Early Support Guide To Key Worker Training[1]

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Early Support Guide To Key Worker Training[1]

  1. 1. Early Support guide to key worker training
  2. 2. Early Support guide to key worker training Contents Acknowledgments ....................................................................................................... 2 Section 1: Introduction ................................................................................................ 3 Purpose of guide ..................................................................................................... 3 Defining key working ............................................................................................... 4 Rationale for key working ........................................................................................ 4 Key worker functions ............................................................................................... 5 Key workers and the developing pattern of service provision ................................. 6 Implications for training – summary......................................................................... 7 Section 2: Knowledge and skills needed..................................................................... 9 Research evidence.................................................................................................. 9 Organisational standards......................................................................................... 9 Practice standards................................................................................................. 10 Assessment, planning and review ......................................................................... 10 Implications for training – summary....................................................................... 11 Section 3: Providing key worker training ................................................................... 12 Research evidence................................................................................................ 12 Features important for a successful programme ................................................... 12 Learning from the experience of others................................................................. 14 Ensuring a positive future ...................................................................................... 16 Implications for training – summary....................................................................... 17 References................................................................................................................ 19 Appendix 1: Organisations providing training............................................................ 21 Appendix 2: Key worker awareness training – half-day workshop ............................ 22 Appendix 3: Key Worker Training – 2½ day programme .......................................... 23 Appendix 4: Key worker training programme for designated and non-designated key workers...................................................................................................................... 25 Appendix 4 (continued): Examples of ongoing training............................................. 26 Appendix 5: Examples of organisations offering courses on specialist subjects ...... 27 Early Support 2006 1
  3. 3. Early Support guide to key worker training Acknowledgments This guide has been written in partnership with Care Co-ordination Network UK; the author is Dr Judith Cavet, an independent consultant and researcher. We would like to thank Miranda Parrott and Gillian Cowdell who worked on an earlier version of the guide and gathered information from services about relevant training materials and their use. We are very grateful to the staff of the projects who contributed information for the guide. In particular, we would like to acknowledge the cooperation of SNIP in Edinburgh, the Devon Children and Young Peoples Services, Joint Agency Teams for Children with Special Needs and NCH Pembrokeshire Children’s Centre for allowing us to present examples of their training materials in the appendices. Finally we wish to note our appreciation of Tricia Sloper, Professor of Children’s Health Care, Social Policy Research Unit, University of York who has provided her expertise, enthusiasm and support throughout the process of preparing this guide. Early Support 2006 2
  4. 4. Early Support guide to key worker training Section 1: Introduction Purpose of guide This guide is designed to be read by those responsible for providing training to key workers for disabled children and their families. It is intended to be useful to strategic and operational managers responsible for arranging the provision of key worker training in their locality and to those who present some or all of the elements of such programmes. The guide aims to:- • Introduce the concept of key working • Indicate the knowledge, skills and qualities needed by key workers • Present what is known about how relevant training might be provided. The guide comprises three main sections. Each section ends with a summary of the implications for training of the information set out within that section. The guide’s format is as follows: 1 Introduction: • Purpose of guide • Defining key working • Rationale for key working • Key worker functions • Key workers and the developing pattern of service provision • Implications for training – summary. 2 Knowledge and skills needed: • Research evidence • Organisational standards • Practice standards • Assessment planning and review • Implications for training – summary. 3 Providing key worker training: • Research evidence • Features important for a successful programme • Learning from the experience of others • Ensuring a positive future • Implications for training – summary. The guide is informed by policy guidance and research, as well as national standards developed to establish best practice in key worker services. It has also drawn on the experience of a number of professionals who have already made efforts to make available key worker training. The authors wish to acknowledge and thank those who have contributed information. The guide aims to set out briefly the most salient information. Additional information is available in a chapter (Cavet, forthcoming) prepared as part of a distance learning course, which is being developed by Early Support (see www.earlysupport.org.uk). For economy of style, the words "child" and "children" are used in the guide to include young people. Early Support 2006 3
