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Family safeguarding

We recognise that in order to support families to make changes that are helpful and long lasting, we need to work with all the members of the family. If we understand and recognise that the needs and desired outcomes of each person in the family affect each other, we are more likely to support and enable sustainable change.

The Family Approach Protocol and Toolkit was commissioned by the 4 Safeguarding Children Partnerships and 4 Safeguarding Adult Boards (4LSABs) in Hampshire, Isle of Wight, Portsmouth and Southampton. The protocol was commissioned in response to findings from a range of reviews  across all Partnership’s which highlight the need for professionals to work effectively together to achieve better outcomes for adults, children and their families across all areas.

As part of the Family Approach Toolkit we have put together some practical tips on having honest conversations, working with families and suggested conversation starters.

 

Professionals are required to have honest conversations with children, adults and their families, on a regular basis. It can sometimes be difficult to navigate these conversations and find the right words and approach to convey what you need to say in a way that will be understood, and accepted by those receiving the message.

Here are some tips to enable professionals to have honest, and at times difficult conversations, and being clear and easy to understand. These should be useful at times when you are having to share difficult news, or information that is likely to be disputed or not accepted.

  1. Prepare – clearly, this only works when you know that the difficult conversation is coming and you are the one who will be facilitating it, but really this can be in regards to any interaction. Take some time to think things through—what are the main points you really want to make? If time permits, write down those ideas, keeping them basic. If you know the person isn’t going to agree with you, also prepare some examples and factual information to support what you are stating. Be prepared for push-back and disagreement and know that it is okay to acknowledge the difference of opinions.
  2. Practice – again this one requires a little bit of prep time. Practice on your own or with another colleague. This will help to make sure that you do get the main points across that you plan to make. In the moment, if it is tense, it’s natural for our communication to speed up or for the words we want not to come, but if you’ve thought through what you want to say (and you take some deep breaths to calm yourself), you are more likely to remain a clear communicator.
  3. During the conversation – share what you need to and then listen, and be empathetic. Be open to the other person’s view and interpretation of the situation. Remember that perception is a good portion of reality—and so you and whomever you are having the difficult conversation with may have very different perceptions (and realities). You can both learn from one another if you take the time to listen. We are more likely to reach a place of agreement if we approach the conversation with empathy, acknowledging the feelings that someone else has, and allowing those to be expressed without judgment. Remember – listening empathetically doesn’t equate agreement.
  4. Allow silence – we are so used to filling every moment with something that often silence makes us uncomfortable. But when having difficult conversations which may cause all kinds of emotions, allowing silence is sometimes key. You can use that time to refocus and centre yourself—breathe and allow that time for processing and keeping yourself calm. Try counting in your head to three, while noticing your breath before responding–especially if you aren’t sure what to say or aren’t sure if you should or shouldn’t be giving a response.
  5. Decide on clear next steps – almost always with difficult conversations, there is a “now what?” that needs to be answered. Sometimes that is as simple as “let’s both take some time to think through what we each shared and come back in x amount of time to decide next steps”. Other times, more specific next steps are warranted (especially if you are delivering bad news). It can be helpful to end a difficult conversation focusing on the future and giving the person you are talking with as clear of a picture as possible about what happens next.

There is increased awareness of the impact that the problems and difficulties experienced by adult family members can have on the development and psycho-social adaptation of children. There is also national recognition that emotional abuse and in particular neglect of children is significantly under-recognised and addressed.

Parents, carers or expectant parents may have difficulties which impact on their ability to meet the needs of their children or expected child and / or adults at risk. These children may be in need of assessment for services provided by a range of agencies from universal and early intervention to acute or specialist.

These questions are designed to guide your decision making when establishing the needs of the adults, children and /or unborn child.

