No Wrong Door: services for young adolescents in care in North Yorkshire

No Wrong Door ensures that the needs of young people in care, no matter how diverse, are addressed within a single team of trusted and skilled workers. These workers would stay with the young person throughout their journey; be it to prevent care, in care, across care or out of the care system.


The challenge

Young people who enter care during their teenage years can traditionally spend considerable periods of time in residential care, often without sufficient planning and support to re-engage in family relationships, or form strong relationships with carers.

These young people often have a wide range of social and emotional needs and may have lived with neglect, lack of attachment, a poor secure base, domestic violence, fractured relationships and multiple placement breakdowns. All of this has an impact on their lives and in the past a traditional approach may have been to move these young people into an out of county/therapeutic placement, meaning that they lose connections with their family, networks and community.  This leaves them more isolated as they become care leavers in another area.

North Yorkshire County Council understood that feedback on services demonstrated that young people get confused by having lots of changing workers. All they wanted was a consistent worker.

The solution

Using the Theory of Change model to define long-term goals, and the actions needed to deliver change, North Yorkshire completely re-engineered how they could deliver services. This led them to determine how the ‘No Wrong Door’ model would improve the following outcomes for young people:

  • improving young people’s safety and stability
  • reducing vulnerabilities
  • engaging in education, training and work readiness
  • improving emotional wellbeing
  • reducing criminal activity
  • raising levels of engagement
  • reducing costs to the council, NHS, police and criminal justice system.

The aim of this new system was that young people and their needs, no matter how diverse, are addressed within a single team of trusted and skilled workers. These workers would stay with the young person throughout their journey; be it to prevent care, in care, across care or out of the care system. This integrated approach would ensure that young people are not passed from service to service (door to door); and that they have a dedicated, highly trained team around them.

With this new model in mind, North Yorkshire County Council sought views on the development of No Wrong Door. Feedback was received by young people who had previously been in residential care, and by young people currently in care. They also consulted widely with key stakeholders and partners, including the police, NHS commissioners, healthcare providers, the Supporting People commissioning body and housing providers; and received universal support.

To deliver these changes and make No Wrong Door a success, they organised work strands into three areas:

  • building the public value proposition: building the evidence to demonstrate better outcomes for young people and financial benefits to the council and partners
  • sustaining the authorising environment: maintaining support from senior executives, councillors, district councils, schools, mental health services, and the police, working to secure shared resources, shared indicators and strong partnership arrangements
  • creating the operating capacity: through recruitment, training, management and supervision, staff restructuring and a plan to engage young people in the development and delivery of the model.

The developed model of practice for all staff is theoretically founded with a strong evidence base. At its heart is ‘Signs of Safety' as an approach to assessment and planning. The evidence from implementing Signs of Safety shows that young people are safer and more stable.  It is associated with reductions in the number of children removed from their families, and the time that cases are open. Other benefits include better outcomes for families such as increased safety and permanency.

It was agreed that the No Wrong Door model would operate from two hubs in different areas of North Yorkshire. It brings together a variety of accommodation options, a range of services and outreach support under one management umbrella. No Wrong Door provides consistent relationships and continuity of a key worker as young people move to more independent accommodation. For the first time it brings together a common approach to working with young people across different specialisms, through common training and management.

The impact

No Wrong Door has been evaluated independently by Loughborough University, who found that:

  • there was a reduction in Strengths and Difficulties Questionnaire scores over time; the more involvement from specialist roles, the better the outcome
  • more involvement from specialist roles led to less missing incidents, indicating participants are happier at home or in their placement
  • evidence of improvements in mental wellbeing from an interview sample, including in a reporting of mental health issues
  • staff able to use a range of strategies with the young people
  • resilience and self-esteem increased, including the use of bespoke activities which were viewed positively by the young people and raised their self-esteem
  • No Wrong Door workers were a key support to the young people in time of a crisis.

Full evaluation report

Demonstrating local leadership and accountability

Whilst it was the council that took the lead on No Wrong Door, partners have been engaged at all stages.  Strategic leads from all partners sitting on a No Wrong Door strategic project board, which makes all decisions on the project, and drives it forward.  Progress is also monitored regularly through the children and adolescent mental health looked-after children strategic group.

Funding for No Wrong Door came from a bid to the Department for Education Innovation Programme Fund, together with funding from North Yorkshire County Council.  However, No Wrong Door provided evidence from its public proposition work that gave confidence to invest to save with funding already being secured to 2020. In fact the model is so impactful that the No Wrong Door methodology is being rolled out in other areas; such as leaving care and social, emotional and mental health services and to other councils.

Contact

Janice Nicholson
Group Manager, No Wrong Door
janice.nicholson@northyorks.gov.uk

This case study, written by Su Turner of Insight to Impact Consulting Ltd, is taken from the forthcoming LGA publication ‘Lessons in local leadership and accountability for children’s mental health services’.


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