Whole Family Wellbeing Funding (WFWF) - year 1 process evaluation: final report – annexes

Annex 8: Outcomes with limited evidence of progress

As previously discussed, the evidence of progress towards outcomes varied across CSPPs. This section reports on the early outcomes outlined in the logic model where there was only limited evidence of progress based on CSPP CSP annual reports and, where applicable, case study findings.

Limited evidence was defined as instances where less than a quarter of CSPPs (who returned CSP annual reports) demonstrated progress against an outcome. Evidence was included in analysis only if it clearly and explicitly described the action taken to achieve an outcome; claims of achieving outcomes were excluded from the analysis if no evidence was provided to support the claim, or the evidence described intended plans or actions rather than what had been achieved.

4. CSPPs begin embedding key principles for holistic whole family support in their own systems and structures

Eleven CSPPs stated an ambition to achieve this outcome in their initial plan, and five reported some progress towards this in their CSP annual reports. The supporting evidence was limited. Based on the evidence provided in the CSP annual report, holistic whole family support principles were being embedded through:

• Establishing new teams or changing the remit of existing roles. For example, a dedicated WFWF delivery team to promote the key principles of holistic support through communication and engagement activities.
• Hosting events and workshops with partners to support awareness and understanding of partner roles and facilitate multi-agency relationship building. For example, South Lanarkshire’s one-off networking event involving staff from education, health, third sector, community learning, employability and social work.

CSPPs who had progressed this outcome were all in urban areas with higher than average funding, and where family needs tended to be higher than average.

Some CSPPs were still in the planning stages of how to embed the principles and were undertaking activities broadly aligned with laying the groundwork for embedding holistic support such as using the National Self-Assessment toolkit to identify gaps in their systems.

5. Early evidence that children, young people and families have improved access to services in communities

Ten CSPPs stated an ambition to achieve this outcome in their initial plan, and five provided evidence of progress towards this in their CSP annual report.

Strategic leads and children, young people and families reported that children, young people and families were more comfortable accessing WFWF support because support was presented as separate from previous family support experiences. However, interviewees were cautious to say whether they thought that there would be reduced scepticism about social workers had shifted significantly, especially among those who had not already engaged with family support.

CSPPs using a place-based, hub approach for accessing support reported improved children, young people and families access rates. One CSPP using a hub approach reported a reduction in referrals to local council child and family teams because children, young people and families were using the hubs more.

Changes to referral processes were reported by CSPPs as having reduced the time taken to find a correct point of contact for families, and feedback demonstrated that earlier, clearer, and easier access to support was increasing engagement and confidence in services. Changes included minimising the need for formal referrals or piloting different referral pathways. Interviews with children, young people and families also indicated that connections to support were happening more efficiently through link workers, hubs, or referrals into a more joined-up system.

Increased collaboration between services was believed to be facilitating improved access for children, young people and families. Staff interviewed reported feeling more aware of the wider services available and were able to make more appropriate referrals. Compared to pre-WFWF, one case study CSPP identified that more reliable and frequent family support was provided by frontline practitioners meaning families were more encouraged to access support.

6. Increased whole family support service capacity among CSPP partners

Four CSPPs indicated they were aiming to achieve this outcome in their initial plans and five indicated that they had progressed towards this in their CSP annual report, however the evidence was limited. Evidence of increased capacity was primarily through additional staff or development of existing staff, or new mechanisms for children, young people and families to access support. For example, one CSPP reported recruitment of Advanced Practitioners and Managers to expand the capacity and support of partners, meanwhile another CSPP was delivering refresher training to existing staff within the CSPP to increase delivery capacity. Alternatively, two CSPPs reported making changes to provision in terms of establishing holistic support hubs, and commissioning partners to undertake scaling of existing services currently offered by statutory partners (such as the Local Authority or Health Board).

Providing holistic and individualised support had positively impacted the pace of whole family support implementation. Children, young people and families who received one-to-one support reported that the flexibility, and tailored nature, of the support was holistic because frontline practitioners were able to support them in all aspects of their lives that were difficult (for instance by attending meetings with schools and doctors or providing emotional, or mental health, support), which reinforced the Scottish Government’s principles of holistic support.

7. CSPP partners begin to develop a holistic workforce approach

Three CSPPs who stated an ambition to achieve this outcome in their initial plan, and these three, plus an additional CSPP showed progress to this in their CSP annual report. Evidence of progress included CSPPs working more collaboratively, recruiting new roles to provide holistic support to parents through collaboration across partners (e.g. social work, health, education). It may be that increased collaboration is how CSPPs are defining ‘holistic workforce’ and so they are seeing achievement of the two as the same.

8. Early evidence that children, young people and families are actively, regularly and meaningfully engaged in service design

Eight CSPPs stated an ambition to achieve this outcome in their initial plan, and four demonstrated progress towards it in their CSP annual report. The case study findings from across all the case studies showed that, despite some strategic leads and frontline practitioners reporting that children, young people and families had participated in WFWF service design, from the point of view of children, young people and families, their participation had been minimal (see Section 4: Consulting children, young people and families for further discussion of this). This suggests that CSPPs may need more guidance on how to effectively engage children, young people and families in design going forward. However, this finding may be attributed to the relatively limited service design work and small scale of fieldwork with children, young people, and families.

Methods for engaging with children, young people and families which were identified included:

Hosting small, informal sessions involving children, young people and families and sometimes frontline practitioners was seen as effective for gathering feedback. For example, in Fife, co-production sessions included families and NHS employees. However, some CSPPs faced challenges in organising group activities due to the complexity of families' current needs, though they aimed to do so in the future.