  • Are you treating, providing a service to a parent / carer, family member with a mental illness, a drug and alcohol misuse problem, a learning disability or adults who are victims or perpetrators of domestic violence?
  • Does the person have the mental capacity to make a decision about their care and support of a child or about their own needs of care and support?
  • Do they have children?
  • Do they have childcare responsibilities or caring responsibilities for adults with care and support needs?
  • What are their ages?
  • Is there a young or adult carer within the family?
  • Does the parent / carer / partner or other adult have very unrealistic expectations of a child e.g. expecting the child to take the emotional place of a grandparent who has recently died? Or expecting children to look after younger siblings?
  • Have you considered the impact of your patient or client’s illness / disability / situation on their ability to meet the development and safety needs of their children and / or unborn child / adult at risk? (For unborn/newborn babies please refer to the HIPS Unborn Baby Safeguarding Protocol)
  • Have you considered the impact of family functioning, family history, the wider family and environmental factors on the parents’ / carers’ capacity to respond to the development and safety needs of the child / unborn child / adult at risk?
  • If your client is pregnant has she accessed ante-natal care? Has her partner accessed any help or advice?
  • Do you think the family / expectant parents would benefit from any additional services?
  • Do you know what other services are involved and what their role is?
  • Have you discussed the need for additional services or making a referral to another service, with the parents, carer, expectant parents or other significant adults in the home?
  • Do you have any concerns about the wellbeing or safety of the child / unborn child’s / adult at risk?
  • Is action required to safeguard and promote the welfare of the child / unborn child / adult at risk?
  • Should a ‘lead professional’ be identified for the family to coordinate the delivery of services to the child and family? This may help ensure that services delivered to them are integrated, coherent and achieving intended outcomes. The identified professional would:
    • act as a single point of contact for the family
    • coordinate the delivery of the actions agreed
    • reduce overlap and inconsistency in the services received

A lead professional is accountable to their home agency for their delivery of the lead professional functions. They are not responsible or accountable for the actions of other practitioners or services.

  • Do you need to discuss this or make a referral to another service?
  • Are you maintaining an open stance of professional curiosity to recognise the signs of vulnerabilities and potential or actual risks of harm?
  • Is your assessment of the child / adult / family regularly reviewed and updated particularly at times of known changes in circumstances?

Prompts for joint working between the children and adult workforce:

  1. Record names, dates of birth, GP and school / early years setting of the children as well as who has parental responsibility and anyone who is a regular carer e.g. step-parent, grandparent. Any private fostering arrangements should be referred to the Local Authority via the relevant Local Authority website.
  2. Consider the vulnerability of any adults in the family and home environment. What impact might this have upon their parenting capacity? If there are any unmet care needs make any referrals where appropriate. Remember that children should never be considered as a protective factor for an adult.
  3. Consider the vulnerability of all children in the family (especially those under 5 years and those with disabilities).
  4. Are you maintaining an open stance of professional curiosity to recognise the signs of vulnerabilities and potential or actual risks of harm?
  5. Ensure there is a safety / crisis plan which identifies someone the child / adult at risk can appropriately call for help.
  6. Practitioners should be aware of the need for respectful challenge of the parents / carers / other adults and not accepting facts on face value. (Please see the ‘Tips for Having Honest Conversations’)
  7. Consider parental disengagement / non-engagement / disguised compliance and hostility as potentially increased risk factors for the child.
  8. Ensure the family make up and history is revisited at regular intervals and there is robust record keeping on this. Practitioners’ should not assume that a parent / carer has no contact with their child purely on the basis that the child lives separately with an estranged partner. In such situations, practitioners’ need to enquire about contact (supervised or unsupervised). Practitioners should also be aware that serious incidents may have occurred when children in care have been rehabilitated back into the family or there has been a change in the [male or female] partner and services were not aware of the changes. If there are no identified concerns regarding parents / carers / other adults record this and continue to monitor.
  9. Get consent to share information at as early a stage as possible so that you can engage with other agencies as needed to support the family.
  10. Children’s professionals should attend adult services meetings as requested, and vice versa. This is important to ensure that all relevant information about a family is shared and that a collaborative ‘family plan’ can be developed.
  11. Children’s workers must inform adult services of significant changes that will affect the parent / carer or alter the needs of the child, for example if a child is returning home following a period of being in care.
  12. Similarly, adult’s workers must inform the child’s Social Worker / lead professional of any significant deterioration in the parent / carer’s mental health, changes in treatment or treatment adherence, or if new information comes to light which has relevance to the adults overall progress and parenting capacity e.g. a return to substance misuse. This includes admission to hospital so that immediate care can be considered.
  13. When planning and providing services and support to parents / carers, consider their childcare responsibilities and provide, or help them to access, suitable childcare provision to enable them to attend appointments, services and group treatments. Try to provide appointments at useful times, such as within school hours.

