Team Around the Child: Multi-agency service coordination for children with complex needs and their families (2001). Free PDF of the whole book

This is the original TAC manual by Peter Limbrick

 

Introduction

This manual describes an approach for providing services to children with complex needs and their families by means of an individualised professional team, called here the Team around the Child (TAC). The focus in this manual is on babies and children in the period between birth and their first school years but the model is applicable in the years after that.

The manual is intended for managers and practitioners in the statutory services, workers in parent organisations and the voluntary sector and individual parents (and other family members) who want to respond to the call for co-ordinated or joined-up services for children with disabilities and special needs and who are looking for practical ways to do it.

The Team around the Child is an approach to multi-agency service co-ordination at the level of the actual service to the child and family. In this model the handful of professionals who already work closely and regularly with the child and family, offering practical input in education, treatment and therapy, agree to meet together regularly to share observations, to agree a joined-up service plan and to review progress. The essence of the TAC is that professionals from the different agencies and the child’s parent(s) come together on equal terms at regular family-friendly meetings to discuss the child’s and family’s needs in detail and to agree a co-ordinated approach. 

The model incorporates a Team Leader for each TAC who takes on the role of keyworker/co-ordinator and provides him or her with a context of multi-agency co-ordination in which to operate. The model recognises and builds on examples of good practice that already occur spontaneously in many localities in response to a particular family’s needs and the interests and motivation of particular professionals around the child. This manual suggests how local services can develop such good practice into an effective system that is available to all families in their locality who need it.

Many local services wishing to offer families a more co-ordinated service think first of the keyworker model. These two approaches, Team around the Child and keyworking are complementary; the Team Leader has a defined keyworker/co-ordinator role and has a ready-made multi-agency context in which to work. In the author’s experience it is unrealistic to expect family keyworkers to co-ordinate the professionals involved with the family unless there is a commitment to multi-agency working from the local agencies and some agreed processes already in place to facilitate it.

The word ‘co-ordination’ is often used to include the process of integration. In this manual the two processes are separated in the interests of clarity. However the Team around the Child model is designed to promote and facilitate integration of goals and programmes as well as co-ordination of services. 

There is very great need for reform of services to children with complex needs (who can also be defined as children who require a complex service) so that they are co-ordinated for the family and not by the family. The general picture in the UK is that when there is some degree of service co-ordination for a child it is because the family have used their own time, energy, and money to achieve it themselves.

The TAC is offered as a first approach for service providers (from statutory, voluntary and private sectors) who wish to remedy this situation and assume the responsibility for joining services together for these children and their families. It is a low-cost model but does require commitment from senior managers, effective planning at all levels in the various agencies and some resources. Disjointed and fragmented services are wasteful of valuable time and energy for individual professionals and the agencies in which they work. In this sense service co-ordination includes an element of service rationalisation and will bring with it the reassurance that wastage and duplication is being minimised. However, if the TAC model were to be adopted as a way of reducing expenditure on this client group we would be doing a very great disservice to children and families whose needs have never been matched by adequate government spending at either local or national levels. While working to provide, with limited funds, the best service we can, we should also look forward to the day when adequate funds are made available for children with disabilities.

Each of the statutory services; health, education and social services, vary greatly across the UK in how they operate. Where they do attempt to collaborate on some sort of joined-up service they will differ in the place from which they start, the journey they will make and the end result they will achieve. The model offered here for the Team around the Child is an outline only and as such is intended to provide a basic plan that can be interpreted to meet the needs of each different locality. Further, the Team around the Child cannot be the complete answer to multi-agency co-ordination for any locality. Where it is adopted it is likely to be just one element in a mosaic of approaches to service co-ordination.     

The Team around the Child model is based on the following assumptions –

• the number of children who have complex disabilities is increasing
• these children and their families require access to all the professionals, expertise and skills found in the traditional multi-disciplinary team
• there are direct benefits to children and families when the many and various parts of services are as joined-up as possible
• there are direct benefits to professionals and their agencies when the many and various parts of services are as joined-up as possible
• this joining-up requires a change in the systems in which professionals work rather than a change in which professionals are involved

The Team around the Child is not the invention of the author though he has collaborated in, and worked to initiate, individualised teams for children with complex needs in school and pre-school settings during the last 25 years as teacher and, during the 1990s, as a family keyworker for the registered charity One Hundred Hours. This independent organisation operated in West Yorkshire where there was, by and large, no multi-agency service co-ordination for children with disabilities. In these difficult circumstances an obvious first step for keyworkers was to try to get the various professionals together in a co-ordinated approach to each individual family. One exception to this was in Castleford in 1995 where the author was invited to join an existing group of multi-agency professionals who met regularly at ‘Support Meetings’ to review and plan services for baby Jade who was born in the previous year with complex needs. This group, co-ordinated by the Paediatric Occupational Therapist from Pontefract General Infirmary (now Pinderfields and Pontefract Health Trust) met every four months or so at the family home and included physiotherapist, speech therapist, Portage worker, member of the Community Team for Learning Disabilities, health visitor and, of course, Jade’s mother.      

In recent years the author has worked to develop the Team around the Child model in consultation with many health, education and social services, parent groups and voluntary agencies in the UK who are working towards multi-agency service co-ordination for this client group. This development of the model has included discussion with many Child Development Centres as they have explored how to translate the CDC multi-disciplinary model into effective teamwork for their children and families. In this consultancy role the author first encountered the expression ‘Team around the Child’ at Eastbourne and County Healthcare NHS Trust’s Family Intensive Support Service (FISS). This multi-agency project supports families with children with learning disabilities and additional challenging behaviour and centres on the assembly of the Team around the Child which is led by the keyworker in consultation with the family to oversee and co-ordinate all work.

The manual is divided into four sections. The first describes the Team around the Child model in detail and explains why some families need this sort of approach. The second details the benefits the model brings to children, their families and their professionals in relation to principles of an effective service. The third outlines how to build the model into an agreed system for a locality. The final section puts the model into the wider context of multi-agency service co-ordination and relates the TAC to the role of the keyworker and the role of the Child Development Centre.

 

Please note: The Team Around the Child (TAC) model is available for anyone to use in any country 

Free PDF of the whole book: https://tacinterconnections.com/images/TACBook2001.pdf