Agenda item
Support for Young Parents
To review the support which is available for young parents in Hackney.
Minutes:
4.1 Following on from work on the disproportionalities in perinatal mental health from the 2021/22 work programme, the Commission agreed to review the support available to young parents (under age of 25) in Hackney. The aim of this item was to:
· Review needs of young parents and ensure that this is being effectively met across local services;
· Assess how services work together to support young parents and as well as their children;
· Identify ways in which the local offer to young parents might be extended or improved.
4.2 A report from Public Health and Children and Families Services on services which directly support or commission services to support young parents was provided to the Commission. The report provided an overview of the range of support which is provided to young parents, including those who are care experienced.
4.3 As well as officers from Children and Families, Public Health and Education, the Commission also invited Cathy Ashley, the Chief Executive of Family Rights Group (FRG) to also attend. FRG is a national charity supporting children and families and which (among other services) provides dedicated advice, help and support for young parents.
4.4 Ahead of this meeting, the Chair and Vice Chair also held two focus groups with young parents to understand more about their experience of being a young parent in Hackney, the range of support they have received from local services and what they thought should be improved for other young people in their situation.
Public Health
4.5 Officers presented the published paper and highlighted the following:
· The Family Nurse Partnership (FNP) would no longer be commissioned to support young parents, but would be replaced by an Enhanced Health Visiting Service (EHVS). The FNP was a licensed service which meant it was inflexible in how it could support young parents (i.e. only support first time mothers under the age of 25, first child only up to the age of 2, and mothers cannot access the programme after 28 weeks of pregnancy).
· The new EHVS would be an additional tier to Health Visiting services currently commissioned which would not be age restricted, or focused on the first child, but would be based on needs of parents. Basing the EHVS within existing health Visitor provision would also enable support to be stepped up and stepped down as needed.
· The FNP will end on 31st August 2023 with new EHVS starting on 1/9/23. It was noted that the FNP had not taken on any additional clients since October 2023 when the decommissioning was announced. New young parents who would have qualified for FNP support are being cared for by universal services in the interim. Those currently on the FNP programme would continue to be supported, but would transition to the EHVS in September 2023.
· Other universal services provided through public health included a community based mentoring service which was also currently being re-commissioned. Other areas of provision included Clinical Health and Wellbeing Service and a substance misuse service.
Children’s Centres
4.6 Children's Centre leaders highlighted the following:
· Although there was no focused work on supporting young parents, young families in need were supported through the universal offer of Children’s Centres work. Around 11% of current users were young parents who used a range of specialist (e.g. PH Midwife) and open access services (e.g. Stay and Play). Open access services were used to identify those families who may need additional specialist support such as SLT.
· The Children Centres service was moving to a Children and Family Hubs model of provision. A key element of this new model would be the Start for Life offer which focused on the first 100 days of a child life after birth.
Children and Families Service
4.7 Children and Families Service leaders highlighted the following from the report:
· The number of care leavers and looked after children who were young parents was low in Hackney. This would suggest that the vast majority of care leavers are successfully parenting.
· The biggest concern for young parents is housing and the service aims to provide a range of options for care experienced parents which include mother and baby fostering, a dedicated mother and baby unit as well as more independent housing options. There are currently two 2-bedroom social rented properties available to care leavers annually.
· The National Adviser for Care Leavers visited the service in 2022 where discussions focused on the corporate grandparent role of the Council, and what that local offer would include.
· There are also plans to establish a care leavers hub in Hackney which could support activities like Stay and Play sessions which could support young parents. Peer support is central in helping young parents to develop supportive networks and personal resilience.
· Engaging fathers is a challenging issue and to encourage them to participate in the parenting process. Young fathers potentially have a lot to offer in terms of family support, but do need to be made to feel welcome and that they have a role to play. Too often statutory services appear to push young fathers away which should be challenged. It was acknowledged that whilst there were probably a number of care experienced young men who were fathers, the service was not aware of who these might be.
