A quick turnaround: the Integrated Family Support project in Wales

(Pictured: Vicky Self, service manager Newport Council)

● Project name: Integrated Family Support.

● Aims and objectives: To help drug and alcohol addicted parents change their lives through a very intensive intervention from a multi-agency team headed by consultant social workers.

● Run by: Newport Council.

● Number of service users: Three families so far.

● Cost: Project has a Welsh Assembly grant of £600,000 a year for three years.

● Timescale: Three-year pilot started on 1 September.

Substance-abusing parents in Wales are receiving intensive, high-end support that aims to keep their children in the family home, reports Chloe Stothart

Between 200,000 and 300,000 children in England and Wales have a parent with serious drug problems. Most of the children stay with relatives and 5% are in care, according to the 2003 Hidden Harm report by the Advisory Council on the Misuse of Drugs.

The Welsh government has responded by piloting the Integrated Family Support (IFS) service, a very intensive intervention from a dedicated team that aims to help children return home from care, spend less time there or avoid it altogether.

But if families are not deemed able to change after such intensive intervention the children will be taken into long-term care or adoption.

Mike Nicholson, director of children’s services at Newport Council, believes this is a chance to transform all their family support interventions.

“Families tend to be referred to IFS at a crisis stage but, pitching it at this stage, with the knowledge that the children could be going into care permanently, often re-energises a family. The evidence from similar projects is that three in four families take that chance to turn themselves around.”

Families are given high-end support to stay together but quick decision-making is essential to ensure children do not bounce between care and home.

Eventually, the service will be expanded to families with mental health problems and where there is domestic violence.

The pilots began on last month in Newport, Wrexham and Merthyr Tydfil/Rhondda Cynon Taff and last three years. They are each funded by a Welsh Assembly grant of £600,000 a year.

It is also backed by legislation requiring local authorities and health boards to work together in setting up the teams. Adult social services assessments have also been changed to identify people whose parenting abilities may be compromised by drug abuse.

The service in each area is run by a team of five, including a consultant social worker with three years’ post-qualifying experience, and four staff with backgrounds in social work, nursing or health visiting.

Over the first 72 hours, the family’s social worker introduces the team member to them. The IFS team worker builds a close relationship with the families looking at their strengths – such as having been good parents in the past – risks, their motivation to change and the causes of their problems.

“Children’s and adults’ services and health do not have the time to spend with the families that we have; it makes such a difference to the relationship and we have not had resistance,” says Vicky Self, service manager at Newport Council. “The model is about assessing people to see their strengths and build on their resilience.”

Together, the professionals and the family decide what changes they need to make to ensure a safe home for the child and to improve their lives. Changes could include establishing routines to ensure the children go to school, finding suitable drug and alcohol counselling or tackling rent arrears.

The family receive four to six weeks of intensive help from the IFS team. At the end, a family plan is drawn up, detailing their goals, risks, needs, information from other care plans, and how the agencies will help them. Over the next year, the IFS team reduces its involvement with the family to reviewing their progress against the plan and providing short, intensive booster sessions if they slip back. In Newport, children’s services support workers will help the family during the year.

Recruitment was the biggest challenge for the project. It took the Newport team three attempts to fill all their consultant social worker posts. One of them, Matt Lewis, admits the idea of being available 24 hours did concern him when he applied for the job but he says in practice he is rarely phoned outside office hours.

The scheme has only just started but Nicholson is confident it will be successful because it is based on a similar Welsh government-funded scheme, Option Two, which saved £1,178 a child on average compared with taking them into care.

Case study

The Andersons* are the first family the Newport team has worked with. The mother, Lisa,* is pregnant and has been drinking excessively for about 10 years, including sessions around the clock. Husband Joe* is depressed and the pair have had violent arguments which resulted in their four children, aged 10 months to six years, being taken into foster care.

Consultant social worker Matt Lewis spent about 12 hours with the family in the first three days and progress has been fast.

Lisa has cut her alcohol consumption dramatically, drinking just eight cans of lager over seven weeks and the couple have talked through the issues that had soured their relationship. Now they feel the relationship is as good as it was before Lisa’s alcohol problems took hold.

They are cleaning their home ready for the children’s return and Lisa is starting to deal with unresolved grief over her father’s death, which was at the root of her drink problem.

Lewis and the family have set a number of goals to help Lisa stay sober, including alcohol counselling, and respite childcare when the children return home.

“Social workers with 20-plus cases do not really have time to sit down with people to listen to the human stories that have led them to these desperate places,” Lewis says.

“They only hear about the bad events and don’t get the opportunity to know the family and see the positive.”

The family’s designated social worker, who had been doubtful about the project, is now so impressed she wants to be seconded to it, he adds.

* Names have been changed

Tips to effect change

● Ask the “miracle” question: “If a miracle happened and everything in your life was put right, what it would be like?”

● Ask the family what needs to change to reach that point.

● Ask them how those changes could be made.

● Listen and ask open questions; don’t tell them what to do.

● Summarise what they say back to them.

● Look for the positive – what attributes do the family already have that could be built upon? These could be strong relationships, well-behaved children or having been good parents in the past.

● Think about how services could be altered to fit the family’s needs.

● Get to know them: what are their values and needs?

● List the risks to them and to their children.

● Get to know what triggers their problems.

● Once change is achieved help them think of ways to maintain it.

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