Working with recurrent care-experienced birth mothers: Online resource pack
Social workers, lawyers and judges have long been aware that some women return to court as respondents in care proceedings after having already experienced the removal of one or more children in previous proceedings. It is also recognised that a proportion of these women return to court on many occasions and lose multiple children to public care and adoption.
A concern about recurrent care proceedings involving women with substance misuse problems was a key factor in the setting up of the Family Drug and Alcohol Court (FDAC) in 2008. Following their initial pilot work in one local authority Karen Broadhurst and Claire Mason were asked to present at the Family Justice Council 6th Annual Debate on the issue of recurrent care proceedings (Family Justice Council, 2012) and Pamela Cox published an article about the issue (Cox P, 2012). In 2013, the London FDAC specialist team brought together a group of academics and practitioners to discuss the issue of recurrent proceedings, share examples of good practice and highlight services being set up specifically to address the problem. A second meeting of this ‘community of interest’ took place in 2014. During 2014/15, a series of papers on the subject of ‘repeat removals’ appeared in a range of journals, placing the issue firmly on the policy agenda (Shaw et al, 2014; Harwin et al, 2014; Broadhurst et al, 2015).
In addition to the FDAC, at this time initiatives were being set up in Suffolk, Brighton, Reading, Salford, Nottingham and Hackney. Both community of interest events in 2012 and 2014 were an opportunity for discussion of the different models and approaches being used. Among these early initiatives, FDAC and Pause  (which began with a pilot in Hackney in 2013) have the highest profile, but many of the others are still going strong and a good number of other services have been developed since. More details about them are provided in this resource.
Some members of the ‘community of interest’ were successful in securing funding from the Nuffield Foundation for an initial feasibility study (2013-2014), followed by a substantive programme of research (2014-2017). In 2014/15 the Lancaster team produced a number of interim outputs from the project which attracted high profile media attention  and engaged in extensive dissemination and advisory work following their release (Broadhurst & Mason, 2013; Broadhurst et al 2014a&b; Broadhurst al 2015a&b)
In 2017, the team at Lancaster University published the final report of a Nuffield-funded research study into Vulnerable Birth Mothers and Recurrent Care Proceedings (Broadhurst et al, 2017). The study analysed data held by Cafcass on all care proceedings in England, enabling the researchers to demonstrate the scale of the issue – that one in four birth mothers will reappear in care proceedings, within seven years, following an initial set of proceedings. Qualitative elements of the research included in-depth interviews with mothers and information from a review of case files, improving our understanding about the factors related to women reappearing in care proceedings.
How this resource pack was developed
The Lancaster team and Research in Practice wanted to collaborate to support the use of the research findings to inform more effective ways of working with this population. A Change Project, which commenced soon after the research was published, provided an opportunity to work with a group of practice leaders working to set up or improve support to parents (with a primary focus on mothers) in this situation. Pam Cox and Danny Taggart of the University of Essex joined the project team, bringing their expertise in evaluating this type of service and in applying theory and research from clinical psychology to working with women who have experienced repeat removal of their children. Mary Ryan, a senior RiP Associate, project managed the six Change Project events and developed this resource pack.
Change Projects give Research in Practice Partners the opportunity to:
- Explore the evidence around a particular problem or topic.
- Bring together professional knowledge and research evidence.
- Improve practice through the application of evidence-informed approaches.
- Share new knowledge and resources with the wider network.
For the Recurrent Care Change Project, a Development Group of practice experts was recruited from 11 local authorities. The group met six times between November 2017 and June 2018. The 11 participating local authorities were:
Birmingham, Blackburn with Darwen, Brighton and Hove, Devon, Hampshire, Leeds, Lincolnshire, Rochdale, Stockport, Waltham Forest, and Worcestershire.
The overall aims of this Change Project were to:
- Share with the participating organisations the messages from:
- The Lancaster research (the Vulnerable Birth Mothers and Recurrent Care Proceedings study –Broadhurst et al, 2017), and
- Essex University’s work on evaluation and workforce development (gained in working with services for recurrent care-experienced parents in Suffolk, Norfolk, Merseyside and Southend).