  5. 5. Early Support guide to key worker training Defining key working The term ’key working’ is used in this document to indicate a service which provides care coordination for disabled children and their families, when the families require specialist input from multiple agencies. The Care Co-ordination Network UK (CCNUK), an organisation with responsibility for promoting high standards in key working in the UK, defines key working as: “a service, involving two or more agencies, that provides disabled children and young people and their families with a system whereby services from different agencies are co-ordinated. It encompasses individual tailoring of services based on assessment of need, inter- agency collaboration at strategic and practice levels, and a named key worker for the child and family." (CCNUK, 2004). This definition makes it clear that what is meant by the term ’key working’, used in this sense, is a situation when a key worker is employed in a formal scheme and has agreed status as a family’s named worker. Some workers, who operate in this way and are therefore key workers, may be known by other titles, including ’link worker’ and ’family support worker’. Key workers can be deployed in one of two different ways. They may operate as: A ’non-designated’ key worker, in which case they provide a key worker service to some families, while undertaking the professional role for which they are primarily employed. A ’designated’ key worker, when they are employed and paid specifically to carry out the key worker role. A recent study of key worker schemes in England and Wales revealed considerable variation in significant aspects of their organisation and the scope of their work (Greco et al, 2005). The variability in the characteristics of key worker services has implications for training. For example, one way in which schemes differed was in regard to the age range of the children who could be considered for eligibility for their service. Some schemes were directed towards younger children only, while others worked with children until their transition to adult services. However, the aims and functions of key worker services remain essentially similar. CCNUK describes the key worker as: “A source of support for disabled children and young people and their families.” “A link by which other services are accessed and used effectively.” (CCNUK, 2004). Rationale for key working Key worker services have been developed in an effort to overcome some of the barriers faced by families with disabled children. There is research evidence, collected over a lengthy period, which demonstrates that families frequently report that they face an uphill struggle in finding out about and accessing the services they need. The complexity of the pattern of service provision presents a major obstacle, which may result in their having to repeat information to a range of professionals in different agencies. Key working schemes were, therefore, developed to coordinate the services available to families with disabled children with complex needs. Early Support 2006 4
  6. 6. Early Support guide to key worker training Where key working schemes have been set up there is research evidence of positive outcomes for families using them. The most recent survey of key worker services in the UK reported that: “Key workers provided a valuable service for families and had positive impacts on many families’ lives. Key workers’ collaborative work with other agencies and professionals and with schools facilitated access to appropriate support for disabled children and their families." (Greco et al, 2005). Earlier research (eg Townsley et al, 2004) and evaluations of individual schemes (eg Barton and Clark, 2005) also suggest similar favourable outcomes for families. In addition, benefits for staff employed in key worker schemes have been reported, even though the resourcing and organisation of services were not without problems. Improved staff satisfaction for those acting as key workers is a frequent gain when key working schemes are established (Liabo et al, 2001; Townsley et al, 2004; Greco et al, 2005; Barton and Clark, 2005). Government policy in England, Scotland and Wales has responded to evidence about the utility of key worker services by requiring their development for children with complex needs who require two or more ongoing specialist services. One significant example of these policy initiatives is the duty, placed by the National Service Framework for Children (Standard 8), on English local authorities, primary care trusts and NHS trusts to ensure that: " Families caring for a disabled child with high levels of need have a key worker/care manager to oversee and manage the delivery of services from all agencies involved in the care and support of the child and family, and to ensure that the family has access to appropriate services." (Department of Health, 2004). Key worker functions The key worker role is summarised by CCNUK as: • “Providing information • Identifying and addressing the needs of all family members • Providing emotional and practical support as required • Assisting families in their dealings with agencies and acting as an advocate if required.” (CCNUK, 2004). Research demonstrates positive outcomes for families result when key workers carry out the following tasks: “Providing information and advice to families about services and support available, both locally and nationally, and how to access these. Coordinating care and working across agencies, including supporting families with regard to care planning and review meetings. Improving access to services. Identifying and addressing the needs of all family members. Speaking on behalf of the family when dealing with services. Providing emotional support. Providing help and support in a crisis. Early Support 2006 5
  7. 7. Early Support guide to key worker training Providing information specific to the child's condition where needed.” (Sloper et al, 2006, quoted in Mukherjee et al, 2006). Key workers and the developing pattern of service provision The policy shift which now specifically requires the provision of key worker services is one aspect of policy developments which emphasise the need for a coordinated package of services to be made available to service users at the point of delivery. In England this overall thrust is set out in the Every Child Matters: Change for Children programme (ECM) and made law by the Children Act 2004, which provides the legislative framework for the ECM. The Children Act 2004, places a duty on local authorities to promote cooperation between agencies and other appropriate bodies, and on key partners to take part in cooperation arrangements. Key worker schemes are one manifestation of this general shift towards an increased focus on interagency collaboration. Those employed in key worker schemes will need to understand this context of continuing change and how they will be expected to operate within the changed system. The ECM sees integrated working as a key component in the move to coordinated services for children: "Integrated working means practitioners [are] enabled and encouraged to work together in more integrated frontline services, built around the needs of children and young people, using common processes and tools which are developed to create and underpin joint working." (Department for Education and Skills, 2006a). New processes and tools associated with integrated working include information sharing guidance, a common assessment framework (CAF) and the introduction of lead professionals. These innovations are being introduced to staff with the aid of centrally developed training materials (see www.everychildmatters.gov.uk/deliveringservices/integratedworking/) The