Manchester City Council

Manchester City Council

Building a Resilient Community using an ACEs Lens

Briefly describe the initiative/ project/service; please include your aims and objectives

Manchester City Council invested in a place-based, Adverse Childhood Experience (ACE) pilot August 2018 to July 2019. The pilot tested whether a trauma-informed workforce in a community (Harpurhey) could allow for a deeper engagement with its citizens. Furthermore, whether an understanding of the root cause of behaviour (rather than “treating” presenting behaviours) could enable public and voluntary sector staff to work in a more strengths-based, relationship focused way and ultimately improve outcomes for individuals, families and the community.

All professionals who provide an operational, frontline service in Harpurhey were offered training and development in ACE awareness and trauma informed practice. Staff from Adult Social Care, Children’s Services, Early Help, Education, GM Police, Health, Housing, Neighbourhoods, VCSE and Youth Justice took part. Content included what ACEs are, their impact on life chances, types of stress, protective factors that mitigate ACEs/ build resilience and how to adopt a trauma informed approach. Focus groups with staff post-training explored how learning was being used and whether any further support was required. This was the UK’s first place-based piloting of trauma-informed practice.

What are the key achievements?

Tangible differences can be demonstrated:A primary school has chosen to stay with children in crisis, focus on repair and consider how to make things better – fixed term exclusions have reduced by 33% and serious behavioural incidents by 30 %. Parents from a family support charity Big Manchester who attended a recovery programme reported a 27.4% improvement in their resilience and 87.1% increase in self esteem. A trauma informed intervention programme at Manchester Youth Zone increased young people’s confidence, ambition, social and emotional skills by an average of 24%. A Children’s Social Services team conducted trauma informed assessments prior to visits resulting in over 90% of cases reaching their desired outcome earlier than other teams..

Two case studies illustrate cost savings:A primary school preventing a pupil from going to a PRU and removing social worker support has saved £33k; Caseworkers at a housing association facilitated the de-hoarding of the property, preventing a tenant’s eviction and saving £50.5k.
Using a Greater Manchester cost benefit analysis tool the total savings on the public purse during the pilot are £595,000. This equates to a saving of £2.50 for every £1 spent.

What are the key learning points?

The main learning is that ‘every interaction is an intervention’ and however small a difference can be made. Workers are thinking differently, partnership working has improved, so too staff morale. The willingness of staff and organisations to try a different, innovative approach has shown that all practitioners can support individuals and families to build resilience, use protective factors to buffer the impact of trauma, and prevent ACEs in future generations.

Each organisation is different so the generic training offer has to be followed-up with scenario-based, solution-focused techniques and strategies.
This work can be replicated and sustained across the City. We have a network of train the trainers who can deliver at scale, emerging good practice that we can share and delivery programmes to cascade e.g. an Adult Recovery toolkit. An agreed partnership funding model will support this. The pilot identified gaps to address in wider roll out:A need to grow the movement from grassroots with residents and community leaders/influencers. The training should have a more practical, solution focused element. Advocate for more structured ‘clinical’ staff supervision – this was mentioned several times in staff groups.

Additional Comments

Quotes:

Parents: ‘Helped to understand how to manage/ control my anger’ ‘I’m starting to open up with my children and understanding their emotions more’ ‘I’m positive and hopeful for the future in implementing what I’ve learnt’

Practitioners: ‘In my 35 years of working in education; learning about ACEs and the resulting impact on health outcomes has had the most profound impact of any training on my practice. It has enabled me to communicate and quantify the reasons behind the generational cycle of adversity’ – Safeguarding Lead, 11-16 Academy

‘Staff now understand the complex emotions that our tenants are dealing with ….we are able to source the right support to enable these tenants to maintain their homes to a satisfactory standard’ – Head of Neighbourhood Services, Housing Association

‘The analogy of ‘if a flower isn’t growing, don’t change the flower you change the environment’ is being trauma informed’ Health Improvement Practitioner

A short video has been produced to showcase the work in Harpurhey https://youtu.be/Ec7pO-s2HEE