4.1 No wrong door
Can we improve service delivery so that clients requiring services in any of the core FSP streams can enter through any FSP service (i.e. a 'no wrong door' approach)? There is considerable enthusiasm for a 'no wrong door' approach to be developed in the FSP. Practitioners positive engagement with clients acknowledging the service is part of a broader network and offering appropriate and assisted referral to other services that can assist families with a wide range of issues constitutes the no wrong door approach.
A major challenge is ensuring that all practitioners working with families understand and are aware of the range of supports available and how clients access these at the local level. Further, it relies on practitioners developing understanding, trust and value in other services to feel confident referring clients to other agencies. This can be difficult in a diverse service system with practitioners from different professional groups not historically trained to function as part of a multi-disciplinary system.
Professional rivalries and differences often go unacknowledged or are underplayed. The differences between health professionals, teachers, social workers, youth workers counsellors, lawyers are significant and fundamental in the training provided to them is often a deep sense of what is 'professional'. Addressing these rivalries will take ongoing education and training – working with universities, encouraging cross sector training and dialogue, fostering collaborative projects that get people working together (as in the Families NSW example below) is the key to increasing understanding of the different strengths each group brings to the table.
Comprehensive orientation and ongoing education for FSP staff is one approach to enhance knowledge of other services. Local project collaboration can also significantly enhance knowledge of other services available and encourage a no wrong door approach. See below Families NSW example.
A risk with the 'no wrong door' approach is that it becomes burdensome. It can be difficult to engage hard to reach families if every contact involves extensive screening and assessment. It is important to recognise and allow different levels of engagement with services. Services can co-host a range of events that introduce families to what is available in their local area without making formal contact and having to become a 'registered client'.
Community information days and open days, family fun days, parent information nights, and/or other social or interest based activities can facilitate initial contact that will help build increased awareness, familiarity and trust between families and the services they may not have previously accessed. The best outcome for families from this approach can be a sense of one door opening to many others rather then having to locate and access many different unfamiliar services that one would normally only attend when having problems.
Working collaboratively across multiple agencies is resource intensive. Investment in this activity is warranted in light of the long term benefits it will deliver through enhancing the effectiveness of the service system overall.
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Practice Example 1: Families (First) NSW
The implementation of Families (First) NSW over the past decade is an example of a coordinated effort to develop a no wrong door approach by creating improved links across different professional disciplines leading to improved outcomes for children and families. Families NSW, formerly known as Families First is the NSW Government’s strategy to enhance the health and wellbeing of young primary school aged children and their families. It is a prevention and early intervention strategy to help parents give their children a good start in life.
The philosophy of Families NSW is that the Government and non-Government services work together and with communities and service providers to plan and develop more responsive and coordinated services. A central platform is providing ongoing opportunities for families and children to be connected with their local community and services that can assist them to build well being and resilience. In several of the key models used to plan for this initiative, local community service organisations were initially funded to establish the needs of an area and facilitate an integration of services by involving other key service personnel and using a strengths-based community development approach, attracting and building trust with local families in communities facing a range of social issues including isolation due to limited public transport options for example.
Families NSW Projects are intended to enhance, support and develop sustainable child and family service networks across regions and embed network processes in local agencies (Local Government, Government and Non-Government Organisations). The main purpose of families NSW projects is to progress change in the way services (working with families with young children) work together and enhance existing partnerships. The development of Families NSW service networks is to create increased capacity to:
- deal holistically with the needs of families;
- provide coordinated support in collaboration with families and other agencies &
- provide improved access to early support at the time families need it and in forms that are most helpful to them.
These Networks assist local child and family services to develop sustainable network practices which enhance coordination and planning, as well as individual, organisational and network capacity.
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4.2 Creating linkages
How can we link with other community services (e.g. FaHCSIA and other Commonwealth programs, state/territory services such as child protection services and mental health)?
Input into local area planning processes is essential to creating better links between services and best results are achieved when all local stakeholders are included and facilitated to provide input. The links created through such processes can immediately increase clients' access to other local services in the short term while also increasing the overall capacity of local organisations to work more collaboratively.
Common performance measures and shared responsibility also create positive interdependent links between services, for example if the 'program level outcome' is a drop in child abuse rates, all local services need to be engaged in their local area to understand the role they play together to make that happen. This increases awareness of other support services and personnel available to assist clients beyond the scope of just one service.
Adequate resourcing helps foster improved links and capacity to respond to local needs where as inadequate resourcing is a barrier to creating the essential connections necessary to develop this responsive capacity. Where resources are inadequate, organisations can spend inordinate amounts of time and energy trying to attract new funds to improve sustainability which often impacts on the business of service delivery.
There are some other particularly good examples of partnerships based on a shared commitment to the local community that can also advance the no wrong door policy and improve inter-disciplinary collaboration. Such an example is the Integrated Family Support Project in the ACT. This has been established as a pilot project from 2008 to 2010 to develop a model for collaboration between government and non-government agencies and families, with the aim of providing sustained, integrated services to families at risk. The project aims to engage with families from a strengths perspective early in the life of the child and the life of the problem, before the problems necessitate court intervention. Findings from this strategy will be important to consider in developing options to facilitate a no wrong door approach within the FSP.
