Big Manchester, part of the national Improving Futures scheme, is a holistic family support service for parents and children aged 5–11 years who are experiencing domestic abuse, to meet need, mitigate risk and build family strength and resilience. This service is delivered by a partnership, led by Barnardo’s, together with Manchester Women’s Aid, Manchester Mind, and Lifeline/Eclypse and Homestart. The model is a mixture of intensive one-to-one support and spot-purchased services.
Part of our Early intervention into action series of case studies on innovation and evaluation
Domestic abuse, substance misuse and parental mental ill health are recurrent themes in serious case reviews and found to co-exist in more than 60% of all neglect cases.
The aims of the service include: increased resilience, family communication, parental mental health, parenting; reduced impact of parental abuse on children, family conflict; positive improved family relationships; satisfactory school attendance and academic performance.
Staff use a variety of standardised assessment tools such as the Strengths and Difficulties Questionnaire (SDQ) (for both school and parent) and the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS), alongside assembling a detailed chronology with inputs from families, schools and other key agencies to assess need. This leads to an introductory period where the key worker meets with the family (parents and children jointly) to ensure all parties are comfortable, before the weekly sessions begin. These sessions usually take place in a school or a children’s centre over a period of 8–14 weeks, depending on need. Through play and a variety of age appropriate therapeutic techniques, the child-led, resilience building sessions explore feelings and understandings, building each child’s emotional literacy and self-esteem. One-to-one, holistic support is provided to parents: this might include emotional support, practical support, help to access and engage with additional support, and support to tackle particular issues faced by the family.
Key components are:
- A relationship with a specialist family key worker, who offers an intensive package of support to parents and each individual child in the family. The emphasis of the work is to engage parents to understand how the children are being impacted (and what needs to change). Families are usually allocated key workers within their specialism – for example, a seconded Women’s Aid worker in the project would support a family which has experienced domestic violence or abuse.
- Individual therapeutic play work with children, to build their resilience and emotional literacy. Project staff explained that the children supported are commonly functioning at a much lower emotional age than their chronological age. Play therapy, which is based on the theory that play is a child’s language, allows the children in the project’s cohort to creatively use toys, materials and roleplay to express and understand their inner experiences, thoughts and feelings. A qualified play therapist supervised this aspect of the work.
- Group and social activities for whole families.
The model of engagement has a number of features:
- a model of working with and listening to both parents and children using a strength-based and collaborative approach, which led to sustainable change
- an example of developing an intervention model built around securing and sustaining relationships, based upon trust and respect with and between partner agencies and families
- an example of highly effective multi-agency working, which demonstrates very good professional practice and a clear and evident commitment to working with partner agencies
- examples of professional practice, which demands a commitment to learning, critical self-reflection and change
- a demonstration of effective multi-agency working based in specific neighbourhoods, requiring well developed and sophisticated models of leadership and management, combined with an understanding of the needs of users, the ways in which key agencies meet those needs, and the local context within which the initiative is located.
Running alongside the project’s core therapeutic work are a number of complementary strands of activity, building on existing family strengths, raising aspirations and changing the family’s own self-perception. These activities include:
- Group work: regular programmes including Triple P Parenting, Children’s Self Esteem Building Groups and ‘You and me, Mum’ (run jointly with Women’s Aid, for mothers who have experienced domestic abuse). All these groups are led by the staff team and run throughout the year, according to demand.
- Parents peer support group: For many families the impact of domestic abuse, substance misuse and/or mental ill health has invariably led to isolation, a sense of dislocation and not belonging in the community. The peer group is run weekly in term time by the peer support worker and a Big Manchester parent volunteer. It involves a programme of activities, such as basic cooking lessons and money advice sessions, as well as trips in the local community, such as to the library or Manchester College. The explicit purpose of the group is to develop a peer support and friendship network for parents and to increase their confidence and engagement in their wider communities.
