Introduction to the Think Family Approach

The Think Family multiagency guidance has been written for professionals working with parents whose complex needs impact on their ability to care for the children around them. For example parents and carers who have mental health issues; disabilities; have drug and alcohol problems; effected by domestic abuse and/or have involvement with the Criminal Justice System. In many of the cases in which there are concerns about a child's welfare, parents will be facing at least one these issues.

Cleaver and Walker (2004) found that domestic abuse, substance misuse, mental health problems and/or learning difficulties was present in three-quarters of the 866 initial assessments they audited in 24 local authorities in England. In many of the assessments, several of these complex needs/issues were identified making it clear that they do not occur in isolation and identifying a complex interaction between them. Further to this, an Ofsted (2010) report ‘Learning lessons from Serious Case Reviews’ noted that the most common issues (relating to the children’s families) were domestic violence, mental ill-health and drug and alcohol misuse. It is important to note however that other triggers such as pregnancy, separation, divorce, bereavement, imprisonment, discharge from prison, return from active military service and financial difficulties may also cause emotional distress and are associated with increased risks to the whole family.

This guidance seeks to embed good practice so that the child’s needs are not overlooked by adults’ services where the focus may be on the adult in front of them and likewise for children’s services to not overlook the adults’ needs. It will seek to ensure services adopt our principles of good practice which include a Think Family approach where it recognises that excellent children’s services and excellent adults’ services are not enough in isolation. Supporting, safeguarding and promoting the welfare of children, and in particular protecting them from significant harm, is dependent upon effective joint working.

‘It is our expectation that services work in accordance with the high level partnership arrangements described in this document as a minimum.’

Parenting at any stage can be a challenge and requires a great deal of physical and emotional effort. Most parents and carers have the capability to provide ‘good’ or ‘good enough’ parenting for their children. They are able to access universal services to support their health, education and leisure needs however sometimes, a usually capable parent will have such overwhelming needs of their own that they may need more intensive support to assist them in their parenting role. Children’s health and development, and sometimes their safety, may be affected by the difficulties their parents are experiencing which may adversely affect their capacity to respond to the needs of their children and/or vulnerable adults in the family. If this is short term, then providing the children’s and adults physical and safety needs are met, most have the resilience to overcome the stress of this with the support of their friends and family.

Parents with complex needs may have experienced trauma or adverse childhood experiences themselves where they internalise their negative beliefs into adult lived experiences. They may well feel overwhelmed and therefore face enormous daily challenges. It is important not to judge or stigmatise the choices made by parents, but recognise that choices often come from negative beliefs about who they are and their own ability to parent. It is important to remember that parents are the experts on their own life experiences and what they need from services.

Throughout this guidance child refers to anyone who has not reached their eighteenth birthday, including unborn children. Parent refers to parents/ carers, relationships with extended family members, friends or acquaintances who have access to the child (enough to cause harm to the child).

 

Consultation with parents

This consultation was supported by parents that work with Bristol Drugs Project

What parents want less of:

  • Actions that make the parent feel isolated, such as when children need to be spoken to sometimes no explanation is given as to the reason why;
  • More drug tests to evidence abstinence so they can prove they are doing well;
  • Stigma and judgement. It is difficult asking for help;
  • Not knowing about things that may happen. Professionals to explain what is happening and when;
  • Not having enough support.

What Parents want more of:

  • More updates from Social Care. Sometimes there was no communication even when they arranged to do so;
  • More detailed communication. When their children have statutory involvement with safeguarding services the process is not explained properly and it leads them to feel more isolated. They feel social care have a responsibility to help keep them engaged;
  • More understanding and support provided through difficult times with a non stigmatising approach;
  • Compassion. It is difficult asking for help;
  • More training needed when managing cases involving domestic violence where the victim is kept separate from the perpetrator;
  • Openness when talking about interventions and their children. This brings more honesty from parents.

 

The principles of good practice

Our multi agency approach in Bristol will be guided by the following principles:

1/ Think Family, Parent and Child

Inappropriate tasks and responsibilities undertaken by a child or young person which adversely impact their emotional, physical, educational or social development should be prevented by providing adequate and appropriate support to the parent(s) and their family.

This means thinking about the child, the parent and the family, with adult and children's services working together to consider the needs of the individual in the context of their relationships and their environment whilst also recognising diversity and personal preferences. This will avoid services having to respond to each problem, or person, separately.

The aim of Think Family as summarised in the original messages from Think Family: Improving the life chances of families at risk (2008) are as follows:

  • There should be no ‘wrong door’ to services. Any contact a family member has with a service is an opportunity to guide them into other services that they need. To transform life chances and break the cycle of disadvantage, services must go further;
  • Practitioners should actively think of the needs of the family as well as, and in relation to, the needs of the service user;
  • The focus should be on families’ strengths and should aim to develop the family’s capacity to look after their own needs;
  • Support given to families should be relative to their need; the greater the need, the greater the support.

Work with the wider family should always be viewed in relation to ‘how will these actions improve outcomes for the child’. This will be achieved by building on strengths as well as identifying difficulties using the Signs of Safety model as well as hearing the child’s voice and that of their parent and carer. Children’s needs are usually best met by supporting their parents to look after them. Participation of parents and carers ensures that they are able to contribute to assessments and plans in relation to them and their families, and can identify and build on strengths and skills to make lasting changes. Services must provide a non-stigmatising service that encourages social inclusion for all users 

2/ Getting the Right Help at the Right Time for the Right Duration

Professionals must focus on intervening at the earliest opportunity. Preventative and early help responses are critical to avoid issues from escalating and families experiencing further harm. Support needs should be addressed by enabling parents to access universal and community services wherever possible, as appropriate. The services provided at this level will provide the consistency needed by the child and family. Additional support needs should be met by using this support to prevent the child and family needing to access higher tier services. This could be through a single or multi agency response with timely provision.

When there is an escalating need(s) a multiagency approach is required. Targeted support, specialist assessment and service provision will be used to identify what is in the best interests of both parents/carers and children. Regular monitoring and reviews of interventions and support to families to ensure a co-ordinated approach to long term multi-disciplinary work will ensure that child(ren) are protected and parents are supported to parent effectively.

Statutory involvement is required when the child(ren) require intensive support and protection as a result of their parents complex needs. To ensure children’s safety and welfare, many of these families will require support from both children’s and adults’ services. These children will require protection under s.17 and s.47 Children Act 1989. This is the threshold for child in need, child protection, and looked after children. At this level of need, social workers, in partnership with families and other agencies, will assess what services, from which agencies, are called for. A collaborative approach would ensure that parents are recognised as having needs in their own right, but the impact of those needs on their children becomes part of a multi-agency response. For further guidance read Bristol’s Multi-Agency Threshold Guidance. This provides a framework for all who work with children and families to provide early help and targeted and specialist support for children, young people, their families and carers.

3/Culture of Responsibility, Challenge and Escalation

Each individual is accountable and responsible for the child and adult. If a need is identified that can be met then the requirement to take action with the confidence to intervene and challenge positively when appropriate must be taken. Embedding appropriate challenge within an organisation is pivotal to ensuring good working practice and positive outcomes for children and their families. Please refer to the KCS Escalation Procedure for children and KAS Escalation Procedure for adults.

Systems should be in place to ensure that:

  • managers working with adults can monitor those cases which involve dependent children;
  • there is regular, formal and recorded consideration of such cases with Children’s Services (social care) staff;
  • if adult and children’s services are providing services to a family, staff communicate and agree interventions;
  • appropriate staff are invited to relevant planning meetings;
  • staff participate in the relevant planning meetings.