Troubled Families Programme

Head of Troubled Families, Louise Casey speaks at the Association of Directors of Children's Services (ADCS) annual conference.

This was published under the 2010 to 2015 Conservative and Liberal Democrat coalition government

Dame Louise Casey CB

Good morning.

Thank you for having me back to this prestigious gathering. I came and spoke to you last year and I’ve been fortunate enough to meet many more of you in person since then travelling round the country.

It’s been a long year and not an easy journey. Many of us in this room have been on that journey together and I want to thank colleagues for the help and support both to me and my team, as well as your strong leadership of this programme.

We should all be pleased with the progress that’s been made - going from less than 5,000 families in family intervention before the launch of the Troubled Families Programme to over 35,000 now being worked with. This is down to work by councils and their partners - in very challenging circumstances. I know it’s tough at the moment. But you have run services in times of growth and now in times of austerity and it is fair to say that troubled families have dominated both.

In West Cheshire for example, they estimate that the average family costs around £8,000 to the local authority, while the average troubled family costs nearly £80,000.

The costs are continuing to rise - so there is a need for a radical change to how we work with these families.

As you know, the troubled families programme is about turning around the lives of 120,000 families who have many problems and often cause many problems by getting to the root causes of what is going wrong for them as a family. These are families who, despite the best efforts of many of us over the years, have not been changed.

The stories of these families tell the history of a generation of initiatives, a generation of programmes, a generation of goals.

Yet from generation to generation we have failed to stop the transmission of problems and disadvantage.

In my view we have let them down – and I include myself in that.

This time therefore is has to be different.

Week in week out when I meet families they nearly all talk about:

  • a history of physical violence and sexual abuse, often going back generations
  • the involvement of the care system in the lives of both parents and their children
  • parents starting to have children very young and unable to deal with them
  • those parents in violent relationships,
  • and the children going on to have behavioural problems,
  • leading to exclusion from school, anti-social behaviour and crime.

You know all of this too of course, but what has our response been to that?

I know this isn’t the case everywhere and of course there are exceptions, but I think many of us would recognise this picture.

There’s the police dealing with endless call outs, going back to the same address to fill out the same domestic violence report, frustrated knowing that nothing will change and they’ll be back next week.

The council getting endless neighbour complaints, making noise nuisance reports and moving towards eviction, sometimes sending a family somewhere else where the anti-social behaviour carries on.

Children’s Social Care involved with the same family for years, taking one child after another into care, as the mother repeats the same cycle, because she hopes it will be better next time around.

What is clear and indeed what is staring us in the face is that in spite of our collective ambition to help these families, a reactive and uncoordinated approach prevails across public services.

Forgive me if you’ve heard this example before but I think it encapsulates the problem in one story.

One survey looked at 3,000 children in one area of the north east - an area that has been through every deprivation programme going, from city challenge, single regeneration budgets, through to new deal for communities and neighbourhood renewal - and more recently had the pupil premium spent on them.

A survey showed that not one of those 3,000 children had been for a routine dental check up - for free - but 300 of them had been to A&E for emergency dental treatment.

We can’t go on like this.

That is why we now have to change the services and systems around the families as much as turn the individual families around and that is a very hard job to do and we need to find out how to do it together.

I was visiting a local authority a couple of weeks ago and they told me about a family with 4 children:

The eldest had been in care, then had been placed back in the home, that child had one social care team around them.

The next child down was on a child protection plan, with their own social care team.

The next one was designated as a ‘child in need’ and referred to a school project called something like ‘Starlight’.

The youngest was being monitored by ‘team around the child’ - essentially a monthly structure of meetings.

Four children, at least 4 different teams, 4 different approaches and yet nobody working specifically with the mother to change.

So there was a sense of inevitability that those children would move up each step in that ladder without the family’s problems being solved.

We may have met and fulfilled our responsibilities on safeguarding in this family, but they will continue to cost a vast amount, being held in a position where disaster is mitigated and risk is managed.

But I think for all of us in this room we probably would want to go further - further in reducing the inter-generational disadvantage and further in reducing the cost to the state.

We can’t go on like this. We should not have done before austerity. We cannot afford to now.

These families are the living embodiment of how the system treats the symptoms – each bit coming at the problem through its own lens.

In the words of a worker:

Instead of starting with the problem or the symptom, we have to start with the family and work out from that.

That’s what family intervention is all about.

