … · v i d u a l s e f f e c t i v e c o n t r i b u t o r s s u c c e s s f u l l l e a r n e r s a c d a i a aberlour child