See also:

• Thrive, Wandsworth
• How local authorities approach evaluation: Lessons from Camden and Wandsworth – a blog by EIF director of evidence Tom McBride

Camden is a typical London borough with pockets of deprivation and disadvantage existing alongside very affluent areas. It has a high proportion of young people and a diverse ethnic minority profile. Operating against the backdrop of diminishing resources, Camden told us they are shifting their focus to intervening earlier to help reduce the pressure and spend on statutory services. They have developed a Resilient Families Programme to drive and underpin the work of the Early Intervention and Prevention services in the borough.

Family group conferences (FGC) are used by the Early Help team to encourage and empower individuals and families to be more resilient and help to prevent them from returning to services. For example, an FGC may be used to address a parental issue, such as a health or substance misuse problem, or to provide childcare and support for a single parent; to tackle a concern for a young person following parental separation; or to address school attendance issues, or behaviour problems at home or in the community.

The focus of this case study is on Camden’s approach to understanding the effectiveness of their FGC offer – we have not explored how this fits with other support services available to families.

What is a family group conference?

A family group conference (FGC) is a way of bringing a family together and enabling them to plan and make decisions for a specific purpose. It is a time-limited process with the intention of creating a plan to support and improve a specific parental issue or a problem or issue a young person is experiencing. Through encouraging a family to address their own issues and create an informal network of support it aims to build resilience and strengthen relationships. It can also help to encourage more links within the community.

FGCs were introduced in the UK from New Zealand in the early 1990s, as a way to encourage professionals to work in partnership with families.[1] They were initially used in Camden in child protection and planning for children on the edge of care when looking at kinship care placements. More recently they have started to apply the approach to the early help context, as a universal offer for families to take the lead in decision-making about the support they need.

What does a family group conference involve?

An FGC is one of a number of options that are considered when referrals are made to the universal front door. There are no fixed criteria to determine their eligibility within the early help context; rather, the early help assessment will determine whether an FGC is an appropriate solution for a particular family or young person.

Once a referral is made, the FGC manager links a family to a trained and independent FGC coordinator, who will steer the family through the process. The coordinator will convene the meeting in a community venue at a time that is convenient for families and with food that they have chosen.

The preparation (stage 1) usually takes four to eight weeks, and is crucial for laying the foundations for a FGC and for ensuring that the agenda is understood and shared by all involved. The coordinator will work with the children and their family to understand who they would like to have at the meeting, and then make contact with all the family, friends or connected others to establish if they would consider attending the meeting and what they might hope to bring to it. They will also make all the practical and logistical arrangements, including arranging the venue, food, translators, transport and so on, to ensure the meeting can take place.

Important work is done with the child to make sure their voice is heard in the meeting, which might be through drawn or written work as well as actual attendance. The coordinator will also arrange an advocate for the child if they feel this is needed.

A typical FGC lasts about three hours. It starts with an information-sharing session (stage 2), which may involve professionals. This is followed by private family time to create the family plan (stage 3). The plan outlines the actions to be undertaken by each member of the group, with the aim of providing support relating to the original referral. When the family has produced their plan, they present and agree this with the FGC coordinator and any professionals (stage 4). Finally, there is an option to review the plan with all the original participants three months later (stage 5). At the end of the review, families are encouraged to organise a ‘kitchen table FGC’ to maintain the support themselves in the longer term.

The keys to success, according to FGC coordinators and managers

The FGC coordinator needs to build a family’s trust in a number of ways, including by:

• creating a confidential and safe space
• managing their expectations throughout the process
• communicating on their terms and in their language
• being culturally aware
• being a good listener and mediator
• being non-judgmental
• being empathetic and flexible.

They also need to ensure that the child has a voice themselves or is involved via an independent advocate.

It is a voluntary process and families need to willingly engage and be ready to accept responsibility for developing and signing up to their plan. They need to feel comfortable about working with their FGC coordinator and about sharing and engaging with their network, because conflict or a poor group dynamic can derail the process.