Family intervention is:

  • a dedicated worker dedicated to the family, someone who the family knows by name, who goes into their home and is alongside them, helping them to change
  • an assertive and challenging approach - challenging the family as well as supporting them and making it clear what the consequences are if they don’t change
  • looking at what’s really happening for the family as a whole – understanding and responding to the real problems
  • gives practical hands-on support – sorting out the chaos, getting a routine, simple things like proper meals and bed times
  • backed by an agreed plan and common purpose among services. This means one family, one worker and one plan - not one plan plus a youth offending strategy or one plan plus an employment package or one plan plus a healthy living plan.

In a nutshell, this approach is not assessing and telling parents they’re doing it wrong, but showing and helping them do it right.

I have heard people say ‘we’re already doing that’, but I’d ask you to question that.

In one area, an experienced social worker turned family intervention manager described it like this:

A typical approach might be to say, “I’m really concerned about your parenting capacity. We’re also concerned about the family environment. We are concerned about emotional warmth and we’re concerned about your ability to ensure your child’s safety and provide guidance and boundaries.

I’ve consistently asked people as I’ve been going around the country – and these are good people, people who work for you - what the difference is with the family intervention approach – how they ‘show’ and not ‘tell’.

One very experienced fully qualified social worker put it like this and I’m quoting her directly, so bear with me:

A social worker would discuss concerns with parents. This is likely to involve mainly talking. It may involve some direct work tools, eg a genogram or eco maps. A family intervention worker would adopt a very ‘hands on’ approach. For example, if the home was very dirty they would work with the family to clean up.

If the parents had difficulty getting the children up and ready for school the worker would go to the home first thing in the morning to help get the children up, together with the parents, and ready for school. If the parents weren’t providing proper meals, the worker might go shopping with the parents to buy food and then together help them to prepare a meal.

This helps to model behaviour and to show there is a better way to change some of the things the family want to change. It also has the benefit of doing an activity alongside a person which often ‘frees’ up the conversation. It becomes more ‘natural’ and honest. This practical way of helping and supporting change is very concrete and seen as helpful by the family in a very straightforward way.

Another key element is bringing challenge to families in a very straightforward way, in plain English, we challenge the status quo. If some aspect of family life or parenting or behaviour is not good enough the family are called to account. What is also done is to offer solutions. This is where the doing of specific tasks with the family comes in. Challenge is integral to the work of the family intervention worker.

I think there are similarities with family intervention and social work in that the relationship is key to bringing about change. Where the differences are is that family intervention workers have time, intensity, they challenge and are consistent and persistent. There may be the odd family that continue with a false compliance, but the intensity and challenge gets through. In some ways we work with ‘dependency’ as this can be a key to allowing families to reveal themselves.

In many ways we give messages not to create ‘dependency’, not to be soft or kind. I do not believe in this, as we all need to rely on others and we all need kindness. This approach is grounded in the reality of a family’s situation. We can care and we demonstrate this through respect, trust and reliability, challenge, authenticity and persistence.

Why am I labouring this in an audience of such senior people?

Because this is what is at the core of system change – changing who works with the families, changing how they work with the families, changing how the system organises itself around the families.

Put bluntly - we shouldn’t only be interested in how many assessments, how many pieces of work or how many discussions have been had with the family.

We should be interested in whether the family has changed. And for me at the moment that’s demonstrated by a few simple things - are they in school, have they stopped committing crime and are they ready or in a job?

Sounds easy but is actually revolutionary.

I don’t want to get into a dead-end debate about whether to focus on the child or the parent - somehow suggesting it’s a choice between polar opposites.

On one side we collude or are optimistic with parents to the detriment of the kids, on the other side the only solution to a family’s problems is taking a child into care.

Always choosing extreme positions won’t turn around troubled families and it won’t improve the life chances of their children.

It’s not speeding up removal of kids vs family intervention, it’s getting it right and doing it quickly.

Because there is too often a hellishly long procedure before a child is removed. As one social worker said to me yesterday, a child is often not ‘at risk enough’.

The parents may say enough and do enough to keep the children at home, while the system watches, preventing worse neglect and abuse - and I’m not undermining that very difficult job.

But it is not enough.

Let me be clear - I don’t want to leave kids with parents that can’t or won’t improve.

At the same time, I believe that family intervention when effective makes those decisions quicker and better informed.

One team meeting I heard about the other day marked the removal of a child into care more quickly in one family at the same time a child in another family was coming off a child protection plan.

Both good outcomes. But best of all, speed being of the essence.

Forgive me but saying as one person did to me a few months ago, ‘We have a world class safeguarding service - touch it at your peril’ simply misses the point.