- Support participating organisations to use theory, research evidence and data to inform the development of new provision, or further develop existing provision, for women who have experienced more than one set of care proceedings.
- Identify essential components for meaningful engagement with women and workforce development components for practitioners working in this field.
- Develop proportionate, meaningful evaluation approaches.
The 2017 Lancaster research focused on women because mothers were easier to identify in the Cafcass data and case files. In 2018-19, Nuffield funded further research focused on fathers who experience recurrent care proceedings. Some services work with both mothers and fathers who have been involved in recurrent proceedings, and much of the content of this resource is applicable to working with fathers.
This resource brings together material presented at the Change Project sessions with information, reflections and practice examples provided by those participating. Its purpose is to provide evidence-informed learning materials for use by others working in this area of practice.
Who is the resource for?
Managers and commissioners in children’s social care, NHS Trusts and third sector organisations who:
- Are interested in setting up a local service to meet the needs of parents who have had one or more children removed through care proceedings
- Want to develop an existing service further
- Want to evaluate an existing service.
Practitioners in Children’s Services, third sector organisations, or health services who are interested in understanding more about:
- The research evidence on the extent of the problem
- Research evidence on the impact of trauma and of removal at birth
- Effective ways of working with vulnerable parents in this position
- The different services currently available to support parents in this position
How to use the resource
The content and structure of this resource is set out below. Sections include summary research findings, PowerPoint slide presentations, case studies, exercises, short film clips, tools, materials provided by participants and links to other resources or sources of information.
For those interested in setting up or further developing a service, we would suggest working through the resource from start to finish. For those more interested in practice or staff development, sections 1, 3 and 4 may be the most useful. However you plan to use the resource, we suggest you check through in advance in order to have a note of what you will need such as: screen and speakers to view films or slides, printouts of case studies and exercises, flipcharts, whiteboards, pens, etc.
The impetus for developing a recurrent care service may well come from local authority Children’s Services. Nevertheless, the main focus of the work will be vulnerable parents, so it is vital that local partners who provide services to adults are engaged. Think about how you can bring local partners together to make use of these resources in order to share practice knowledge and plan for new provision.
What’s in the resource?
This resource is divided into five sections, as described below. Learning materials include research or practice information in the form of:
- Slide presentations, including animated slides
- Short films
- Tips for Practice – practice points and tips that emerged during the Change Project session discussions
- Exercises (sometimes supported by case studies and action planning templates)
- Six learning modules for workforce development
- Links to background reading.
Section 1: Setting up a service – Messages from the research, understanding local need and local provision, getting going
Section 2: Setting up a service – Evaluation and cost benefits
Section 3: Workforce development: Reconceptualising ‘non-engagement’ – attachment and complex trauma and its impact; trauma-informed approaches to service design and direct practice
Section 4: Workforce development – Understanding complex grief and the impact on mothers of removal at birth
Section 5: Setting up a service: Learning from other recurrent care services – 13 case studies
 The FDAC was launched in 2008 as a new way of dealing with care proceedings where parental substance misuse is causing harm to a child. It aims to support parents to stop using alcohol or drugs and, if possible, to keep families together by coordinating a range of services to meet the family’s needs. The court uses its authority to provide a comprehensive response to the problems that led to care proceedings. Its work is underpinned by the belief that parents can change and that the court has a role as an agent of change. The Centre for Justice Innovation hosts the FDAC Partnership supporting the work of local FDACs http://justiceinnovation.org
 Pause works with women who have experienced, or are at risk of, repeated pregnancies that result in children needing to be removed from their care. Through an intense, relationship-based programme, Pause aims to give women the chance to pause and take control of their lives. It works with women in a way that addresses everybody in their lives – fathers of their children, partners, family members and friends – as well as professional agencies such as social services, housing, the NHS and the justice system. www.pause.org.uk
 BBC Today Programme, News (2015) Huge rise in newborn babies subject to care proceedings, by Sanchia Berg, BBC Today Programme, 14. December 2015. https://www.bbc.co.uk/news/uk-35088794,
 For more information on this study see: www.nuffieldfoundation.org/birth-fathers-recurrent-appearance-care-proceedings