Support for families through care proceedings: Developing integrated, evidence-based and trauma-informed approaches

What is the issue?
Care proceedings are initiated by social services to protect a child who is considered to be at serious risk of harm. Parents of these children often have a range of health and social care needs, including substance use challenges, domestic violence, poverty, experience of the criminal justice system, homelessness or mental ill health (called multiple disadvantage). Support for families is needed from a range of professionals, including social care, public health and primary care. The consequences of taking children into care are hugely significant for children and their families. The grief and loss that parents experience sometimes can lead to worse health outcomes for themselves. Currently, there is a lack of understanding of how multiple professionals can engage with and provide the best support to families, in an integrated and coordinated way, before, during and after care proceedings. A diverse group of academics, practitioners and people with lived/living experience contributed to this work with an aim to gather insights to inform future research and projects on this under-researched subject area. We’ve consulted with almost 300 participants from across social work, healthcare, the voluntary, community and social enterprise sector, and individuals with lived and living experience of having had children taken into care to understand:

1. How families can be supported to
enable children to remain safely
at home.

2. How to support the health and
wellbeing of parents of children in or at
risk of being in State care.

Combining these consultations with research evidence, policy and local practice, we have developed key insights to inform further work to ensure that families can be better supported through care proceedings. Addressing the gaps in support for parents requires changes to make sure that services are accessible, provide the right support at the right time, and consider the trauma and adverse life experiences that parents may have faced or are currently facing. This means making systems more trauma-informed, relationship-based, family-focused, evidence-based and multi-disciplinary. What needs to happen? The table below sets out the insights identified. By acting on these suggestions, services can potentially reduce harm, enhance trust, and empower parents to
navigate the care system more effectively while prioritising the well-being of children and families.
Key insights identified by the stakeholders:
1 Join up working across multiple services
In addition to multi-agency working between social care, police, healthcare,
and education (as advocated by the Children’s Wellbeing and Schools Bill),
stakeholders recommend including key voluntary, community and social
enterprise (VCSE) staff, physical and mental health support staff, and housing
staff as appropriate.
2 Provide trauma-informed, evidence-based support for staff and families
Both staff and families require approaches that recognize trauma, avoid re-traumatization, and build trust. A scoping review highlighted evidence-based
interventions that support parents that are trauma-informed, relationship based, family-focused, multidisciplinary and long-term. This includes services
with specialist teams who work with parents at risk of child removal both pre- and post- birth, providing trauma-informed support which is easy to access. It
would also need to include support for staff themselves, who may be impacted
by vicarious trauma from service users.
3 Improve cultural understanding
Provide cultural awareness training, particularly around the different cultural
norms within families, and specific cultural issues. Parents may need culturally
specific advocacy and more can be done to understand how different cultural
factors impact upon pathways into care proceedings. Courts may also need to
consider cultural aspects more fully within their processes. Ensure that each of
these insights are considered and acted upon in culturally appropriate ways.
4 Expand advocacy and peer support for parents
Signpost to and provide practical, legal advocacy and psychological support for
parents throughout care proceedings. Use plain language to explain care proceeding processes to families and enable them to get legal support and advocacy in place. Peer advocates with lived or living experience can support parents during/after care proceedings. Peer advocates need to be appropriately trained and supported.
5 Provide support for parents after care proceedings and support reunification where possible
Support for parents after proceedings can potentially prevent parental ill-health and prevent repeat care proceedings, as evidenced by national evaluations. However, sustainability and continuous funding of support
interventions is a national challenge. Where appropriate, maintain connections
between birth families and children after care proceedings to help repair relationships and support reunification.
6 Expand support to fathers and the wider family during the care
proceedings process
Resources and strengths of wider family and other friendship networks may be under-utilised to provide appropriate support for children. Family group conferences are an evidence-based intervention that can support wider family involvement. Research shows that kinship care has the best outcomes of all placements. However, people who have experienced multiple disadvantage, or have experienced honor-based abuse, may have strained relationships with wider family, which need to be taken account of when placing children in kinship care.
7 Prioritize early intervention for families at risk of care proceedings
During pregnancy, parents need trusted relationships with professionals, clear
information, and wraparound support as soon as the pregnancy is identified.
Support could potentially be offered through specialist midwives, family support workers or voluntary sector workers.
8 Support families with substance use challenges
Families with substance use challenges may experience stigma and increased
barriers to access the right support. There are evidence-based interventions
that may support families such as Family Drug and Alcohol Courts and
Multi-Dimensional Family Therapy.
9 Build links across different health sectors including primary care
Improve referral pathways for primary care practitioners to identify and support
patients who may be at risk of care proceedings. Building on evidence-based
models such as IRIS, a specialist domestic violence and abuse (DVA) support and
referral program for General Practices, may support this work.
10 Prioritize staff well-being to reduce stress and staff turnover
Finding ways to support social workers and VCSE staff when working in this
area is key to help reduce turnover and high vacancy rates. Tackling staff
stress, providing the right training and skills development and supporting
well-being, for example by providing funded supervision, may help to create a
longer-term sustainable workforce.