Professionals are required to have honest conversations with families’ about how their needs and decisions can impact on the children living within the family unit.  It can be difficult to know how best to approach these conversations and find the right words to convey what you need to say in a way that will be understood, and accepted by those receiving the message. Here are some suggested ‘conversation starters’ and tips for talking to families about whether a parent’s learning disability, mental health or substance misuse is having an impact on their parenting capacity.

  • Choose a time and place where you can talk alone. Share your thoughts in person; this is not a conversation to have on the phone.
  • Make sure both you and the parents have enough time to talk. This should not be done in a hurry
  • Be prepared for strong emotions. Parents often sense there may be a problem but have been afraid to talk about it. Often they may not know how to put their concerns into words.
  • Be caring, supportive, and respectful. Some parents may be relieved to talk with you, but others may be defensive or scared. Showing warmth and respect will help parents trust and listen to you.
  • Share your own observations and concerns. Do this only after the parents have had a chance to talk.
  • Choose your words carefully. Give specific examples and describe what you have seen.
  • Avoid using labels or technical terms. Remember you are not trying to present yourself as an expert.

Using the following questions

  1. What’s happening now? What has been happening? Practitioners should use detailed questioning to draw out what life is like at home for the child and their relationship with their main caregiver. The ‘day in the life’ exercises are useful in exploring in detail the level of parental care across the child’s daily life.
  2. What are you thinking and feeling? Practitioners need to ask detailed questions to explore how parents and children think and feel about the level of care provided. It is important to establish whether the parent understands the concerns and the level / type of feeling expressed would give further indication of understanding and motivation to change. Children need to be give space to talk about their current concerns and feelings about them.
  3. Who is affected and how? Practitioners should use detailed questions which draw out how a child is affected by the level of parental care. The impact of each area of parental care should be considered against each area of the child’s health and development should be considered. Practitioners should talk to the child / young person’s to gain an understanding of how they are being affected.
  4. What needs to happen to make things better? Practitioner should spend time exploring with parents / care givers and children what needs to happen to make things better. They should be a focus on parents and care givers thinking about the changes they need to make and how they will do this. Practitioners need to explore with parents and care givers additional support required to make things better for the child.

Top Tips

“I can’t seem to get the family to understand what I am concerned about?” Try the following:

  • Be clear – use language that can be understood not just verbally but in plans and assessments too.
  • Think of creative ways to discuss the issues you are concerned about.
  • Produce individual cards with a concern written on each one. Ask the family to prioritise them. Leave them with the family to think about.
  • Ask the family why they think you are visiting and use their response as a springboard to talk about issues.
  • If you have been involved with the family for a long time and you feel that when you talk about issues you are no longer making an impact try and visit with a colleague to produce a new way of talking about the same things.
  • Be mindful of level of cognitive ability of the family and adjust your language accordingly (particularly relevant with families with significant learning disabilities).

