The Singapore Experience in the Implementation of FAST in Family Service Centres(FSCs)Harnessing our collective wisdom, building a community for continual professional learning

Shawn Koh, RSW, M.B.A.Paulus Sutjipto, M.S.W.

☼ Where is Singapore?

☼ The Evolving Social Service Landscape in Singapore

☼ What is a Family Service Centre?

☼ TCOM and the FSC Capability Development Plan

☼ FAST and the FSC Integrated Practice Model

2

Where is Singapore?

3

Where is Singapore?

Area: 719 Km2

Population: 5.5 million

Languages: English, Malay Mandarin, Tamil

4

The Evolving Social Service Landscape in Singapore

5

The Singapore Social Service SectorThrough the years

1958

Formation of Singapore Council of Social Service

In the early years, there was very little money and few voluntary organisations engaged in social service.

1960 – 1970

Formative years of the voluntary effort

In some ways, it was still very much a Victorian concept of charity. People of leisure came together to set up voluntary welfare organisations (VWOs) and devoted their time in helping out.

1983

Launch of ComChest

To raise funds from the community for the nation’s many charities to help the community in need.

1970 – 1990

Growth of Social Services

Ground-up organisations and services for elderly, persons with disabilities, families, youths were gradually formed.

1990s – 2012

Masterplan for Elderly and Persons with Disabilities

Co-developed by the representatives from the Public, People and Private sectors.

1991

Service Blue Print for the Next Lap

First gathering of policymakers, professionals and academics to develop blueprint towards holistic service delivery for people in need.

1992

Restructuring of Singapore Council of Social Service to become the National Council of Social Service

2005

Launch of ComCare Fund

Today

• More than 400 VWOs

• 10,000 staff & many more volunteers

• 400,000 service users annually

• S$0.8b annually in annual expenditure

☼ Economic volatility, higher cost of living, changing socio-demographic profiles, social mobility, increasing public expectations, rising divorce rates.

☼ The need to rethink policies and redesign delivery of social services.

☼ Key is in the implementation of our policies.

“It's not easy for citizens to cope with these rapid changes, even when overall standards

of living are rising and the country is making progress, as has been the case with

Singapore. It goes beyond specific items, where you can calculate dollars and cents, to

a sense of reassurance and concern and empathy.”

– PM Lee, 9 May 2011

Rapid Changing Times

2012: Formation of MSF Ministries restructured to form MSF, MCCY & MCI wef. 1 Nov 2012. MSF to build strong family ties, develop social services, look after those in need of social support.

2013: MSF Reorganisation

Transfer of 2 Functions to MSF to strengthen nexus between service implementation and policy development i.e. the Social Assistance (SA) function and the service development and implementation functions of MSF-funded programmes and staff from NCSS.

Setting up 2 new divisions to focus on citizen-centric and coordinated service delivery. Social Service Office Division (SSOD) oversees service delivery and operations of SSOs. Service Development and Management Division (SDMD) oversees development and management of VWO-run social services; responsible for regulation of residential homes and sector administration role of social service charities.

Responding to Change

balance

inforce

design

The need to transform…

9

1

2

3

Rebalancing ResponsibilityTowards Greater Government and Community Involvement

1

The Search for a New Balance

☼ Review Assistance for Lower Income Groups

Enhanced long term assistance

☼ Enhance Support for Person With Disability (PWDs)

Employment & Employability

Transport for PWDs

☼ Support for Vulnerable Elderly

Ramping up of Senior Activity Centres (SACs)

☼ At-Risk Youth and Children Requiring Protection

Setting up of Child Protection Specialist Centres for children with moderate risks

2 ReinforcingSector CapabilityTowards Stronger Manpower, Technology, Productivity

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• Talent Management of Social Service Professionals

• Reposition Social Service Institute (SSI)

• National Social Work Competency Framework i.e. package common fundamental competencies and specialised skill sets for social workers across sub-sectors and organisations

Manpower

• Development of Voluntary Welfare Organisations (VWOs) e.g. VWO-Charities Capabilities Fund (VCF): Organisational DevtGrant and Augmented Innovation and Productivity Grant

• National Council of Social Service (NCSS) to provide membership advisory services to help VWOs to scale up effectively.