introduction of the concept of the lead professional is particularly pertinent to key workers, since the tasks ascribed to both roles share much in common. The functions of the lead professional are to: “Act as a single point of contact for the child or family, who they can trust and who can engage them in making choices, navigating their way through the system and effecting change. Co-ordinate the delivery of the actions agreed by the practitioners involved, to ensure that children and families receive an effective service which is regularly reviewed. These actions will be based on the outcome of the assessment and recorded in a plan. Reduce overlapping and inconsistency in the services received." (Department for Education and Skills, 2006b). It is the role of both lead professionals and key workers to coordinate services, but the key workers’ role is to work in a more in-depth capacity with families who have children with the most complex needs (Eagle, 2005). Where a key worker is in place for the family of a child with complex impairments or health needs they will act as lead professionals (Department for Education and Skills, 2006b). Policy guidance has produced the diagram below which represents how a spectrum of support is to be made available to children with differing levels of need. Early Support 2006 6
  8. 8. Early Support guide to key worker training The diagram showing the spectrum of lead professional support, below, illustrates where the key worker role fits in to the overall pattern of service provision for children. Staff undertaking the key worker role will need to be clear about the arrangements in place for children and families who no longer are eligible for a key worker service. Their training will need to include information about how a smooth transition to other services is to be accomplished. In recent years there has been a considerable focus on the need to co-ordinate services for children from ages 0-3 years (Department of Health and Department for Education and Skills, 2003). The Early Support programme which was set up to promote the implementation of this policy has helped to develop key working for this age group and is being extended to children up to the age of five years. Key workers for these pre-school children will need to be clear about how service co-ordination for families will be provided when the children approach school age. Key workers employed in schemes which offer a service to children and young people until their transition to adult services will need training to ensure they are familiar with the transition arrangements. Key workers for children of all ages will need information about how service coordination is to be achieved for those children and young people whose needs diminish so that they no longer qualify for a key worker service. I = Identification and action T = Transition N = Needs met Spectrum of lead professional support (Department for Education and Skills, 2006c) Implications for training – summary When being introduced to the concept of key working, staff will need to understand: What is meant by key working. Early Support 2006 7
  9. 9. Early Support guide to key worker training The difference between designated and non-designated workers. Key working can improve outcomes for families. Key working can lead to greater staff satisfaction. Key working is required by government policy. Which key worker functions improve outcomes for families. Key working is part of a more general change to interagency cooperation. Key workers act as lead professionals for children with complex impairment and for their families. How transition to appropriate services is to be achieved for children who no longer qualify for a key working service because of their age or changes in their level of need. Early Support 2006 8
  10. 10. Early Support guide to key worker training Section 2: Knowledge and skills needed Research evidence Key working is a complex and challenging role which requires a good deal of knowledge and skill. There is research evidence that shows parents do not believe that it is important for key workers to have a specific professional background. However, they are clear about the basic skills and qualities required: “Good communication and listening skills. Ability to empathise with families, build rapport and develop relationships of trust with families and other professionals. Respect for parents and children’s expertise about their own lives. Ability to ‘stand back and step outside’ one particular discipline. Negotiating skills and diplomacy. Ability to see the whole family. Team working skills. Knowledge of the roles of other agencies, how other agencies work and what is available locally and nationally. Ability to find information and to admit that they don’t know all the answers. Time management skills, ability to plan effectively and be a good organiser. A good understanding of disability issues.” (Mukherjee et al, 2006). In the light of evidence from research, CCNUK has developed a set of standards which well functioning key worker schemes must achieve. These are set out under three headings: • Organisational standards • Practice standards • Assessment, planning and review. For the purposes of this guide, the CCNUK standards have been used as the basis for the development of a detailed list of the knowledge and skills necessary for key working. These are set out below. The expertise outlined will be required by key workers in order that the services, within which they work, achieve the necessary service quality. Organisational standards In respect to the service in which they work, key workers need to know: The nature of the multiagency commitment to the service, both at a strategic and at a practical level. The nature of the multiagency management group. The referral system and eligibility criteria for the service. Early Support 2006 9
  11. 11. Early Support guide to key worker training The multiagency protocol for joint assessment, including the process for producing interagency care plans and for reviewing the needs of the disabled child and their family. The joint policy for information sharing between agencies. The communications strategy for the service and how they and service users are to be involved in planning and developing the service. Who is to manage the service on a day-to-day basis and report to the management group. What resources are available for running the service, including administrative support and arrangements for training and supervision. Job descriptions relevant to themselves and colleagues. Links with other agencies which impact on the lives of disabled children. The cultural needs of the local population and their implications for practice. Systems for monitoring, reviewing and evaluating the service. For non-designated workers – how their job descriptions are to be adjusted and how they are to be allocated protected time for their key worker role. Practice standards Key workers need to understand: The need for proactive, regular contact. The importance of a supportive, open relationship based on respect for the views of parents and children. The importance of a