Agreeing a clear referral and selection process for the new intervention
Partnership, coproduction and vision
Consistency in selecting a caseload
Coordination for clients and services
Flexible responses from services
Service improvement and workforce development
Measurement of success
Sustainability and systems change
A successful MEAM Approach area will:
Consider and agree the focus, drawing on the research described in the previous element. A small number of the right people is better than a bigger group. A small caseload will allow partnerships to test opportunities for flexible responses and changes in the system. Local areas can then explore ways to broaden the impact to a wider group.
Develop and agree a methodology to identify individuals facing multiple disadvantage in the local area. Identification tools like the NDT Assessment can be a useful starting point, but further consideration should be made to reflect equality and diversity issues. Consistency does not mean rigidity. Partnerships should be able to make an informed judgement regarding the most vulnerable people based on the evidence available.
Develop a process for seeking referrals and agreeing a caseload. Referrals should come from all types of services, as well as individuals themselves. This could include hospitals, police, night shelters, outreach, soup kitchens, family members and CRC/probation workers, for example. A multi-agency group should agree the caseload. This creates buy-in and ensures a coordinated intervention for the “area as a whole” rather than an intervention that is seen as a “new service”. Referral processes should focus on individuals’ strengths, hopes and aspirations as well as their problems.
Be clear that all referrals must come with an offerfrom the referring agency to play their part in the solution – don’t allow ‘dumping’ of individuals. An individual on the MEAM caseload should remain on the caseload of all other services involved, however a coordinated approach will now be adopted.
Recognise that tackling multiple disadvantage is about intensive, sustained support to a small group of people and the caseload should reflect that. It is recommended not to go above one worker per ten clients (many report that 1:8 is better) and individuals should be kept on the caseload for as long as is needed (for some individuals this may be a number of years). Individuals should remain on the caseload not only when they are at crisis point, but also when their situation stabilises and they move away from the need for such regular support. At this point the partnership should explore how to help people develop and maintain a fulfilled life. Individuals’ journeys are often not linear and they may need different levels of support at different points in time.