We spoke to Joe Garraway, Strengthening Families’ Strategic Manager, about the Strengthening Families model and its approach to preventing recurrent care proceedings.
In April 2012 Strengthening Families (SF) was set up by Salford City Council as a direct response to the growing number of women repeatedly losing their children to the care system. Historically, the North-West has had the highest number of recurrent care families in England and, in Salford, data collected between 2005 and 2012 told the council that:
- 65% of all looked after children were from mothers who had had more than one child taken into care
- there was an average of 17 months between the first time mothers appeared in court with an infant, and the second time she appeared with another infant
- the hardest to reach families were resistant to accessing support or advice, safeguarding concerns therefore had the potential to be left unresolved following the removal of a child
- no support was offered to families prior to 20 weeks’ gestation
- parents were not accessing health services consistently.
SF’s primary goals were to increase the number of parents and babies able to stay together after the removal of a previous child and reduce the number of recurrent care proceedings. However, in achieving its goals its work is more far reaching; focusing on the long term health and wellbeing of parents and babies, improving child development outcomes through early attachment and bonding, and working with parents towards school readiness for children. Key to this work is the intensive, long-term, nature of the programme. As well as antenatal support, SF provides support for the first five years of a child's life.
During the data collection there was also a realisation that some improvements would be required to the local system to make these goals possible, such as; improving links between social care and health care and the integration of local support services into a single pathway to ensure timely and appropriate referrals. This is key, as since the programme has started, families have expressed the importance of a swift, relevant and supportive response when they experience problems.
Eligibility and referrals
SF is available to pregnant women/families who are pre 20 weeks’ gestation, are at risk of their unborn child being removed from their care, and have had previous children removed. Also, parents who have already had children removed and remain currently non-pregnant are able to access the programme - thus helping to reduce future care proceedings if they have another child.
Referrals are submitted to the SF team directly from the local Multi-Agency Safeguarding Hub (MASH). This is a professional referral, usually from a midwife where, in their professional judgement, there are concerns for the welfare of a child. Agencies outside of the child social care environment, such as the police and GPs, can also refer into SF.
SF has developed three pathways which seek to encompass the parents and children the programme has aimed to target for holistic support. The pathways are designed to help parents and children at different stages of their lives after care proceedings. After initial contact and face-to-face meetings with parents, needs assessments, and liaising with social services and/or midwives, parents are then entered into one of the three pathways.
Pathway A - is a post-proceedings early intervention and prevention pathway which supports parents during the weeks and months after their child has been taken into care. Support is available for a maximum of two years - which is in line with evidence indicating that parents are most at risk of recurrent care proceedings if their next child is born within 18 months of the first removal. SF supports parents as they come to terms with the ruling and begin to address some of their choices and behaviours that might have contributed to the judgement and helps to better prepare people for parenthood in the future. The pathway also provides appropriate support to manage contact with children previously taken into care.
Pathway B - is a pre-birth pregnancy support pathway. Expectant mothers who have had a child removed, or whose partner has had a child removed, are referred to SF as early as possible in their pregnancy, as this is a unique period during which parents are highly motivated to change. Intensive work is done with both parents to support them to grow their parenting skills, helping them learn how to provide a safe and loving environment for their baby. The SF team also works alongside children’s social workers to prepare for the assessments parents who have had a child removed must complete, to demonstrate that their baby will be safe and cared for. Support transitions to Pathway C when parents are able to take their baby home safely.
Pathway C - is a post-birth family support pathway which supports parents until their child begins school. The SF team works alongside social workers, early years providers and healthcare professionals to continue to support parents to develop their parenting skills as their child grows and their needs change over time. Practical support is also given to help with housing, debt management, benefits advice, support into work etc. Over a maximum of five years the support parents receive reduces, moving from intensive to on-going until eventually parents graduate SF when their child begins school. The SF team uses school readiness indicators to evaluate the impact of SF for children of graduating families.
Practitioner support and partnership working
A team composed of a Practitioner, Lead Practitioner, a Midwife and Team Manager, all work towards supporting individuals within the SF programme. The roles these practitioners carry out are critical to providing the support and healing needed to break intergenerational cycles of harm and trauma. Practitioners and Lead Practitioners provide intensive caring support to families, building strong bonds with individuals and often becoming parents' first port of call when issues arise. Midwives provide important medical care to mothers, act as conduits between health care and social care and assist with parent education and child bonding. Team Managers’ roles are important for supporting and motivating the team in often difficult and emotionally challenging circumstances and they build and develop partnerships to support the programme. Joe stressed to us the importance of a core set of values and beliefs within the SF model. In conjunction with high levels of knowledge, skill and experience, members of the SF team have at their core the mindset that everyone is capable of positive change and no parent sets out to be a bad parent. They have ingrained values which means they engage with parents in a non-judgemental, honest, fair and attentive manner. The levels of dedication and commitment needed by all members of the SF team is critical to such intensive and potentially life altering work.
As well as providing direct intensive support to parents, the SF team works in partnership with a wide range of service providers to access and coordinate the specialist help that vulnerable families need. For example, housing, work and benefits agencies; statutory children’s services, individual social workers, local health and mental health care providers, early years providers, education services, the police - and counselling and specialist recovery services for drug and alcohol addiction, are all key.
Changing lives and the landscape
To the SF programme’s great credit there are a myriad of good news stories from parents who have gone through the programme and SF has been hailed within the local and national press. Many participants speak of the programme as giving them the confidence and support to change their lives. A participant of the SF programme told how she had already had five children removed following a mental breakdown and a spiral into drink, crime and drugs, when she found herself pregnant again. Without SF she would have just handed her child over, because it is “what she expected”. But the programme showed her a different way. She knows now that she is a good mum, because she cares about her child. Another parent, who had previously had ten children removed by the courts, has been able to keep her subsequent two children in her care and is now in employment. Furthermore, additional siblings have been born to parents supported by SF to keep a child. Many have been able to remain with their families without further assessment.
SF has also had an impact on the landscape of recurrent care proceedings and social care practice. Joe tells us they have seen a shift in pre-birth social work and midwifery practice in the area, with a Strengthening Families Handbook being produced for local authorities. Salford’s Strengthening Families, has been codified and their evaluation headline summary showed that the service directly contributed to the avoidance of 118 children becoming looked after, creating cost avoidance of £3.8 million.
Strengthening Families’ funding is secured through the local authority and moving forwards Joe said that the ambition is to work with all ten Greater Manchester local authorities to change the landscape of recurrent care proceedings. Part of this work includes creating a blueprint of the SF model, at a wider Greater Manchester level and could mean more effective coordination of support which maximises the chances of improving these families’ lives. It could also improve the consistency of families’ experiences, creating fairer access to services.
For more information about this project, please contact Joe Garraway at firstname.lastname@example.org
This case-study was compiled by Jason Watt in 2021