family-centred (not only a child-centred) approach What different agencies offer and how to go about gaining access to them. How to work with families’ strengths, act as an advocate and enable parents and children to gain advocacy support when required. Arrangements for training, supervision and peer support. The location and nature of an information resource covering local, regional and national services and information about different conditions and impairments. How to ensure families have information available which is accurate, accessible, timely and appropriate. Assessment, planning and review Key workers will need to be familiar with and understand: Interagency assessment processes and how they lead to an interagency care plan and link with any other assessments undertaken. The agreed system for interagency care planning reviews and how to time these according to family preference. The need to support the preferences of parents and children regarding assessment and review meetings. How to ensure appropriate support for children and young people to participate in their assessment and review, including children who do not communicate by speech. Appropriate support for parents to participate in the assessment and review process. Early Support 2006 10
  12. 12. Early Support guide to key worker training How to facilitate the participation of families from minority ethnic groups in assessment and review. The agreed system for record-keeping, including parents and/or young person held records. Implications for training – summary Research indicates that the key worker role is multifaceted and requires a complex mixture of knowledge, skills and qualities. Training is needed about organisational issues. Training is needed about practice issues. Training is needed about assessment, planning and review procedures. Early Support 2006 11
  13. 13. Early Support guide to key worker training Section 3: Providing key worker training Research evidence The required content of key workers’ training has been summarised as: “Disability awareness training. Childcare legislation and policies relating to disabled children and key working. Child protection. For non-designated key workers, differences between the key working role and their professional role. Roles and working of different agencies. Local services and how to access these. An information pack about local services and resources should be produced to support this training. Communication and listening skills. Direct work with children, including training on communication with children who do not use speech. Family-centred working and advocacy. Team working skills. Negotiation and chairing skills. Time management skills. Recording systems for key workers. The system used for multiagency care planning and review.” (Mukherjee et al, 2006). This list reflects the findings of recent research, and should inform a programme of training, which begins with induction and is followed by the provision of regular, continuing opportunities for staff development and learning. Features important for a successful programme Clearly not all of the diverse skills and knowledge needed by key workers can be addressed at once. Decisions have to be made about which areas of training need to be prioritised. New key workers will need to learn both about how their local service will operate and to practise the skills required to facilitate the proper operation of a key working service. Those preparing staff to undertake this work will need to develop a programme of training which takes into account their existing knowledge and skills. A variety of other local factors will also affect the specific content of the proposed training. For example, the nature of the local scheme, what other training programmes are being implemented in the area contemporaneously and the particular characteristics and needs of the local population. Key worker training should build on the existing strengths of the staff to be trained, including their prior learning. Although key working is a complex and demanding role, some key workers will have considerable relevant experience and qualifications. In an evaluation undertaken by Barton and Clarke (2005) the overwhelming majority of staff who were about to become key workers "demonstrated a comprehensive array of expertise." (Barton and Clarke, 2005). The range of skills and knowledge available varied according to previous professional backgrounds, though many felt they had insufficient knowledge of the benefit system. It was concluded that "there should be Early Support 2006 12
  14. 14. Early Support guide to key worker training some appreciation that some professionals will need more training and support than others." (Barton and Clarke, 2005). On the other hand, a group of professionals from diverse backgrounds makes available to a key worker service a broad range of knowledge and skills (Greco et al, 2005). The advantages of the interagency contacts intrinsic to key working were noted by Townsley et al (2004), who found that working in multiagency services provided professionals with enhanced opportunities for personal and professional development. Staff said that working more closely with other professions enabled them to learn more about each other’s roles and to provide a more efficient service for families as a result. However, from the same study it was also clear that, although professionals did learn from working with each other, targeted training was needed to promote the gaining of knowledge and skills, relevant to multiagency working. "It appeared that although learning opportunities were better overall there was insufficient training on specific aspects of multi-agency working such as what it meant to be a key worker, how to chair meetings, and so on." (Townsley et al, 2004). The absence of the right training resulted in families receiving a service where professionals were relatively unsuccessful in their multiagency role, such as service coordination, family advocacy and paying attention to the needs of the child and family as a whole. Therefore, it is recommended that: “Multi-agency services for children with complex healthcare needs should pay attention to the need to provide generic training on partnership working and what it means for individuals and their agencies." (Townsley et al, 2004). The course content of key worker training programmes must include information about how professionals from different agencies are to work together and how they can develop the necessary techniques and skills. In addition, opportunities for the development of knowledge about the roles and cultures of other professionals should be encouraged by training being carried out in multiagency groups. The first key principles for the delivery of training about integrated working are: “Training to be delivered in a multi-agency setting to help build networks, understanding of other’s roles and situations and start to break down professional silos. Specific activities and time for attendees to get to know each other are incorporated into each training course to make the most of the multi-agency opportunity. Specific activities and time for experiential learning are incorporated into each training course to provide attendees with opportunities to test, reflect and discuss the changes to working practices.” (Department for Education and Skills, 2006d). Work in Wales indicates the benefits of interagency training in developing: • “Effective working relationships • Shared goals and objectives Early Support 2006 13