Organisational

Reinforcing Manpower & OrganisationalCapabilities

14

3 RedesigningService DeliveryTowards Better Accessibility, Quality, Coordination and Integration

15

Enhancing Service Planning, Development & Delivery – Social Service Office (SSO)

17

Gov

ern

ment

Age

nciesMore

information on help available

360 Degree View of Client

Data collected once, used many times

Provide Information Once

Information Anytime, Anywhere

Improved data sharing for planning

Timely access to more accurate data

Timely Service Planning

Receive holistic help

Serv

ice P

roviders

Bene

ficiaries

Integrated Client – Client Centric Delivery Whole-of-Government Approach

Linking Up Social Services for More Integrated Delivery

What is a Family Service Centre?

43 FSCs in Singapore, run by Voluntary Welfare Organizations (VWOs)

Supported by MSF, NCSS Community Chest and/or Singapore Totalisator Board

Overview of Family Service Centres

Community-based social work agencies that enhance individual/

family’s ability to cope with their personal, social

and emotional challenges.

Collaborate with key stakeholders

to help families obtain

needed resources

Long term goal is for families served to achieve independence, resilience

and stability

Key Social Services / Programs in the CommunityFSC remains a community-based and family-focused Social Work (SW) agency, a key node of social support.

Note: The above list of programmes is not exhaustive

Ke

y N

od

es

Re

sid

enti

al

Co

mm

un

ity-

bas

ed

Persons with Disability

ElderlyChildren & Family

Family Service Centres

Crisis Shelters

Sheltered Homes

Childcare/Student Care

Homes / Hostels for

Disabled

Early Intervention& Dev Support

Programmes

Befriending

Seniors ActivityCentres and

Cluster Support

Specialist Programmes

E.g. Gambling Addiction

Management

E.g. Family Violence

E.g. Gero-Counselling

E.g. CommunityMediation

E.g. Welfare/Destitute

Homes

Children’sHomes

Day Activity Centres

Senior Group Homes

Targeted Group

Pro

gram

me

typ

e

Training &Employment

Outreach & Supportfor Youth

Social Work Services within FSCs

Casework

Social Work Practitioner works directly with individuals and/or families around their

different needs

Groupwork

FSC Social Work Practitioner uses group setting to bring about changes in individuals

and/or families.

Community Work

FSC Social Work Practitioner uses community setting to

work with individuals and/or families to:

a) Enhance the individual and family social network support,

b) Allow communities to assist individuals and families.

Present State of FSC Sub-Sector

☼ 25, 830 total number of cases managed by FSCs in FY12

☼ Financial, Marital, Parenting/Child Management, Housing/Shelter and Family Conflict top 5 presenting issues

☼ Women forms 2/3 of client population

☼ 70% live in 4-room flat or smaller

☼ 59% with <$1,999 household income

☼ 59% with GCE ‘O’ level education or lower

☼ 59% are 45 year-old or younger

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Service Delivery

Stay relevant to changing needs

Build competency and specialised

skills

Attention to program quality and delivery of

effective services

Enhance collaboration with other

stakeholders

• Implement Code of Social Work Practice

• Raise practice standards and professionalism

• Foster professional development i.e. Master Social Worker Scheme

• Develop competency framework and training roadmap, e.g. essential training modules, Practice Certificate in Case Management

• HR initiatives e.g. Thriving at Work and Corporate Development Funding

Enhancing capability

• Partner sector committees e.g. Committee for Practice Standards

• Dedicated resources to enable collaborative outreach

• Facilitate FSC-SSO collaboration e.g. pilot referral and workflow processes

Establishing strong network of

community & social support

• Review FSC service model for continued relevance

• Enable synergy amongst key initiatives to support multi-stress families

• Expand capacity and increase accessibility of services

Responding to community needs

Reinforcing Sub-Sector CapabilityFamily Service Centres (FSCs)

TCOM and the FSC Professional Development Journey

Characteristics of Modern Practice in Singapore

☼ Many different professionals and agencies are involved in the livesof the clients / families we serve.

☼ Each professional has a different perspective and, therefore,different agendas, goals, and objectives.

☼ Even clients have a different perspective on what they need helpwith!

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Restoring Trust — The Essential Outcome of Conflict Management and Strong Partnerships

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“If you give me a fish you have fed me for a day. If you

teach me to fish then you have fed me until the river is

contaminated or the shoreline seized for development.