The recent evaluation of the Stronger Families and Communities Strategy outlined some clear success in the Communities for Children (CFC) sites that further underpin the importance of collaborative practise and a no wrong door approach. Increased service coordination and collaboration were major outcomes of CfC. It was established that increases in service provision and capacity were accompanied by an improvement in recruitment and engagement of families previously disengaged from early childhood services and from groups considered hard-to-reach. Service reach increased when:
- funding was made available for consulting with the community throughout.
- interventions and recruitment methods were tailored and designed for specific groups (for example, ‘soft entry’ approaches, which took traditionally formal services into familiar, non-threatening locations where families congregated), and practical support like transportation and active referrals were offered.
- there was networking and coordination between service providers.
- staff and outreach workers had local connections and where at least one worker was of similar background to the target group.
Service reach was also facilitated because non-government organisations were perceived as less threatening than government departments (based on the fear that governments may try to remove children).
Recommendation 6: Facilitate service provider input into local area planning processes and foster the development of cross sector networks to increase local links between FSP services and other service streams in related sectors such as health and education. [
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4.3 Standards
Should we have a set of standards for staff delivering any FSP service? FRSA supports the development of a Quality Framework for the family support services in which standards for service delivery would be an important component. Given the diversity of the services delivered under the FSP standards relating to specific work roles or positions would be difficult. However, broader standards building on the FRSP Approval Requirements and other standards currently applicable to FSP service delivery would help to build community confidence in the service system and ensure consistency.
Standards generally set minimum benchmarks. A Quality Framework can move beyond minimum benchmarks to promote continuous improvement and set aspirational goals. This is particularly important in a sector as diverse as the FSP with some programs delivered by trained volunteers and others delivered by highly skilled professionals that participate in a practitioners registration scheme or adhere to a professional code. The context of service delivery is also highly variable – the standards we might reasonably apply to conducting a group therapy program in a metropolitan location may be too high for a remote community where services and staff have fewer resources o draw on.
What quality service standards do you think the FSP should have and are there existing standards that might apply? There are two sets of standards that could be readily adapted include:
- FRSP Approval Requirements
- Family Support Standards
Across these and many other service standards applicable to the community sector (disability, HACC, children's services etc) the standards relating to generic functions such as governance, financial management, human resource management, client data systems etc should be standardised. More specific standards that relate to service types could be modular and applied only to those services that are relevant. For example, standards for post separation services might include security provisions that would not be appropriate in early intervention services. Alternatively, program or service guidelines rather than standards might be used to establish norms in relation to aspects of service delivery unique to different service types.
A potential benefit of developing a Quality Framework would be to develop some common branding that services could use to indicate to the community that they are quality assured and funded by the Australian Government. This could be in the form of a symbol or logo with some words that serve to build community confidence. It is important that this does not compete with the organisations own branding and community presence but rather complement this and acknowledge government investment.
Recommendation 7: Develop a Quality Framework for the FSP building on existing service standards. [
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4.4 Sharing Information
In what circumstances would providers benefit from sharing information/data/resources (including offices, administrative processes, workers, products) and how could this be facilitated? Again, for effective responses to local needs of clients and service providers alike, the program cannot rely on a one size fits all approach. The circumstances in which providers would benefit from sharing a variety of resources will depend on existing local needs and infrastructure, the extent and nature of established relationships between services and the flexibility of program funding to support and encourage sharing. There can be significant efficiency gains through increased economies of scale but this will only be successful if several other important factors are not compromised.
It is important that resource sharing should not diminish client choice and accessible engagement opportunities. In some cases consolidation would be a good thing while in others, more disbursement of services across a region would be better – this needs to be informed by local consultation. Respect is demonstrated when discussion with and between the full range of services working with children and families of different needs takes place. This results in a more holistic picture of the capacity for innovative sharing of information, data and resources between agencies that will ultimately result in better outcomes for children and their families.
It is also imperative that such consolidation occur where services' enter willingly into these arrangements having considered that there is an alignment in their mission and goals and that there organisation cultures are compatible. Respect is threatened when such consolidation is imposed or experienced as a 'take over' resulting in lasting tensions that can undermine any efficiency gain.
Co-location of a range of services can have benefits for local families and agencies alike provided access is not reduced and compatibility is sound. Such co-location can significantly improve referrals between services as both staff and clients are more likely to feel confident to make use of a service in an existing location they have already accessed and had a positive experience. However, there are many other practical means to improve collaboration and increase referrals without co-location.
As reported in the National Evaluation of Stronger Families and Communities Strategy (FaHCSIA, 2009) 'Communities for Children (CfC) stakeholders reported that the number and strength of networks had increased in their communities between 2006 and late 2007, and that the nature of the relationships between service providers had changed for the better, largely as a result of CfC. Trust and respect increased and service providers became more willing and open to working together as time progressed. They said CfC helped break some of the silos that previously existed in the early years service sector. Collaborations also helped service providers to solve problems, upgrade skills, increase capacity, identify the best providers for different service delivery areas, and minimise the duplication of services. The improvements in service coordination and collaboration in CfC sites were so marked that a number of stakeholders interviewed described the occurrence as a cultural change. Given the implementation challenges discussed above, this is a significant finding which indicates the strength of the CfC model.'
In that same report, the 'Service Coordination Study' revealed that most of the collaboration within CfC occurred around activities, although to varying degrees depending on the activity, for example, planning, service delivery, sharing information, professional development. All of these coordination activities were found to be quite useful.
Recommendation 8: Facilitate service collaboration in program design through enabling mechanisms that remove barriers and provide incentives for increased sharing of resources.