What is the current evidence base?

The evidence base for the use of FGCs is still developing, and the ways in which the impact of their use is measured is contested.[1]

FGCs originated as a form of partnership decision-making for use in child protection and child welfare systems.[2] As a result, they are typically embedded within a comprehensive system of children’s social care, with associated monitoring and review.

In Camden, however, FGCs are being used to address a wider range of needs, including as part of their early help offer, and the key evidence reviews we have identified do not directly relate to this ‘lighter-touch’ early help model. In these reviews, FGC or ‘family group decision-making’ (as its known internationally) used in child protection were found to be valued by participating families, children and/or practitioners. They can provide a space for families to interact in a safe and productive way, and they support family engagement. However, there is much less research on outcomes. The reviews highlight limited, inconsistent evidence of improved outcomes for children, for example, in terms of reduced maltreatment and recurrence or out-of-home placement.[3]

There have also been some recent UK evaluations of FGCs.[4] In line with the international reviews, these focused on the use of FGCs within the child protection system, rather than early help, and provide similar findings, with families giving positive feedback about the conferences, including feeling listened to, respected and helped.

However, strong evidence of impact was limited, due to methodological challenges. For example, in one of the UK studies, FGCs were implemented as part of a wider system-change programme designed to spread restorative practice across children’s services. A year after the implementation of the whole programme, positive outcomes were identified relating to children’s social care, such as significant reductions in the number of looked-after children and the number of child protection plans. However, the methodology does not allow us to be confident about the direct causal impact of FCGs on these outcomes, due to the challenges of having a robust counterfactual in this type of systems change intervention, and FGCs being only one aspect of the intervention.[5]

Current learning and evaluation plans

In Camden, families and staff reflected positively about taking part in an FGC. Families reported feeling empowered by the process, and reflected on the way it helped to boost their confidence and self-esteem, despite any initial anxieties. There are also some early indications that an FGC may perform just as well as more formal, professional early help casework, in terms of reducing repeat referrals to early help. Camden’s recent analysis found that 79% of families who have had an early help FGC remained free from further early help or social work intervention within 12 months of closure. The percentage was similar (83%) for those families receiving formal early help casework.

Camden is committed to a robust evaluation of their work. They are seeking to test the potential of FGCs in different contexts and to assess their impact on individual wellbeing, social connectedness, to relationships and resilience within families and the local community, and ultimately to helping prevent social work involvement.

Camden has made additional funding available to expand the use of early help FGCs each year, subject to the outcome of their impact evaluation, at which time a growth target may be set. They are also in the process of identifying appropriate outcomes that a FGC could improve to measure progress for families, potentially using resilience scales.

They are about to commission a rapid evidence review of FGCs and an analysis of FGC plans and journey mapping. This is an opportunity to fully understand what evaluations of FGCs have shown to date, and the gaps in the knowledge base, including how they might be applied in an early help setting. They are also exploring the use of social return on investment methodology to assess the social value and financial savings of carrying out an early help FGC. They have estimated that a standard FGC costs around £1,200–1,500, including the review but not the referral process.

Strengths of their current approach

While their current approach is valued by families and coordinators for making a difference, Camden is committed to robustly evaluating the use of FGCs as a tool for early help. The analytical capacity and integrated data systems and funding is in place to allow them to start addressing these questions.

Across the local authority there is a very strong commitment and interest in learning and understanding what works in early help to inform their outcome based budgeting. They have developed a corporate data strategy and invested resources to build the infrastructure to support this agenda. At a senior level, there is an interest in the use of FGCs as part of the borough’s early help agenda.

Camden is working with the Local Government Association to develop an innovative data-linking and matching tool which will enable them to link routine administrative data from areas such as education and housing. This would, in turn, allow them to analyse how families’ circumstances and use of services change over time. They are exploring the metrics which will best provide insight on the impact of services. They are also open to exploring approaches to assess impact and are interested in using predictive analytics as part of their approach.