  15. 15. Early Support guide to key worker training • Understanding of the roles and responsibilities of different professions • Appreciation and respect for agencies values, expertise and constraints.” (Linck et al, 2002). Partnership working, both with other professionals and with families, needs to be a central component of key worker training. Family involvement in training programmes about key working is essential for similar reasons to those for multiagency training. Greco et al (2005) note that "parents and disabled young people can play an important role in training key workers." (Greco et al, 2005). Full parental involvement in training helps to model and foster working in partnership with parents in the same way that multiagency training can model working in partnership with professionals from different agencies. Professionals can learn from parents – who are conveying their perspective – and from their experience and knowledge. Parents should be involved in training as recipients of training – for example, in the case of those parents who are acting as the family’s care coordinator. Parents should also be involved as trainers themselves, sharing their expertise with trainees. Importantly, parents should be part of the team responsible for the development and management of the key working service. This latter role relates to the fact that parents should be members of the steering group responsible for the service. Training at all stages needs to recognise the importance of ’people skills’ which may be more difficult to acquire than specific knowledge. Parents realise key workers will not have all the necessary knowledge at their fingertips, and may have to elicit information on their behalf. However, parents especially appreciate: “ …listening and communication skills, tact and diplomacy, approachability, respect for families‘ expertise, and persistence.” (Greco et al, 2005). All training should promote a family-centred approach. Particular attention needs to be paid to ways of raising awareness of the importance of consulting with children directly with regard to decisions about their own well-being and decisions about the pattern of service delivery. Key workers are likely to need training in ways of communicating with disabled children, especially those with cognitive or communication impairments (Greco et al, 2005). Communication with children, including children who do not communicate verbally, is now part of the core skills training programme, developed by the Department for Education and Skills (2005). Learning from the experience of others The development of training programmes for key working appears to be much more established in some services than others (Cowdell and Parrott, 2006). However, it is possible for those currently developing training to learn from the experience of those who have already made efforts in this field. Information elicited by questionnaires from key worker projects established under the Early Support programme and reported by Cowdell and Parrot (2006), suggests that key worker training in the nineteen areas in question showed considerable variation in the stages of development achieved. The amount of resources afforded to training also appeared to differ markedly among services. Evidence for this was the considerable variation among the schemes in the number of days spent on induction training (from 0.5 days to 5 days). Early Support 2006 14
  16. 16. Early Support guide to key worker training A few schemes had achieved considerable experience, while others had yet to begin training. Several were taking action to develop programmes. Two more reported that awareness raising about key working and the role of the lead professional had resulted from training related to integrated working, which was being carried out in their area. In one case this training related to CAF and in the other to information sharing and assessment. An example of one of the most developed training programmes included the provision of information about: • CCNUK key worker standards • The model of key working to be adopted • Basic counselling, listening and communication skills • Respect for families’ expertise • Advocacy and negotiation skills • Knowledge about disability • Knowledge about services • Time management and planning skills • Home visiting • Child protection. It is evident that programmes were being developed according to local need, conditions and circumstances. For example, another service had prioritised the provision of training sessions about statementing, benefits, including Disability Living Allowance, and MAKATON. The overwhelming majority of schemes involved parents in delivering training, and several had employed trainers from outside organisations to contribute to all or part of their programmes (see Appendix 1 for a list of their names). At the time of their delivery some training programmes were supported by the provision of written information for participants. For example, trainers for one programme developed a Practitioners’ Pack to support key workers. They also sent out preliminary reading as preparation for the training workshops. This reading included: • A short description of the key worker role • The CCNUK standards • The relevant chapter from Professional Guidance (Early Support, 2004). The provision of written material as part of induction training is recommended by Mukherjee et al (2006). A useful source of information about how key worker training has been provided to date is available in the form of induction programmes prepared for key worker training in the recent past. Appendices 2, 3 and 4 contain brief summaries of three induction programmes devised in different parts of the UK to lay the foundations for effective key working. The programmes in Appendices 2 and 4 were initiated by key worker schemes which work with families with disabled children and young people up to their transition to adult services. The programme in Appendix 3 was developed by an independent training provider rather than by staff producing a programme for a particular key worker service. Appendix 4 also contains brief details about subsequent training provided to further extend workers’ knowledge base. Early Support 2006 15