But if you teach me to organize then whatever the

challenge I can join together with my peers and we will

fashion our own solution.”

Ricardo Levins Morales

Artist/Activist

The Philosophy: Transformational Collaborative Outcomes Management (TCOM)

• Focused on the business of supporting personal change.Transformational

• All system partners are working together towards a shared vision of helping.Collaborative

• The measures are relevant to decisions about approach or proposed impact of interventions.Outcomes

• Information is used in all aspects from individual family planning to supervision to program and system operations.

Management

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Family & Youth Program System

Decision SupportCase Planning

Effective practices

EligibilityStep-down

Closure

Resource ManagementRight-sizing

Outcome Monitoring

Service Transitions & Celebrations

EvaluationProvider Profiles

Performance/ Contracting

Quality Improvement

Case ManagementSupervision

AccreditationProgram Redesign

Service ModelDesign

FSC TCOM Grid of Tactics

Managing Transformation

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Embarking on the Transformation Journey

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This is not going to be easy!

We need to create and communicate a

shared vision that is about wellbeing of our clients and families.

This shared vision has to involve the participation of all

key partners in order to restore trust.

We need to use that information to make good decisions about having an impact (rather than spending time and space with

clients)..

This information must be used simultaneously at all levels of the system to ensure that we are all

working towards the same goals.

Code of Social Work Practice

☼To articulate the role of FSCs in the social service landscape

☼To provide quality services to clients through clarity of the scope of FSC integrated social work practice and its component activities and the development of required competencies

☼To provide understanding for stakeholders on the scope of FSCs’ work and strengthen partnerships in serving individuals, families and communities.

Overview of the CSWP

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Individuals without SW qualifications, & SW designation

Introduction Frameworks CSWP in FSCs Practice Domains

CSWP

Integrated CSWP Framework

Continuum of Practice

Methods of Practice

Mission and Role of FSCs

Social Work Role of FSCs

Risk and Complexity Classification

Levels of Intervention Classification

Functions of CSWP

To be applied by 3 Groups of Social Work Practitioners:

Individuals with SW qualifications, &

SW designation

Individuals with SW qualifications, but non-SW designation

Will be operationalised in CSWP Practice Guide

Working in an Ethical Manner

Working in an Organisational Setting

Working with Reflective Practice

Working with Individuals, Families and Communities in a Professional

Manner

Introducing FAST into CSWP Framework

☼ The Family and Adult Support Tool (FAST) is the family version of the Children & Adolescents Needs & Strengths (CANS), which is currently used by the Ministry’s statutory services to share information about key needs of the child(ren) to different providers/agencies involved in a case

☼ The current version of FAST was developed with inputs from

☺ FSCs

☺ Master Social Workers

☺ MSF FAST Workgroup

How FAST Fits within CSWP?

☼ Aligned with the Bio-Psycho-Social-Spiritual (BPSS) Assessment

☼ Serves as an output of the BPSS assessment in CSWP Assessment Framework

☼ Describes the “what” (not the “why”) issues and concerns presented in the family

☼ Allows prioritisation to be conducted for intervention

☼ Facilitates CSWP Risk and Complexity Classification

Localisation of FAST

Date Key Achievement/ Decision

Aug 2013 1st draft of the Singapore version – customization for use in the National Council of Social Service (NCSS) pilot programme

Jan 2014 2nd draft - customization for use in the “Strengthening Families Together” pilot programme to include additional items and a Systemic barriers

May - June 2014

3rd draft - complete revamp of the FAST tool based on feedback from Master Social Workers, FSC reps & SDMD.

FAST tool renamed as Family and Adult Support Tool to reflect major revisions to include both family (FAST) and adult (ANSA) items.

Risk and Complexity Classification

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R I S K R I S K

COMPLEXITy

Group 3Low Risk and High Complexity of NeedThere are many aspects to the case either within one aspect or across aspects (instrumental, social, personal) which are acute and/or chronic but there are no or low risk to individual’s safety.

Case assessment and intervention plans to be endorsed by Supervisor

Group 2Low Risk and Low Complexity of Need There are no or low risk to individual’s safety and the case is restricted to specific areas or exhibit low chronic or acute states.