Aspects of evaluation to consider

Camden has made an impressive commitment to understanding if FGCs work and if they are an effective tool for early help. An FGC is a relatively light-touch intervention: while it is valued by participants, there is a need to be realistic about what it can achieve and the extent to which it is likely to contribute to tackling entrenched problems, such as substance misuse or parental mental health issues. Currently, Camden is applying the approach to a wide range of circumstances, matching a family’s needs to an FCG where it is appropriate and could be helpful. Camden has developed a theory of change for community-led early help for its recent Troubled Families earned autonomy bid, and might think about its application to the early help FGC model.

It would be beneficial to use the rapid evidence review to examine whether there are any examples of evidence relating to FGCs being used and tested as an early help model. It should examine key characteristics of evaluated FCGs, including who coordinates them, their dosage, their target population, and any impact found. The findings of the literature review could contribute towards the theory of change exercise, and help Camden to fine-tune what they are aiming to achieve and how FGCs are embedded in their overall service. If FGCs have not been used in early help previously, or the evidence base for outcomes remains weak, this should be acknowledged. Camden’s evaluation approach will benefit from using outcome measures that are plausible for measuring a FGC and can realistically be assessed. The availability of linked data on outcomes such as school attendance and rent arrears is useful, as these are objective outcomes. However, Camden will need to consider if this is a realistic part of the FGC theory of change.

Camden has shared the proposed measures for assessing impact of their new model of FGC, which will be ‘community-led’. This is part of the next stage of development in Camden’s FGC service, which will seek to use a volunteer rather than a paid professional to coordinate the process. It should be noted that this is a departure from the current model, and so will need careful planning and evaluation to fully understand the risks and benefits of this approach. For this, Camden is looking into measures of social capital and wellbeing, which will need to be aligned appropriately to the new community-led FGC’s theory of change.

Camden’s proposed measures of social capital and wellbeing consist of a series of questions taken from several sources, including the European Social Survey and the Office for National Statistics. It is important to note that removing questions from other scales in a ‘pick and mix’ approach provides no guarantee that the newly created questions are valid and reliable, even if the original scales are. Camden would benefit from selecting one or more valid and reliable measures, and each measure should be used in its entirety.

Further, the proposed questions are largely survey questions, designed to provide snapshot data about the wellbeing of a population at a particular point in time. Such measures are not designed to show change from pre- to post-intervention, and therefore may not detect change resulting from the FGC, even if change has occurred. Camden would therefore benefit from choosing a measure designed to show change over time, such as the Warwick-Edinburgh Mental Wellbeing Scale. Further longer-term assessment of FGCs would be useful, to understand more about their effect and whether any outcomes are sustained; as would rigorous testing of how effective volunteer coordinators are in comparison to professionals.

Measuring impact will require comparing the outcomes for FGC individuals and families to those of a comparison group or counterfactual. This will require a level of analytical capacity and capability that may be hard to resource internally, and Camden is working with local fundraising experts to find the funding and resources needed.

Camden are keen to share their learning; if you have questions or would like to explore this further, please contact Tim Fisher or Becca Dove.

Notes:

1. Mason, P., Ferguson, H., Morris, K., Monton, T., & Sen, R. (2017). Leeds Family Valued: Evaluation report, London: Department of Education.
2. Frost, N., Abram, F., & Burgess, H. (2014a). Family group conferences: Context, process and ways forward. Child & Family Social Work, 19(4), 480-490.
3. Frost, N. et al. (2014b), Family group conferences: evidence, outcomes and future research. Child & Family Social Work, 19: 501–50; Bartelink, C., van Yperen, T. A., & Ingrid, J. (2015). Deciding on child maltreatment: A literature review on methods that improve decision-making. Child abuse & neglect, 49, 142-153.
4. Mason et al., 2017; Sebba, J., Luke, N., McNeish, D., & Rees, A. (2017). Children’s Social Care Innovation Programme: Final Evaluation Report. London: Department for Education.
5. Mason et al., 2017