  17. 17. Early Support guide to key worker training These appendices are made available to indicate ways forward which have already been developed. They are not necessarily reproduced verbatim. Some of them have been condensed and made accessible to a readership who are unfamiliar with local conditions and specific models and practices. They are not intended to be regarded as blueprints, but rather as background information and in an effort to avoid future training providers having to ’reinvent the wheel’. Where possible, the programmes are set out in sufficient detail to indicate to readers the methods and pace of training, as well as the content. Ensuring a positive future The relative effectiveness of the programmes outlined above has not been evaluated, but we do know that a large-scale research study found: “Key workers who received regular training, supervision and support were likely to carry out more aspects of key working and had more positive impacts for families." (Greco et al, 2005). At the inception of a key worker service, induction training is essential for staff before they take up their new roles. An induction programme should ensure key workers fully understand the tasks they are expected to take on for the family, (and those which they are not), which areas they are responsible for and to whom they are responsible (Mukherjee et al, 2006). Following induction, a continuing programme of training, supervision and peer support will be necessary if a high-quality service is to be provided which meets the standards developed by CCNUK. An evaluation of key worker schemes in Norfolk suggested that: "… all projects existing and in the future, would benefit from: • More opportunities for formal multi-agency training … • Increased opportunities for different professional groups to meet and talk together to enhance inter-professional understanding and co-operation." (Young and Robinson, 2005). Young and Robinson point out that it takes time for a group of experienced professionals from a variety of backgrounds to achieve a shared culture and set of values, and to become a cohesive, fully functioning team. Opportunities for meetings with peers and for multiagency training are needed, in addition to support and supervision (Young and Robinson, 2005). The role of service manager has an important part to play in the provision of induction and ongoing training, plus regular, individual supervision and opportunities for peer support. The manager’s post needs to be sufficiently resourced for these functions to be carried out. Training and supervision play an important part in encouraging key workers to reflect upon their own practice. Key workers also need training and supervision which encourages them to monitor the overall quality of service provision available to families. Key workers should be encouraged to participate in internal and external evaluations of the key worker service and to value communication from families about its quality. Key workers will be aware that the provision of a key worker service per se will not overcome resource constraints. They should be trained to document unmet need so that information can be collated and used to influence future planning. Early Support 2006 16
  18. 18. Early Support guide to key worker training The training which has been outlined above needs to be made available as one of the measures necessary to ensure an optimally functioning key worker service. The extent of resources available will affect the pace of training; local factors will influence the specific content of training. However, the overall content required of training programmes for high quality key working is clear and evidence based. Greco et al (2005) found that: “The provision of regular key worker training, supervision focused on the key worker role, and peer support between key workers strongly influenced the way in which key workers carried out their role, including carrying out the different aspects of key working and having appropriate amounts of contact with families, and thus impacted on outcomes for families." (Greco et al, 2005). Staff will vary in the sophistication of their appreciation and grasp of the required knowledge base and skills, depending on their prior learning and their own aptitude and skills. Those responsible for the provision of training will need to ensure that there is initial and ongoing identification of staff learning needs relevant to key working. Decisions about what training to organise for teams of key workers should be informed by an awareness of their existing skills and any gaps in their knowledge base, as well as the need to keep abreast of new developments. Key workers’ views about priorities for their future training are one indication of what should comprise the content of future training. Equally important are families’ views about what are families’ greatest needs in terms of information and service provision. More advanced and specialised information relevant to key workers who wish to develop their expertise further is available from a variety of sources. Some organisations of and for disabled people and their families may offer brief courses on specialist subjects (see Appendix 5 for some suggestions). For key workers employed by services for young disabled children, Early Support have developed five separate training programmes which are aimed at parents, practitioners and managers. The concept of partnership underlies the different types of training on offer; contact points are eileen.strevens@rnid.org.uk and www.earlysupport.org.uk In addition, some universities and other institutions of higher learning offer opportunities for extended part-time study on an interdisciplinary basis for staff who are keen and able to make the necessary commitment. These interdisciplinary courses offer a broader curriculum than key working alone but afford opportunities for developing relevant knowledge. The courses are available for students at different educational levels, as well as from different professional backgrounds. Some courses have been developed to be available on a distance learning basis and so can offer opportunities for study to staff from a large geographic area. Implications for training – summary Research provides indications of areas of training which can contribute to key workers’ ability to work to high standards. Training must be tailored to local conditions, needs and circumstances. Training should recognise existing staff strengths. Working in close contact with other professionals promotes useful learning, but specific training about how to function as a member of a multiagency team is essential. Early Support 2006 17
  19. 19. Early Support guide to key worker training Key workers new to the role require training in partnership working. Training in groups which include staff from different professional backgrounds and agencies affords a variety of benefits. Family involvement in key worker training is essential. Training must include recognition of the importance of ’people skills’. All training must be family-centred, and should include information about communicating with children. Programmes produced by those who have experience of providing training for key workers offer useful indications about the possible content, pace and modes of delivery. Written information provides a useful learning aid to participants undertaking initial training. Prior to undertaking key working, staff must be provided with induction training which clarifies their areas of responsibility. This initial training should be followed up by a continuing programme of formal, multiagency training to develop and update workers’ knowledge and skills. Opportunities for peer support through regular meetings of key worker staff can help to foster mutual understanding and a shared culture. The service manager has an important role to play in ensuring the regular provision of group training and individual supervision which can improve service quality for families. Training should encourage key workers to participate in measures which aim to improve the quality of the service overall. Once the basic knowledge and skills required for key working have been acquired, those organising training may wish to commission more advanced training from organisations with special expertise in areas related to disability provision. More prolonged study of an interdisciplinary nature is available on a part-time basis and/or in the form of distance learning at some UK universities and colleges. Early Support 2006 18
