Families First

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Families First
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Families First?

• A joint Children and Adults team working with
  individuals and families with problematic
  substance issues
• Offering advice, holistic family interventions
  and support on issues related to substance misuse
• Assessment and support for adults and their
  carers in the community

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Families First?

• Provide assessment and support to adults
  requiring residential Rehab and community support
  programmes.
• Provides as a core element of its work a time
  limited intensive support package for families
  where the impact of drugs/alcohol has reached the
  point of crisis

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From Concept to Reality

• Project initially began in 2 halves
• A social support team from adult treatment
  services/ adult social care. (set in the context
  of Community Strategy and Adult Treatment Plan)
• A family support service working with parents who
  have problematic substance issues where there was
  the likelihood of a baby/child being removed
  (based on NRF family support project and
  inspiration from model of family intervention-
  Option 2)

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Team Structure
Suzy Kitching Team Manager
John Scadden Senior Practitioner
Janet Cox Senior Social Worker (drugs)
Elspeth Alexander Social worker (alcohol)
Jude Brown Social Worker (Part-time)
Claire Lunn Social Worker
Julie Taylor Social Worker (Part-time)
Diane Connor Housing/Rehab Support Worker
Public health nurse Nikki Clarke
Paul Short Benefits/Generic Support Worker
Chris McNicholas Family Support Worker
Gill Bennett Family Support Worker
Stacey Watts Family Support Worker
Colin Grant Family Support Worker
Kay Duffie Family Support Worker
Helen Foxton / Wendy Johns Admin Officer (Job
Share)
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Our Aims

• To offer advice, support and assessment to
  individuals and families affected by substance
  misuse
• To keep children with their families where it is
  safe and possible to do so
• Enable parents with drug and/or alcohol problems
  to make and sustain the necessary changes to care
  for their children

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Roles and Responsibilities

• Range of expertise working across disciplines
  from pre birth to adults from parenting skills
  and hands on practical support, to complex
  community care assessments and child protection
  skills.
• Capacity to ensure individuals health, and
  complex care needs are met
• Team working across adults and childrens cases
  enabling holistic family interventions
• Facilitation of support services via support
  groups service user groups, education and life
  skills.
• Co ordinate the Primary Pregnancy Protocol, LSCB
  protocol ensuring all mums in treatment have a
  pre birth assessment and plan

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Intensive Support Package
Consent to share information must be attached
Referral Form
Family must be aware of referral
Professionals and family
Information Leaflet
Response within 48 hours
Response within 72 hours
Contact made with family
Intensive package and transfer to be completed
within 4 months
Decision regarding acceptance of the case
Consultation Meeting Team Members, Manager
referrer
Yes
No
Acceptance of case responsibility for adult /
child
Advice given
Intensive Support Package
Stability/Permanence
Completion of intensive support package
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Team Process (for intensive support package)
Acceptance of case responsibility for adult /
child
Team Discussion re allocation and planning
Risk Assessment
Initial Visit
Safety Plan
Working Agreement
Intensive support
Case to be transferred at 4 months
Goal Setting
Assessments to be completed within 3 months
Maintenance
Assessments
Stability / Permanence
Maintenance Plan
Completion of intensive support package
End of Case Responsibility
Crisis
Follow-up visits (1, 3, 6 12 months)
Reinforcement
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Adult Drug Referral Route
Self referrals
Probation
Carers / families
DIP
Drugs Services
CARAT (Prison Drug Team)
Alcohol Services
First Steps
Health Services
Families First or Access Team (Adult Social Care)
Signposting/Advice
48 Hours
Initial Assessment of Needs / Screening
Families First initial assessment
28 Days
Comprehensive Assessment
Care Plan
Complex Care Co-ordination
Community and Rehabilitation
Community based
Residential Tier 4 Rehab
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Adult Support Services

• Enables adult workers to contribute to family
  interventions.
• Raises the profile of childrens needs in adult
  treatment and care plans
• Development of Relapse prevention work within the
  team
• Community care assessments and support plans
• Highlights the needs of Carers, the often complex
  family dynamics, and support for these needs
• Service user groups/community support
  groups/access to education and life skills
• Targeted group work, accredited courses

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A Familys Journey

• Single mother and 3 daughters (aged between 3 and
  8 yrs old). Mother is a binge drinker.Maternal
  grandmother is a alcoholic who lives nearby.The
  children were removed from mothers care and
  placed in foster care because of an incident
  where mother was inebriated and incapable of
  caring for the children. The children sought
  assistance from a neighbour.( this was the second
  time the children had been removed from mothers
  care)

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I think it was me fault that our mum was
drinking

• Families First picked up the case soon after the
  children were accommodated.The plan of work with
  the family was-
• Rehabilitate the children to mothers care
• Empower mother to address her behaviours around
  alcohol
• Meet the childrens individual needs
• Develop strategies to improve family functioning
  
• Transfer back to referring social worker around 4
  months with Maintenance Plan

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A Familys Journey

• Mum and Dad, first child together. Mother has 3
  other children living with extended family. Drug
  culture in paternal family. Both parents have
  extensive drug and criminal histories, including
  prostitution. Couple living in flat not seen as
  suitable (housing) for a baby Mother has
  additional health needs. Both parents continue to
  use drugs on top of treatment. Mother using
  intravenously until point of delivery. Pre
  birth assessment undertaken, matter went to ICPCC
  and Plan for foster placement to be secured as no
  family members came forward and mater to go
  before Court. Baby born prematurely and
  experienced withdrawal symptoms.

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A familys Journey

• Families First had some involvement through
  Primary Pregnancy Protocol
• Family agreed to work with team and wanted to be
  given opportunity to care for baby.
• Removal of the baby was their motivator to change
• Couple worked closely with team contact quickly
  progressed into the home, and extended within
  weeks to daily contact.
• Plan supported multi agency in Court arena (Twin
  Tracked) to unsupervised and subsequently
  overnights.
• Extensive family interventions/support with
  family to support changes
• Baby at home full time (4 months) we are
  recommending a SO. Maintenance plan will include
  ongoing adult support work and Relapse
  prevention. The case is in process of transfer to
  locality team.

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Challenges so far - Process

• Appropriate referrals and understanding of the
  model
• Establishing consistent working relationships
  with colleagues
• Concept of a commissioned piece of work and
  movement of case responsibility (in childrens
  services)
• Statutory paperwork impacts on time with the
  family members
• Mainstream pressures impacting on handovers and
  referrals
• Separation of treatment and care
• Future funding/sustainability/staffing/loss of
  skills and learning

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Challenges so far - Practice

• Professional dilemmas when the family
  intervention can not secure the safety of the
  child and childrens outcomes have to take
  precedence
• Consideration that outcomes for families and
  children do not always align
• Working with families where alcohol use is
  extremely high and there is violence
• Working with families where children are often
  very young/babies
• Managing high thresholds of risk

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Families First

• Giving Families a Chance to Change
• Contact us
• 1 Albert Terrace
• Middlesbrough
• TS1 3PA
• Tel [phone]
• Fax [phone]
• Email suzy_kitching_at_middlesbrough.gov.uk