“I’m treated as an individual, not a problem:” The “No Wrong Door” policy

The “No Wrong Door” (NWD) programme means exactly that – there is no wrong door to turn to for young people seeking support.

NWD works on several core principles, which include working with young people’s birth family or guardians, allowing care leavers to “stay close” to continue accessing support, and working closely with young people to identify ways to help their self-esteem and give them opportunities. NWD has been introduced in several areas of the UK.

England

The term “No Wrong Door” was coined in North Yorkshire, where two hubs were created in Scarborough and Harrogate. The North Yorkshire County Council website provides details on the work their teams do.  

Each hub has a dedicated team which includes a life coach, a speech therapist, two community foster families and community supported lodging places for 16- and 17-year-olds with trained staff. On top of this, every young person in the NWD programme has their own key worker who is supported by another team. Many young people struggle when they are moved around as they grow up; new teams or workers don’t know their history or personality well. Having one consistent key worker for each young person makes it easier to build trust and create a more positive relationship.

Wales

A report from the Children’s Commissioner for Wales has described the steps taken by the Welsh Government to implement a ‘no wrong door’ approach to supporting children and young people. Funding has been earmarked specifically for children with complex needs, and all regions of Wales now have specific multi-agency groups for young people.

Regions like Cardiff and Vale have been implementing some of the common core principles of NWD, such as continuity of staff, key workers and streamlined appointments, in addition to a “proactive not reactive early intervention response.”

Scotland and Northern Ireland

NWD was introduced in Scotland by the Children and Young People’s Mental Health and Wellbeing Board (CYPMHW). In addition to building the original programme, it gave young people the opportunity to identify wellbeing priorities. These included having a job, a safe and warm place to live, food and clothes, good relationships, safety, feeling happy and confident, good health and opportunities to learn.  

There seems to be less evidence of NWD being implemented in Northern Ireland, although it has been proposed as a way to support children of parents with mental illness.

Impact

There has been a great amount of evidence that NWD is effective in helping young people. The Department for Education (DfE) published a report in 2017 which looked at the initial success of the “No Wrong Door Innovation Programme.” They found that for young people who were supported under NWD, there had been a decrease in arrests and incidents of them going missing, which indicates that giving young people more stable support systems leads to an overall higher level of happiness.

The report also found that under NWD, 25% of those who were not previously in education, employment or training went on to become engaged in education, training or work. 87% of young people who were using substances when they entered the NWD programme had also stopped when they were interviewed as a follow-up.

What can be improved?

There are a number of aspects under NWD that can be improved. A lack of long-term funding has meant that staff were not given the security of knowing if their contract was being extended. This meant many workers found permanent jobs elsewhere to ensure their own job security, and those who stayed were anxious about their future which impacted them negatively. It also had a negative effect on the young people under NWD if staff leaving was not handled appropriately.

On top of this, some young people had mixed feelings around their transition out of the support network. While many felt they were being supported efficiently, others described the transition as “abrupt” and “too fast.” This is definitely something that can be improved on with more training for staff and more structure in place for those who need more time when moving forward into the next stage of life.

Final thoughts

While NWD is by no means perfect, it has significantly given young people support during the most transitional period of their life, from adolescence to adulthood. Having key workers develop consistent relationships has allowed them to more strongly advocate for young people as they see them as more than just a case number. As stated by one young person in one of the studies, with NWD, “I’m treated as an individual, not a problem.”

As the programme evolves and more structure is put into place, there is hope that many more young people can be encouraged and given the platform to achieve their full potential.

Photo by Priscilla Du Preez on Unsplash.

Further reading: more from The Knowledge Exchange Blog on children and young people

From failure to improvement: how public services can turn themselves around

Abhacken

A new report on the instructive role of failure has been published this summer by the Institute for Government.

Failing Well describes the experiences of four previously failing public services organisations which managed to turn their services around.

Introducing the report, the authors highlight what failure means for public services.

“Failure matters because failure happens. The constellation of organisations that constitute public services in the UK is inherently complex and therefore at permanent risk of failure. This risk, while longstanding, is particularly acute at present. Service providers remain under pressure to cut costs and reconfigure the way services are delivered.”

In addition, structural changes to the ways services are being delivered – a push towards more decentralised and autonomous models of public services – can heighten the risk of failure.

And the authors note that the impacts of failure in the context of public services can be serious:

  • unacceptable standards of service provision
  • harm to service users
  • disruption to service provision
  • discontinuation of the service entirely

Doncaster Council

Four case studies in the report illustrate the different ways in which identified failings in a public sector organisation can lead to changes for the better.

In 2010, a corporate governance inspection by the Audit Commission reported that Doncaster Metropolitan Borough Council:

“does not do enough to meet the needs of its most vulnerable people, does not safeguard children, and has not been good at helping vulnerable people find a home.”

In short, the commission described Doncaster Council as “a well-known failure”.

In the light of this damning assessment, the Communities Secretary appointed a new chief executive and a team of commissioners to oversee a turnaround at the council. As Failing Well’s authors note, the move by central government to impose its will on local government in direct opposition to democratically elected councillors was an extraordinary step. One of the lessons from Doncaster’s case is that earlier forms of support may prevent such interventions before a public service reaches the point of serious failure.

The report goes on to describe the improvement plan for Doncaster Council agreed by the new commissioners, covering areas such as corporate issues, health and caring. At the same time, the commissioners sought to repair breakdowns in personal relationships at the council that were partly responsible for the problems in running the organisation. By 2014, confidence in the governance of Doncaster Council was restored, and the commissioners were withdrawn ahead of schedule.

West Sussex Children’s Services

Another case study in Failing Well describes the traumatic impact a poor Ofsted assessment had on West Sussex County Council’s Children’s Services, particularly concerning recruitment and retention. But the labelling of failure also proved to be pivotal in bringing problems into the open and stimulating action.  Children’s Services presented its own improvement plan, with progress measured by the council’s Improvement Board. Subsequent Ofsted assessments demonstrated that the journey from failure to improvement was under way.

Lessons from failure

The case studies from Doncaster and West Sussex, along with those from a school and an NHS foundation trust, highlight the different pressures faced by a range of public service organisations. But the authors found some common lessons emerging from these different stories:

  • Peer-to-peer support provides opportunities for earlier intervention – but it needs a trigger.
  • Interventions may not need to remain in place until the turnaround is complete.
  • Insularity is often a characteristic of failing organisations.
  • Responses to failure can be over-reliant on structural reforms.
  • Creating an open, no-blame culture helps to protect against future risk of failure.
  • There is scope for more sector-wide learning from failure.
  • Failure can appear to get worse before it gets better.
  • Turnarounds should set the foundation for long-term improvement, as well as dealing with immediate problems.

The authors warn against an over-reliance on blame, suggesting that this can forestall attempts to understand why failure arose. And they conclude that cultural reform is key to responding to failure:

“In all of the case studies, turnarounds were to some extent predicated on the adoption of new cultures and ways of working…Open, blame-free cultures, where staff are actively encouraged to flag risks or concerns about standards of provision, allow organisations to prevent further failure and encourage reflection when failure does occur.”


Previous blog posts on the the subject of public sector services include: