Final Report: Thematic Review of No Wrong Door – Redcar and Cleveland

Executive Summary
The No Wrong Door (NWD) model is a residential and outreach service for young people who are on the edge of care or in care.

Pressures on funding and resources on local authorities and the care system can lead young people to feel as though they are being ‘bounced between services and residential or foster placements.’ The NWD model offers a hub at the heart of the model, within the local authority, opposed to moving young people out of area.

The NWD service, developed by North Yorkshire Council, and adopted by Redcar and Cleveland, offers a new approach for local provisions for young people, including those within the local authority of Redcar and Cleveland. The service offers a multidisciplinary team of professionals who work collaboratively.

To carry out an immersive evaluation of the Redcar and Cleveland NWD provision a mixed method approach was undertaken by the current research team, with the following five objectives:

1.Conduct a quantitative analysis of existing data collected by the service linked to three key areas; speech and language, policing and health.
2.Conduct a thematic review of case studies.
3.Work and spend time within the hub to get to know staff and how the service operates (researcher in residence).
4.Design longer term process and outcome evaluation for years two and three.
5.Conduct a focus group with staff who deliver NWD services within, and alongside the hub.

A focus group was conducted with six members of the NWD professional team working at the Redcar and Cleveland NWD hub. Furthermore, four case studies were analysed, written by four NWD professionals, with differing specialisms. Additionally, quantitative data obtained from the NWD Redcar and Cleveland Model were analysed. Eight themes were identified within the thematic review of the qualitative data obtained, in both the focus group and case study findings.

•Inter-Professional Collaboration
•Education
•Family
•Finance
•No Wrong Door Interventions
•Outreach
•Residential Care
•Vulnerable Groups

The NWD staff discussed the specific strengths of the current NWD model on offer in Redcar and Cleveland. Staff spoke of the importance of collaborative working and trust between NWD specialists, young people and their families. For instance, staff placed an emphasis on building personable and meaningful working relationships with young people. There was a perception that NWD staff work in a collaborative manner, to assist young people with their multiple needs – for instance- educational needs, communication needs, psychological welfare needs and familial relationships.

This report accounts for the period from October 2020 to mid-2023 within the evaluation. Within such a time,103 participants engaged with the NWD service in Redcar & Cleveland. Within the period evaluated, police engagement, outreach and residential elements of the NWD model compiled several considerations within the report.

Data indicates that engagement with NWD may have an impact on engagement with the criminal justice system. Prior to engagement with NWD, 21 young people who would go on to be supported by NWD were arrested, and seven were charged. In contrast after the establishment of NWD, 29 young people who were actively engaged with NWD were arrested, with 14 being charged. However, when looking at the period after engagement with NWD, 14 former young people were arrested, with 5 being charged. Whilst it may be viewed as a negative that numbers of NWD actively engaged young people were arrested and charged this would be an incorrect view. Due to the embedded nature of the Police post (the Police Intelligence Analyst) there are opportunities for greater information gathering and identification of issues and concerns with the young people and more scope to develop trust with the families of the engaged young people. Therefore, the likelihood of any issues of concern being identified may increase identification of issues which are subsequently reported to the police amongst this population in the short to medium term.

We noted a similar trend when looking at missing person incidents. When looking at all participants prior to engagement there were 55 young people who had a missing incident, totalling 280 missing incident (5.1 incidents per young person), with a median missing time period of 4 hours 17 minutes. This cost approximately £562,928. When looking at young people whilst engaged with NWD there were 49 young people who had a missing incident, totalling 422 missing incident (8.6 incidents per young person), with a median missing time period of 6 hours 59 minutes. This cost approximately £971,232. However, when looking at data once young people had been discharged from NWD 14 young people had a missing incident, totalling 75 missing incidents (5.4 incidents per young person), with a median missing time of 4 hours 56 minutes. This cost approximately £157,040. To contextualise such quantitative data is imperative, as the NWD specialists work with young people with very complex socio-economic positionings. Thus, there is an anticipated level of missing episodes which will have an impact on costs. The NWD team work to reduce police time by responding to the missing episodes professionally, and actively search for all their young people who go missing (see section 3.1.1).

Of the 103 outreach young people who engaged with NWD during the lifetime of the evaluation, 86 completed the SALT screening tool, 43 of whom also completed a SALT assessment and screening tool, with 37 of them going on to complete a communication plan. The communication support worker delivered an average of 17 working instances with young people per month across the evaluation period. Total savings associated with having an embedded communication support worker within this service are estimated at £87,078. Similarly, the life coach embedded within the service delivered an average of 14.7 working instances with young people per month. Total savings associated with having an embedded life coach within the hub are estimated at £115,279 across the evaluation period of 22 months.

In total, using data provided by the hub it is estimated that engagement with the NWD has resulted in a total cost avoidance of £459,379 for the three young people who were residential to the Hub and is the cumulative cost of partners.

Following the completion of the evaluation the following recommendations were made:

1.The inter-professional collaboration and multi-agency approach in Redcar and Cleveland NWD was a particular strength of the service. It is recommended that the nurturing and growth of in-house specialists continues in the NWD project, including the roles of the Speech and Language Therapist, police liaison officer, Police Intelligence Analyst and clinical psychologist. This recommendation is related to the data provided by NWD staff who state this element is quintessential within the NWD model; assisting young people in avoiding large waiting lists and avoiding the perception of a non-personal clinical approach. In terms of financial savings in the short, medium and long term this approach has already shown itself to be effective in reducing costs by the disengagement of young people from Criminal Peer Group (CPG). Financial savings in the medium and long term will occur through the in-house identification of young people with previously unidentified SALT needs to enable their support needs which will reduce future costs.

2.The use of non-terminology driven and accessible language within written documents about and addressed to young people was perceived to be employed in a successful manner; - an aspect that would benefit from being included as standard protocol for all internal and external staff documenting information about (and addressed to) the child. Partners may wish to reflect on this in their own organisations.

3.The practice of the NWD model to support young people until the age of 25 was identified as a strength of the NWD service and has been identified as supporting financial savings in the short, medium and long term.

4.The SALT assessment procures should remain in-house within NWD as they represent an immediate cost saving and being conducted ‘'in-house' reduces the delay of transmission of information between professionals. In-house working also allows for the rapid development of supporting strategies to assist in working with the young person on a) communication issues b) issues appropriate to life coach intervention.

5.Future evaluations would benefit from the inclusion of a robust cost-benefit analysis to more accurately predict the cost savings of the NWD in Redcar and Cleveland.

6.Future evaluations should include the views of young people who have been involved with NWD both on an outreach, and a residential basis.