“I want to gain the child / young person’s views but am not sure what questions to ask them“. Children when asked what they consider to be good practice, valued professionals who:

  • Listen carefully, without trivialising or being dismissive of the issues raised.
  • Are available and accessible with regular and predictable contact.
  • Are non-judgemental and non-directive, explaining choices and suggesting options.
  • Had a sense of humour
  • Are straight talking with realism and reliability, and didn’t offer false promises.
  • Can be trusted, maintain confidentiality and consult with children before taking matters forward.

Try asking the child / young person the following:

  • Tell me what a normal school day is like for you, from when you first get up on a morning, to when you go back to bed at night?
  • How do you know when it is time to get up on a morning? (this will establish whether they have an alarm clock or someone calls them up, or they are left to their own devices)
  • Who is in the house with you, when you get up on a morning?
  • Where are they? (this will hopefully establish whether or not responsible / supervising adults are up out of bed to help the child get ready)
  • What is the very first thing you do when you get out of bed? Then what do you do? And then? Etc.
  • Do you have any breakfast before you go to school? What do you have? Who makes this?
  • How do you get to school? Does anyone go with you? Do you have to take anyone else in your family to school? (i.e. younger siblings)
  • What happens at home time? Who is in the house when you get home from school? What are they normally doing?
  • What happens at tea-time? Where do you eat? What do you eat? What is your favourite tea-time meal?
  • Tell me what you do from tea-time to bed time?
  • How do you know when it is time to go to bed? Tell me what happens at bed time?
  • So when it’s not a school day, tell me what happens then from you getting up on a morning, to going to bed at night?
  • Younger children can be asked to make drawings of some of the above (e.g. draw their favourite meal) or use play people to demonstrate where people are and who does what.

“The family had shown that they do know and understand what good parenting is… but they don’t do it consistently”. Try the following:

  • It is common for parents who have received support and services such as parenting skills programmes to have knowledge of what good parenting is. Often parents can talk about what they should be doing with their children and a lot of the time they demonstrate an ability to provide good enough care, however they are not always able to do this consistently.
  • Consider involving individuals who can act as role models to parents preferably in the home. There may be resources within the extended family for this or services that provide this support. The aim of this exercise would be to spend significant periods of time in the home assisting and guiding parenting. It might mean helping a young mother or father to safely bath a baby. Or, helping a family to understand the necessity for good hygiene in the kitchen.
  • Keep the needs of the children in focus. Talk to the children and find out what their experiences are.
  • When you know that parents can care adequately some of the time it becomes harder to remain objective and there could be a tendency to err on the side of optimism. Record carefully when the dips in parenting occur and compile chronologies of accidents and issues around poor supervision.
  • Bear in mind that there has been a tendency to use a different criteria to the neglect of disabled children. The criteria should be the same. Disabled children are 3 to 4 times more likely to be abused than non-disabled children.
  • Understand whether this is a motivation or capacity issue.

Family Safeguarding is based on the principle of safeguarding being a shared and equal responsibility between adults and children’s services.

This is a whole family approach focusing on improving outcomes and reducing harm to children, by working with the adults in the family. This way of working supports the adults to address their difficulties and will support children to live safely at home with their families. It will prevent more children and young people coming into local authority care. By addressing the difficulties that adults can experience, it will enable them to develop a better understanding of their children’s needs and to focus on developing their skills as a parent.

The Family Safeguarding Service includes specialist adult workers bringing expertise on adult issues, such as substance misuse, domestic abuse, mental health needs and social isolation. Motivational Interviewing is the unifying practice model. This focuses on strengths based approach, building relationships and working with resistance & behaviour change

These adult worker are co-located within the Children’s Locality Social Work Teams. These workers practice alongside children’s social workers, contributing to existing Child in Need and Child Protection processes.

The Family Safeguarding Service provides:

  • Specialist advice, including Team around the Worker guidance
  • Specialist assessments and planning with families
  • Direct work on a 1:1 or group work basis with adults who care for children
  • Up2U: Family Practice
  • Access to specialist adult referral pathways when required