Stage 1 – agreeing what needs to change:
A referral is received from the housing provider. A CHIP worker then arranges an initial meeting to include the referrer and all relevant family members. The purpose of the meeting is to discuss areas of concern and the changes desired by each party. An action plan is then devised in conjunction with the Outcome Star, which will follow the family through the course of their engagement.
Stage 2 – discussing and practising the change
Intensive work then begins with the family/individual, which consists of one-to-one sessions, home visits, attending meetings and assisting with practical tasks alongside providing emotional support and guidance. This regular contact provides an opportunity to organically review progress, keeping track of changes and areas that are still problematic. In most cases the worker will also call formalised review meetings to celebrate change and suggest new approaches where there has been limited success. Action plans are reviewed every 4-8 weeks so that all parties can monitor, amend and add targets.
Stage 3 – acknowledging and sustaining changes
Upon entering the final stage of intervention (maintenance and closure), all parties are once again called together to review the action plan, focusing on the positive changes have been achieved and encouraging the family/individual to continue to sustain the changes going forward. A closure meeting is then held and a decision is made between all parties as to whether to extend support, refer into another service or hand back to the referrer. It is essential to understand that given the complex nature of CHIP cases, it is likely that further support will be required post intervention.
Theory of change explained
Agreeing what needs to change
A referral is received from Colne Housing or Colchester Borough Homes who provide an outline of the presenting difficulties and desired outcomes. A multi-agency meeting is then arranged by the CHIP worker to include the service user and all relevant agencies involved. All parties are encouraged to share their views in relation to the service user’s circumstances along with details of current and past support. This along with the service user’s own perspective begins to form a working action plan.
Planning meetings are intended to bring to light the areas of difficulty, but equally to celebrate and praise strengths. This is important, as equipped with a better understanding of functioning aids the CHIP worker in assisting the family/individual to build on their strengths and acknowledge things that are not working so well. Encouraging self-awareness also helps to transfer some of the positive coping skills into the more problematic areas.
Discussing and practising the change
Four to eight weeks after the initial meeting, and every four to eight weeks thereafter, a multi-agency review meeting is held. This provides a formal setting to monitor the original agreement and set new targets, which is carried out in conjunction with the Outcome Star. Meetings are designed to focus on the positive changes made by the service user, as well as to ensure that all professionals are adhering to their specific areas of responsibility. CHIP workers will also use these meetings as a forum to tactfully challenge any unmet targets and encourage a group discussion on how to overcome the issue.
Reviewing change is not limited to such a formalised setting, as throughout the course of engagement the CHIP worker will utilise their frequent meetings and activities with the service user, by consistently encouraging dialog about making and sustaining changes.
CHIP workers promote positive change by providing intensive and reliable support in the identified areas of need. Intervention can include:
- one-to-one sessions,
- home visits,
- facilitating social activities,
- informal mediation (familial and neighbourhood),
- emotional support,
- practical support with physical tasks,
- negotiating payment plans, and
- referring into specialist agencies.
Acknowledging and sustaining change
Support typically lasts for one year, however there are instances whereby all parties agree that an extension would be beneficial or instances where such intensive support is not required.
Having worked with the family/individual for the agreed period, a closure meeting is then arranged. This meeting will look back at the positive changes made over the course of the intervention and seek to offer solutions and strategies going forward post intervention. The original referrer is made aware that support is nearing an end and will be part of making the decision to refer on for further support or close the case.
Post support, service users are either sent out feedback forms or visited by a member of the team who will find out more about their experience of the service. Service users may still contact their support worker in the event that they need advice and are encouraged to do so rather than spiralling in to chaos.