- BM Radio Project: In partnership with a local community radio station, the team delivered two BM Radio Projects, where a number of families met over a period of eight weeks to create a radio show for live broadcast. Through storytelling, creating adverts, features and jingles, parents and children worked together, developing listening and communication skills. Big Manchester also delivered a music project, where families worked together to write, record and perform music over the summer holidays.
- Family-held budget: Families have access to a small personalised budget (£250 per family). Parents are encouraged to identify for themselves what activities or trips the children would benefit from while the core work progresses. This has ranged from structured activities such as swimming lessons, attending a Guide club and camp or going to dance or football classes, through to family daytrips to the seaside, cinema or bowling alley. The aim is to encourage families to look for local and potentially affordable and sustainable activities.
- Whole project activities: in the school holidays, Big Manchester organises events and activities for all families, including regular excursions, picnics and a seaside trip each summer.
What worked well?
The project has a consistent and committed strategy group with representation from all five VCS agencies, together with representatives from Children’s Services, Complex Families and Health. It is also aligned both strategically and operationally with the Complex Families and Early Help services in the city.
What was hard or challenging – and how was this overcome?
A number of key challenges were identified:
- Establishing the parameters of the support for families and setting boundaries on the work: “because it is holistic, where do you stop?” It was found to be important for the service to be clear on what they can and can’t provide, both for families and referring agencies.
- Managing practitioner time could be difficult due to the intense and open-ended nature of the work, which can mean that families need extensive face-to-face contact. Practitioners noted that the families can also be large, for example with four siblings, which, because the project ethos requires all family members to be supported, can have time implications.
- Practitioners’ ability to remain neutral: the families often have complex dynamics, requiring workers to mediate between all family members and consider everyone’s needs without taking sides. Reflective practice was felt to be crucial to overcoming this challenge. It was also felt to be very effective in understanding the family and the effectiveness of the support.
- Securing external support for the families was sometimes problematic, particularly for supporting mental health needs.
- The reach with black and minority ethnic (BME) families was not reflective of the local population, particularly when there was a need for interpreters. This has changed considerably in the last 14 months, with now over 30% being from BME communities.
- Recruitment and staffing problems came up this was about getting the staff with the needed skills and attributes rather than simply ‘staff problems’ – for example, it took six months to recruit an additional family support worker early in the delivery of the project.
- Increasing family complexity and needs over the lifetime of the project meant that the work has become more resource-intensive, particularly in terms of safeguarding. It is becoming more common that project staff refer families upwards to social care, where this would have been very unusual in the early days of delivery.
What are the key lessons?
A number of lessons have been identified:
- It has been important to have someone with local knowledge and experience leading the project, as it has enabled them to quickly develop links with local senior members of public services. This has been important for a number of reasons, but particularly in terms of ensuring the project is aligned with local approaches.
- Equally, it has been vital to have local senior leaders (such as the leader of the Complex Families team) sit on the project’s steering group to ensure it is aligned with other local whole family service provision.
- In developing the multi-agency team, it has been particularly important to spend time putting together a robust partnership agreement to ensure equality in working conditions for practitioners. Investing time in building a relationship of trust among the partners from the start has been critical in keeping the partnership strong in a difficult funding climate.
- It has been important for practitioners to spend time with their home agency specialist teams (for example attending team meetings and clinical supervision) in order to stay up to date with developments in their field, maintaining their specialist skills. This has also been important in terms of sharing operational learning more widely within the partner organisations.
- The nature of holistic support means it is particularly important that the service sets boundaries on what they do and don’t do – for both referrers and families. This equally means that reflective practice has been crucial to ensure practitioners do not get too heavily involved with a family or work beyond their remit.
- The complexity of family needs means that caseloads need to be of such a size that practitioners are still able to work intensively and as flexibly as the families require.
- The project has seen a definite impact on the progress in families’ with mental health conditions. This is thought to be as a result of appropriated services and led to challenges the project has faced in referring families into more specialist provision. Considering mental health needs make up one side of the ‘toxic trio’ that the project is trying to address, this would warrant further exploration.