I can’t tell you how to safeguard, but I can tell you how to intervene in a troubled family and I’m standing here today telling you there is room for both.

Where family intervention works alongside safeguarding, it comes into those situations where a child isn’t at risk enough to be removed, but not safe enough to be left and it lays bare what is really going on in that family, making easier the very difficult and important job of safeguarding.

And let’s face it, that’s something that all of us want to do.

I’m very aware of the fact that it’s you, not me, who go home at night carrying that responsibility for keeping children safe from neglect and abuse.

I do though, keep with me some sections of serious case reviews, as a reminder of the weight of that responsibility and I hope you’ll allow me to read a little from that now.

It’s striking that when you look the most awful and tragic cases that have resulted in a serious case review, there are some common themes.

Things like:

  • parents not ‘engaging’ so being left
  • a multiplicity of agencies all over the family
  • no-one grasping what was really going on
  • parents knowing how to play the system
  • lack of information sharing
  • lack of a ‘family focus’

One serious case review into a child who was killed in 2010 said about the mother, and I’m quoting:

She continued to refuse to cooperate with professionals and frequently complained about anyone who challenged her approach to the care of the children.

And it goes on to say:

Professionals and agencies frequently failed to question or challenge these views.

Quoting now from another serious case review, again where a child had died:

There was insufficient challenge by health and social care agencies about the nature and scale of substance misuse by both parents. The parents successfully deployed attack as a means of defence and diversion when challenged.

And from another one:

The extent of the parents’ lack of engagement, avoidance and dishonesty grew over time and although this was recognised by practitioners there was insufficient challenge by professionals and no sustained, planned approach to protecting the children.

What was lacking was the authoritative challenge to this lack of cooperation there was a lack of enforcement of consequences. There was a lack of challenge by practitioners across the range of agencies.

There is a sense that practitioners had a view that the sharing of information with the social worker absolved them of responsibility for authoritative action.

Quite clearly this lack of sanction, this lack of challenge, this lack of authority is not something unique to one case or one local authority - and I think many of us here do recognise it.

This programme therefore is about doing something fundamentally different. We need to drive radical reform across all public services, not just local government.

But this will take leadership.

You will have seen the announcement of an expansion of the troubled families programme after 2015, allowing us to bring this approach to a further 400 thousand families.

It’s no secret now that I went out during the spending round and fought to find more money to put together a new programme from 2015-16.

That’s because I believe and colleagues in local government believe:

  • we can prevent the need for many children to be on child protection plans or be taken into care by changing the way the family functions and by doing so earlier
  • we can tackle the problems families have better if we get to children with problems aged 4 rather than as excluded children in pupil referral units at age 11
  • we can change the way the police police so that if a family is the source of endless call outs, and the police know that the family is on the way to becoming a serious burden on the criminal justice system, the response is more than same reactive service each time 999 is dialled
  • we can work with families to make sure they register with a GP; increasing child immunisations and reducing A&E admissions.

The news that the programme will be extended from 2015, not even half way through our current programme, is credit to your leadership within local government - you are making such good progress on the Troubled Families Programme that the government wants to build on the approach.

It’s clear that from this time last year to now the numbers of families being helped has gone up ten fold.

The results claims this summer will be a test of credibility. But it’s clear that colleagues locally have gripped this programme and made it their own.

And it’s now abundantly clear that we have to maintain momentum on reforming services – to help families, yes, and to help our collective public finances too.

We know it works and we are proving it works. And it saves money.

The London Borough of Wandsworth has evidence that the net savings per family from this approach are £29,000 per year; and here in Manchester the City Council are projecting savings of £32,000 per family per year

So we have responded to the calls for the programme to be sustained and extended to wider group of families.

We want to reach a generation of children rather than be a 3-year initiative.

The expanded programme will be as much about system reform as it will be about reforming families.

Because if we don’t get his right, we will keep having families causing misery to themselves, their children, their neighbours, over generations.

I want though, to end with a thank you.

Without colleagues in local authorities and especially colleagues in children’s services as the leaders of this within local government, we would have really struggled with this work.

Your heads have always been full of wise advice and guidance, your doors always open to dispense it and, I believe, your hearts fully committed to helping these families and their children.

To quote one council chief executive talking about this programme:

It is an appeal to both the head and the heart and it unites Whitehall and the Town Hall in common purpose.

The future of this programme is in your hands and I really hope you will use the considerable power you have to be leaders for change.

And maybe we can give the children in these families a fighting chance.

So I wish you well and stand ready to help.

Published 16 July 2013