Case assessment and intervention plans to be endorsed by Supervisor

Group 4 High Risk and Low Complexity of NeedThere are medium to high risk to individual’s safety however the case is restricted to specific areas or exhibit low chronic or acute complexity issues.

Case assessment and intervention plans to be endorsed by Executive Director/ Centre Head

Group 4High Risk and High Complexity of Need There are many aspects to the case either within one aspect or across aspects (instrumental, social, personal) which are acute and/or chronic and there are medium to high risk to individual’s safety.

Case assessment and intervention plans to be endorsed by Executive Director/ Centre Head

LOW

LOW

HIGH

HIGH

Developing the CSWP FAST Algorithm (n=919)

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Not Group 1

Not Group 4

Not Group 3 Group 2

Profile of Cases in FSCs (n=919)(Nov 2014 to Jul 2015)

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FSC Total Group 1 Group 2 Group 3 Group 4

Blue Sky FSC 399 0 239

(59.90%)

144

(36.09%)

16

(4.01%)

Green Grass

FSC

201 0 136

(67.66%)

58

(28.86%)

7

(3.48%)

Clear Water

FSC

140 0 94

(67.14%)

36

(25.72%)

10

(7.14%)

Tall Trees FSC 179 0 103

(57.54%)

63

(35.20%)

13

(7.26%)

Total 919 0 572

(62.24%)

301

(32.75%)

46

(5.01%)

Systems : Review of Resourcing

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Classification of clients based on

CSWP groups

No. of Group 2Cases

No. of Group 3Cases

No. of Group 4Cases

Costing for different CSWP

groups

CollaborativeOutcomes

45

46

Early Intervention/Preventive

Secondary Intervention

Tertiary Intervention

Scope of Social Work Practice

Normal Functioning Emerging Risk Escalating Risks

Higher Risks / Chronic / Acute

Concerns

StateIntervention

Group 1 Group 3 Group 4

Specialist

FSC (CSWP)

Community WorkGroup Work

Case Work

Group 2

CDCs, GROs

Family violence, Child protection, Mental health

Low risk, Low complexity

Low risk, High complexity

High risk, High or low complexity

Statutory

SSOs

Continuum of Social Work Practice

The FSC’s scope of Social Work practice will focus on individuals and families with emerging risk up to those with higher/acute risks.

PrimaryIntervention

Secondary Intervention Tertiary Intervention

Scope of Social Work Practice in FSC

Normal Functioning

Emerging Risks Escalating Risks Higher Risks

Group 3 Group 4Group 2Group 1

Outcome Indicators

1) % of Clients are successfully linked to appropriate agencies

(a) % of Clients are

successfully linked to

appropriate external agencies

(b) % of Clients

successfully linked to suitable

intervention within own

FSC

2) % of Clients who achieved at least 50% of goals at

case closure

3) % of Clients whose self-reliance

and resilience capacity are

enhanced at case closure

4) % of Clients who showed

ability to meet needs and/or

manage risks at case closure

5) % of Clients who indicated

satisfaction on the Client Feedback

Form

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% of Clients who showed ability to meet needs and/or manage risks at case closure

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The initial Family and Adult Support Tool (FAST)

assessment and the re-assessment done at case

review stage, just prior to case closure

The highest FAST assessment and the re-assessment done at case review stage, just prior to

case closure

A consistent FAST rating throughout the lifespan of the

case.

To be counted as a reduction, the client’s grouping has to be reduced by at least one group (eg. Group 4 to Group 3, Group

3 to Group 2, or Group 3 to Group 1).

To be counted as manage, the client’s grouping must be consistently at Group 2

The total number of cases where clients show a reduction or managed needs and risks based on a comparison between:

3

2

4

3

2

4

2

2 2

Reduction

Managed

Examples of meeting needs and/or managing risks:

What does not constitute as meeting needs and/or managing risks:

If CSWP grouping at case closure is higher than case open, with no reduction

(eg: Group 2 – 3 – 3 – 4)

If case remains as Group 3 or 4

throughout

(eg: Group 3 – 3 – 3 or 4 – 4 – 4 – 4)

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3 3 3

2

4

3 3

FAST and the FSC Integrated Practice

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Code of Social Work Practice