About the evaluation
The Big Manchester evaluation is part of a wider national assessment of the projects funded as part of the Improving Futures programme. Both the local and national level evaluations combine quantitative and qualitative methodologies capturing family level outcomes as well as the views and experiences of staff stakeholders and families.
The Big Manchester evaluation is based on:
- a desk review of various documents, including business plans, application forms, locally collected evidence on outcomes achieved, and mid-year and annual monitoring reports
- analysis of project monitoring data inputted by project staff and collected through the Improving Futures Monitoring Information System (IFMIS)
- a qualitative case study visit, during which researchers interviewed staff, stakeholders and families
- an in-depth interview with the project coordinator.
What were the conditions of the evaluation?
As part of the Improving Futures programme, the Big Lottery Fund engaged Ecorys UK, Ipsos MORI, the University of Nottingham and Family Lives to evaluate the programme at a national and local level from October 11. The evaluation is funded over five years, to assess programme effectiveness and impact, alongside continuous dissemination. There is a national evaluation that sits alongside this local evaluation and can be found at www.improvingfutures.org/
A ‘mixed methods’ approach has been adopted:
- Programme-level monitoring data collection: a secure online monitoring system, the Improving Futures Monitoring Information System (IFMIS), is accessed directly by project workers to create and maintain a profile for each family (and individual child and adult family members) using a standardised set of risk factors and strengths.
- Project-level monitoring data collection: collection of bespoke data at an individual project level, drawing upon core assessment data and other administrative sources.
- Longitudinal survey of families: a panel survey of Improving Futures beneficiaries (adults), exploring satisfaction with referral and support received, and ‘distance travelled’ during and beyond their involvement.
- Stakeholder survey: a quantitative survey of key local stakeholders to: explore levels of visibility and awareness of Improving Futures; understand the synergies with other programmes; and gain a further perspective on the impact achieved at a local level.
- Case study research: a rolling programme of case study to all Improving Futures projects. The visits include qualitative interviews with project staff, partners and families, and supplementary data collection. All case study visits have now taken place.
- Cost-benefit analysis: a programme-level assessment of the costs and benefits of the programme will be undertaken, including estimates of the projected savings as a result of positive outcomes achieved and negative outcomes avoided, plus in-depth work within a subset of projects.
- Participatory Action Research: a Family Panel comprising of beneficiaries will meet at key points during the evaluation to inform the research tool design, analysis, and recommendations.
- Learning activities: a programme of internal learning activities has been designed to facilitate the exchange of good practice between the 26 projects, through events, social media and a bespoke website. The evaluation consortium has also overseen a programme of learning activities for projects to exchange good practice within the programme, and to learn from and share best practice with other stakeholders. A learning seminar was held with the projects in July 2015.
- Action research cycle: The evaluation included a discrete strand of research to gather evidence for the three good practice themes featured in this report. The evaluation consortium adopted the principles of action research, so that the themes for year three were explored through an ongoing process of evidence-gathering and testing with different stakeholders. This included drawing upon the Family Panels, learning seminar, case study research, literature reviews and interviews with stakeholders, including policymakers, academics and think tanks.
What changes or outcomes were observed?
Evaluation data shown that the programme is associated with an improvement in strengths and a decrease in risks between entering and leaving the programme. These include:
- a reduction of some of the key risks faced by the families particularly stress and anxiety, as well as problems with discipline or boundary setting, behavioural issues and domestic abuse
- an improvement in relationships between parents and school, as well as reported improvements on time spent together as a family through play and learning
- increased participation by children in activities and play, particularly sports and leisure.
What is hard or challenging about conducting an evaluation?
The main challenge for the team was ensuring that the report was completed in time to be of use in the Reaching Communities submission as most of the evaluation work was done by the external team. There were also some challenges as the evaluation report took evidence from the year-one evidence from Manchester and did not note that some of the issues raised at that time had subsequently been resolved by the end of the funding.
What was useful about the evaluation?
The evaluation was very helpful in securing further funding through the Reaching Communities programme funded by the Big Lottery.