  20. 20. Early Support guide to key worker training References Barton, L. and Clark, L. (2005) “Altogether Now” An Evaluation of the Key Working Processes in Warwickshire: First Report, Stareton: Warwickshire County Council. Cowdell, G. and Parrot, M. (2006) Guide to Key Worker Training, unpublished paper, York: Care Co-ordination Network UK. Care Co-ordination Network UK (2004) Key Worker Standards, York: Care Co- ordination Network, available at http://www.ccnuk.org.uk Cavet, J. (forthcoming) Best Practice in Key Working: What do research and policy have to say?, Working in Partnership through Early Support, distance learning programme being developed by Early Support. Department for Education and Skills (2005), Core of Skills and Knowledge for the Children's Workforce, Nottingham: Department for Education and Skills Publications, available at http://www.everychildmatters.gov.uk/deliveringservices/commoncore Department for Education and Skills (2006a) Introduction to Integrated Working; Delivery Notes, Nottingham: Department for Education and Skills Publications, available at http://www.everychildmatters.gov.uk/resources-and-practice/IG00123/ Department for Education and Skills (2006b) The lead professional: Managers’ guide, Nottingham: Department for Education and Skills Publications, available at http://www.everychildmatters.gov.uk/leadprofeessional Department for Education and Skills (2006c) Introduction to Lead Professional: Delivery notes, Nottingham: Department for Education and Skills Publications, available at http://www.everychildmatters.gov.uk/resources-and-practice/IG00122/ Department for Education and Skills (2006d) Supporting integrated working: Outline training strategy and plan, Nottingham: Department for Education and Skills Publications, available at http://www.everychildmatters.gov.uk/iwtraining/ Department for Education and Skills and Department of Health (2003) Together from the Start – Practical guidance for professionals working with disabled children (birth to third birthday) and their families, Nottingham: Department for Education and Skills Publications. Department of Health (2004) Disabled Child Standard, National Service Framework for Children, Young People and Maternity Services, London: Department of Health Publications. Eagle, M. (2005) Extract from Speech at CCNUK Conference, York: Care Co- ordination Network, available at http://www.ccnuk.org.uk/ Early Support (2004) Professional guidance, Nottingham: Department for Education and Skills, available at http://www.earlysupport.org.uk Greco, V., Sloper, P., Webb, R. and Beecham, J. (2005) An Exploration of Different Models of Multi-Agency Partnership in Key Worker Services for Disabled Children: Effectiveness and Costs, Nottingham: Department for Education and Skills. Early Support 2006 19
  21. 21. Early Support guide to key worker training Liabo, K., Newman, T., Stephens, J. and Lowe, K. (2001) A Review of Key Worker Systems for Disabled Children and the Development of Information Guides for Parents, Children and Professionals, Cardiff: Wales Office for Research and Development National Assembly of Wales. Linck, P., Elliston, P., Robinson, C., Parry-Jones, B. and Williams, M. (2002) Partnership Development Framework for Interagency Working, Bangor: Centre for Social Policy Research and Development, University of Wales. Mukherjee, S., Sloper, P., Beresford, B., Lund, P. and Greco, V. (2006) A Resource Pack: Developing a Key Worker Service for Families with a Disabled Child, York: Social Policy Research Unit, University of York (available from CCNUK, York) Townsley, R., Abbott, D. and Watson, D. (2004) Making a difference? Exploring the impact of multi-agency working on disabled children with complex health care needs, their families and the professionals who support them, Bristol: The Policy Press. Young, J. and Robinson, J. (2005) An Evaluation of the Norfolk Care Co-ordination Initiatives, Norwich: University of East Anglia. Early Support 2006 20
  22. 22. Early Support guide to key worker training Appendix 1: Organisations providing training 1. CCNUK, Tower House, Fishergate, York YO10 4UA. www.ccnuk.org.uk 2. Gollcher Associates, Meanwood House, Rooleymoor Road, Rochdale OL12 7AX. astrid@gollcherassociates.co.uk 3. Early Support, Royal National Institute for Deaf People, 19–23 Featherstone Street, London EC1Y 8SL. www.earlysupport.org.uk 4. Peter Limbrick, Interconnections, Parks Farm, Clifford, Herefordshire. www.interconnections.services@virgin.net 5. Special Needs Information Point (SNIP), Royal Hospital for Sick Children, 14 Rillbank Terrace, Edinburgh EH9 1LN. www.snipinfo.org Early Support 2006 21
  23. 23. Early Support guide to key worker training Appendix 2: Key worker awareness training – half-day workshop Devon Children and Young People’s Services, Joint Agency Teams for Children with special Needs A PowerPoint® presentation covered: 1. Aims of key worker training – to develop greater knowledge and understanding of the role of multiagency team (MAT) as established locally and key worker role. 2. Objectives of key worker training – increased awareness of the key worker process to equip workers, outline responsibilities, support and available resources. 3. Every Child Matters – requirement in Green Paper and Children Act 2004 for single named professionals to lead where children are known to more than one specialist agency. 4. Key worker definition. 5. Key worker protocols (these indicate possible source of referrals to MAT). 6. Support coordinator role. 7. Children with special needs: process flow chart indicates process from initial contact to service plan review, including initial assessment, consultation meeting, appointment of key worker, ’assessment summaries’ and drafting of integrated assessment and service plan. 8. Initial key worker competences (knowledge of issues facing family, of services and ability to communicate in person and in writing and build effective relationships). 9. Initial key worker competences continued (information gathering and analysis, use of professional judgment, including knowledge of research). 10. Initial key worker competences continued (integrated assessment, service planning and review). 11. Key worker competences (child protection, practices informed by policy). 