“We hold lots of informal meetings where the families come along and it is just a conversation. It's not a formal meeting. Everyone's just pulling together in the community to get the best outcomes” Frontline Staff

Utilising partnerships and existing relationships to collect children, young people and families feedback was a common approach. For instance, East Ayrshire partnered with a school to host a parent event, where ideas were discussed. Parents who attended the school session suggested using a champions model to support emotional wellbeing among young people, but the frontline practitioners interviewed reported that they were unsure whether this had been implemented. They noted that relying on partnerships takes time but was facilitated by having experienced participation and training officers who had maintained good relationships with past participants.

Establishing working groups were established such as lived experience groups or children, young people and families focus groups who would meet regularly to input into design. Evidence from the CSP annual reports highlighted use of focus groups with families where actions were recorded and taken forward. Other CSPPs indicated in their CSP annual reports that they had formed panels of children, young people and families who would review proposals or contribute to relevant aspects of design and assessment of progress.

Using surveys or feedback forms for gathering children, young people and families input was common. For example, East Ayrshire conducted surveys to establish baseline data and plan for future services. In Glasgow City, children, young people and families feedback prompted design changes (see Figure 19). CSP annual reports showed feedback forms used to consider parent input on pilot locations and gathering feedback at the end of support sessions. However, some CSPPs relied on informal ‘conversations’ and feedback forms after support sessions, focusing on individual needs rather than children, young people and families’ role in service design.

Figure 19 CSPP Spotlight: Glasgow City

More meaningful name for support chosen following engagement with children, young people and families

Glasgow City engaged children, young people, and families through in-person sessions to develop Support Hubs. These locality hubs intended to provide a wide range of holistic whole-family support through a consortium of providers, including support with parenting skills, home skills (e.g. energy advice and managing bills), attending appointments and understanding children’s development and neurodiversity needs.

The engagement revealed that their pre-conceived ideas did not align with what families wanted; they desired more relational support. This led to renaming the service ‘Support Networks’ and placing greater emphasis on relational support. Although this consultation was conducted outside WFWF, the feedback informed WFWF priorities.

9. Early evidence of culture in CSPPs that encourages and empowers staff to develop innovative whole family support solutions

Evidence for this outcome was limited, with just one CSPP intending to achieve this in their initial plan, and three reporting progress towards it in their CSP annual report. Empowering staff to be innovative tended to materialise as general openness to sharing of ideas among staff and willingness to consider proposals for more innovative family support solutions. One CSPP that was undertaking various pilots recognised that the opportunity to pilot services enabled them to trial new methods.

“We now have a work environment where they [employees] can have those conversations with colleagues and be open and curious and ask, ‘why are we doing it like this, is there a better or a different way to do it that suits that family’. Social workers feel empowered to ask questions and ask for support…Saying, let's think outside the box and pull on the skills from the other folk who around us.” Frontline staff

10. Early evidence that feedback analysed by CSPPs informs adult and related services planning/delivery

Five CSPPs stated an ambition to achieve this outcome in their initial plan, and at the end of Year 1 two showed progress towards this in the CSP annual reports. Some CSPPs identified various ways they intended to use data and feedback to inform services based on the changing needs of the community (see Section 6: WFWF delivery for further discussion), however there was little evidence of this happening yet.

Feedback from children, young people and families was typically gathered by frontline practitioners at the end of sessions such as asking whether the children, young people and families needed any other support not received. The information tended to be reviewed by a multi-disciplinary group such as strategic groups, data and performance groups, or child services board, who presented and commented on the feedback and then made decisions about how to respond to the support needs identified. In South Lanarkshire, analysis of feedback informed commissioning of new support to fill gaps in service needs (see Figure 20).

Figure 20 CSPP Spotlight: South Lanarkshire

Funding of support reflects evidence of need and level of output

In South Lanarkshire data analysis highlighted the opportunity to be more strategic in how the information they collected could be used to better inform delivery. An existing Data and Performance group looked at what the different sources of data were showing and how they should be interpreted to make decisions.

Data on the evidence of need was used to underpin decisions about the best use of funding and any subsequent commissioning and service re-design. Using this approach, the partnership has been able to make joint decisions about investment and disinvestment. This has meant shifting funding from programmes that were not producing anticipated outcomes, to developing new opportunities, informed by evidence of good practice and an understanding of areas for improvement.

11. Local investment by CSPPs in planning system change (budgets already set for 2022-23)

Two CSPPs reported they had progressed towards this outcome in their CSP annual report, of three who said they were aiming to achieve this. However, evidence provided related to general investment in local teams and pilot programmes. Within the CSP annual reports, spend to date on WFWF activities was often recorded at 0% or very close to zero. CSPPs who reported spending more of the funding to date tended to be in rural areas. Data from the case study interviews suggested that this lack of progress may be because CSPPs were still in the planning stages to which they have not ascribed a cost, or that at the time of interview they had not yet been able to recruit to new roles.

Unintended and emerging long-term outcomes

CSPPs reported making progress against some early outcomes which were not expected to be evidenced until between end of Year 2-4: (according to the logic model proposed):

• Improved young person confidence and improved mental health: One CSPP described this as a result of young people to having one-to-one support from frontline practitioners and increased socialising opportunities.
• Services shift to needs and rights-based planning and participation: three CSPPs indicated that due to increased focus on local needs including review of existing services and gaps in support, there had been greater emphasis on the needs and rights of children, young people and families in planning. One CSPP mentioned using a lived experience focus group discussion to ensure proposals met local needs.

One negative unintended occurrence observed in some case study CSPPs was the emergence of fragmented relationships between CSPPs and the third sector (see discussion in Section 5: Implementation and delivery of WFWF to date: Factors limiting implementation). In one CSPP this was due to poor communication from CSPPs about WFWF to the third sector and perception among frontline practitioners of poor management, however, the third sector interviewee reported that the situation was improving.