+Practice Guide

LOGICALLY SEQUENCED

THEORETICALLY INFORMED

AND DIRECTED

PURPOSIVE PRACTICE

INTEGRATED PRACTICE

Casework

Knowledge

Values/EthicsSkills

Reflective practice/Supervision

Working in organisational

setting

Knowledge

Values/EthicsSkills

Reflective practice/Supervision

Community work

Knowledge

Values/EthicsSkills

Reflective practice/Supervision

Working with systems

Knowledge

Values/EthicsSkills

Reflective practice/Supervision

Group work

Knowledge

Values/EthicsSkills

Reflective practice/Supervision

Stage 1

Intake

Enquiry (I&R) Form

Intake Assessment Form

Stage 2

Assessment

Assessment Form

Stage 3

Case Planning & Management of Case

Plan

Case Plan & Case Management Plan

Form

Case Intervention Form

Stage 4

Review of Case Plan

Case Review Form

Case Assessment Form

Case Intervention Form

Stage 5

Monitoring & Closure

Case Closure Approval Form

Stages of Casework Practice

Meeting Minutes (for sessions beyond 20 minutes) Contact Log (for sessions less than 20 minutes) To open intervention (after Case Planning), use Case Intervention Form To close all intervention before case closure

Integration of FAST into Professional Casework Practice in FSCs

Social

Environment

Family

Individual

Assessment

Family and Adult Support Tool (FAST)

Individual Functioning

Safety Concerns

Family Functioning

Risk Behaviours Parent/CaregiverStatus

Family Strengths

FAST as the Output of Assessment

Family Functioning

Indicators

Family Conflict Family Communication Family Role Appropriateness Financial Resources Social Resources Housing Stability Supply of Nutrition Family’s Involvement in Criminal and Protective

Systems Family’s Interaction with Systems

PendingEnquiry

Treatment Target

Effect / Background Need

Prioritisation

Outcome Concepts

Outcome Concepts

Causal Concept

Causal Concept

Causal Concept

Causal Concept

Causal Concept

FAST Prioritisation Process

PendingEnquiry

Treatment Target

Effect / Background Need

Prioritisation

Outcome Concepts

Outcome Concepts

Causal Concept

Causal Concept

Causal Concept

Causal Concept

Causal Concept

Case Planning Prioritisation:

a) Priority one – you cannot define what you have not assessed

b) Priority two – select causal concepts based on: i. Addressing immediate risk or

safety concerns

ii. Causal concepts which yield the greatest multiplier effect

FAST as the Input into Case Planning

Forward Plans on FSC Capability Development

Future of Integrated Practice in FSCs

Casework Group work

Comm. work

Group work

Comm. work Casework

Coordination Collaboration

On-boarding Programme

FY15 onwards

Intermediate Training

FY17 onwards

Advanced Training

FY19 onwards

Comm. work

Casework

Group work

Discrete

Current State

Casework Group work

Comm. work

Integration

Future State

Where do we go from here?

Casework

Group Work

Community Work

CaseworkGroupWork

CommunityWork

CaseworkGroupWork

CommunityWork

FOUNDATIONAL

INTERMEDIATE

ADVANCED

FSC On-boarding Training

Supervision

Training

Coaching

How it all works together

Supervision

Training

Coaching

Casework

Group

Work

Community

WorkSupervision

Training

CoachingSupervision

Training

Coaching

Multi-Method Social Work Practice

It’s not just about training and equipping…

Casework

Foundational

Intermediate

Advanced

Professional Practice

Casework

Foundational

Intermediate

Advanced

Professional Practice

Supervision

MSW DeploymentPractice

Circles

Sector Engagements &

Cluster Implementation

Workgroups

It’s about the practice ecosystem

External Clinical Consultants

FSC Clients

“It is not the critic who counts; not the man who points out how the strong man

stumbles, or where the doer of deeds could have done them better. The credit

belongs to the man who is actually in the arena, whose face is marred by dust and

sweat and blood; who strives valiantly; who errs, who comes short again and

again, because there is no effort without error and shortcoming; but who does

actually strive to do the deeds; who knows great enthusiasms, the great devotions;

who spends himself in a worthy cause; who at the best knows in the end the

triumph of high achievement, and who at the worst, if he fails, at least fails

while daring greatly, so that his place shall never be with those cold and timid

souls who neither know victory nor defeat.”

Theodore Roosevelt

Thank you

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