12. Key worker competences (teamwork, promotes equality, flexibility, legal knowledge). 13. Key worker competences (applies knowledge of child development, information available to MAT, time management). 14. Key worker competences (applies theory, research, IT skills). 15. Evidence of effectiveness of key workers (from research). 16. Key worker tasks (proactive, regular contact with family, ensure implementation of agreed plan, act as contact point for family and professionals, reviews and paperwork). 17. Elements of a quality key worker service (proactive regular contact, a supportive, open relationship, a family-centred approach, working across agencies, working with families’ strengths and ways of coping, working for family rather than agency). 18. Criteria for eligibility for service (age range, level of impairment, multiagency input). 19. Possible responses to initial contact. 20. Content of information pack (which is one potential response to initial contact). 21. Possible decisions resulting from initial contact (and how they should be recorded). 22. Responsibilities of referral and information coordination. 23. Factors underlining successful key worker services. Early Support 2006 22
  24. 24. Early Support guide to key worker training Appendix 3: Key Worker Training – 2½ day programme SNIP, Edinburgh Aims of training programme: To emphasise the importance of developing self-awareness in the role of care coordinator/key worker. To identify and promote the development of attitudes and values needed for effective working in the role. To identify and promote the development of the skills needed for effective working. To stress the need for regular review and reflection of practice. To encourage ongoing development of skills through identification of further training needs. Programme outline: Session 1 – Setting the context: Care coordination and key working (day 1) Reviewing the background and development of care coordination at local and national level. Defining our terms – establishing a shared understanding of the language of key working. Care coordination documentation, recording and sharing information. Session 2 – Childhood disability, families, society and the key worker (day 1) Reviewing the history behind attitudes to disability and childhood. Exploring our own feelings about disability. Evidencing of understanding of the social and medical models of disability and the challenges the key worker faces in working within the social model. Defining the key worker role and responsibilities and how these differ from and relate to the usual practitioner role with individuals and families. Session 3 – The emotional impact of having a child with special needs (day 2) Examining stereotypical responses to how families respond to their situation. Evidencing understanding and awareness of the complicated nature of individual and collective responses to having a child with special needs. Identifying the core skills necessary to work with people’s differing responses and the dynamics between the individuals involved. Early Support 2006 23
  25. 25. Early Support guide to key worker training Session 4 – Being a key worker (day 2) Examining the practical implications for families where there is a child with special needs with regard to the lack of parental control over appointments, interventions etc. Evidencing understanding and awareness of the emotional implications with regard to compliance etc. Identifying the core skills necessary to effectively coordinate and manage, (in partnership with families) the practicalities, including when there are issues around compliance, dispute over suitable treatments etc. Exploring the role that a contract or agreement can play in defining and maintaining the role of the key worker. Session 5 – Supervision, professional development, monitoring and evaluation (day 3) Examining the role of supervision and support. Evidencing an understanding of the need for monitoring and evaluation of practice as a key worker. Identifying some possible future training needs. Early Support 2006 24
  26. 26. Early Support guide to key worker training Appendix 4: Key worker training programme for designated and non-designated key workers NCH Pembrokeshire Children’s Centre Title Time Content What is a key worker? ½ day Role, time commitment, working across agencies Team building 1 day Getting to know you, shared values Disability equality 1 day Attitudes and practices A parent’s perspective ½ day Partnership with professionals Developing a planning ½ day Assessment framework, planning, system monitoring, reviewing documentation Information sessions on: Social care 2 hours Access processes and services Health 2 hours Services and referral processes Education 2 hours Statementing and SEN services Benefits 2 hours Disability benefits Housing 2 hours Rehousing, adaptations Leisure 2 hours Specialist and mainstream Voluntary organisations 2 hours Barnardos, Family Fund Early Support 2006 25
  27. 27. Early Support guide to key worker training Appendix 4 (continued): Examples of ongoing training New services Circles of support Direct payments New residential services New legislation Carers Act Disability Discrimination Act Extra information sessions Equipment Disabled facilities grants Visual impairment Hearing impairment Communication with children Child protection Types of disability Autism Epilepsy Cerebral palsy Muscular dystrophy Down syndrome Ongoing training held once a month for a two hour session. Early Support 2006 26
  28. 28. Early Support guide to key worker training Appendix 5: Examples of organisations offering courses on specialist subjects 1. British Association for Counselling and Psychotherapy, BACP House, 35-37 Albert Street, Rugby, Warwickshire CV21 2SG. www.bacp.co.uk 2. Centre for Parent and Child Support, Munro Centre, Guy’s Hospital, 66 Snowsfields, London SE1 3SS. The centre offers training and consultation in the Family Partnership Model (formerly the Parent Adviser Model). The model and associated training aim to help practitioners understand what it really means to work in partnership with families and to develop the skills of working collaboratively with them. www.cpcs.org.uk 3. Child Bereavement Trust, Aston House, West Wycombe, High Wycombe, Buckinghamshire HP14 3AG. www.childbereavement.org.uk 4. Down Syndrome Association, Langdon Down Centre, 2a Langdon Park, Teddington TW11 9PS. www.downs-syndrome.org.uk 5. National Autistic Society, 393 City Road, London EC1V 1NG. www.nas.org.uk 6. National Children’s Bureau, 8 Wakley Street, London EC1V 7QE. www.ncb.org.uk 7. Scope, 6 Market Road, London N7 9PW. A charity which has a course and information on supporting communication through Alternative and Augmentative Communication. This is designed for people whose communication through speech is difficult, or slow to develop. These systems supplement or support the spoken element in communication. There are different vocabularies and languages to choose from, so the individual can use the most appropriate system. 'Supporting Communication through AAC' is available to download from www.scope.org.uk Early Support 2006 27

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