Family Rights Group
4.8 The Chief Executive noted the mission of the Family Rights Group (FRG) was to create a more socially just society in which the child welfare and family justice systems support children to live safely and thrive within their family, while strengthening the family and community networks of those children who cannot live at home. The FRG has 5 strategic priorities:
1. Families involved with the child welfare and family justice system are treated fairly, have their rights respected and are able to make informed decisions;
2. Children and families get the help they need, so wherever possible children can live safely and flourish within their family network;
3. All children, including those in care, have lasting and supportive relationships to sustain them throughout their lives;
4. Our child welfare and family justice systems – and wider society – promote social justice and create conditions that enable children to achieve their potential;
5. Children and families’ voices and experiences drive decision making at an individual and strategic level within the child welfare and family justice systems.
4.9 FRG works with Become, a national care leaver charity to provide dedicated advice, guidance and support for young care experienced parents and would encourage local services to refer young parents to this service where necessary. The FRG also conducted research into the needs of young parents which concluded that in many local authorities, the specific needs of this group were not sufficiently recognised in service priorities, or reflected in local protocols or practice.
4.10 The organisation also supports a dedicated website to provide advice, guidance and advocacy to young parents. When children’s social care was involved, young parents often felt the process to be alienating and had difficulty navigating and negotiating with care authorities. FRG found that young parent’s access to local independent advocacy and advice services was inconsistent, and was therefore a key part of a new FRG offer.
4.11 FRG also noted that there was a failure to fully recognise young fathers as a resource, and consequently were often not fully incorporated or left out of support plans for young families. Young fathers had spoken of being ‘ghosts in the room’ thereby limiting the potential support role that they and their wider family may be able to provide.
4.12 Further feedback from the national helpline suggested that a number of authorities continued to hold child protection conferences on-line. Parents indicated that the on-line format was problematic as this did not help them to understand or engage with proceedings and the decisions being taken (e.g. it was often difficult to know who was in the room and the role that they played, and how they themselves could contribute).
4.13 The importance of co-design and co-production was also emphasised by the FRG to ensure that local services acknowledged and responded to the needs of young parents. From its own work and from its knowledge of what worked in local authorities, it was important that engagement to support this was not ‘one-off’ but through established and ongoing structures.
4.14 The Born into Care Study highlighted higher levels of care proceedings with children born to young mothers. Analysis of calls to the young parents helpline operated by FRG also noted the frequency at which domestic violence featured in concerns presented. It was suggested that this should also be reflected in local plans to support young parents.
4.15 To conclude, a key defining feature of the needs of young parents, particularly those with care experience, was that in many cases these young people were socially isolated and did not have an extensive network of support from families or friends. In this context, support for young parents should focus on helping them to build relationships to extend their network of support.
Feedback from Focus Groups
4.16 The Commission held two focus groups with young parents who were care experienced and facilitated by Hackney of Tomorrow. The key issues to emerge from these focus groups are summarised below:
4.16.1 Accessibility of key antenatal and maternity services:
These services felt intimidating for young parents to access, particularly as some young parents accessed these services alone;
Young parents also questioned whether such services were aware of their specific needs?
4.16.2 Housing issues for young parents was a key issue and figured prominently in all discussions:
· Some young parents described how they were moved multiple times before the birth of their child over to setting in which they had little choice and were often given little notice;
· Young parents were often placed in temporary accommodation which left them unsure of their future options for them and their child, and they also questioned the suitability of such placements for mother and babies (e.g. single room with cooking facilities enclosed);
· Those placed in temporary accommodation cited that this was frequently outside of the borough and away from their social support networks.
4.16.3 Young parents also spoke about their postnatal mental and emotional health needs:
· A number described feeling isolated after the birth and as a single parent, which was compounded by transient nature of housing and accommodation;
· Young parents also noted that there were limited opportunities for peer support - to engage and share with other young parents;
· Whilst young parents understood the need for some restrictions on visitors to temporary accommodation units where they may be staying, this further limited opportunities for social contact and support.
4.16.4 Care experienced young parents reported strong and positive relationships with their social worker (SW) and or personal adviser (PA).
· There were a number examples of positive and affirmative support for young parents from their SW/PA, though some were better equipped to support them in their journey to parenthood than others (a social worker offered to be a birthing partner and another knitted a blanket);
· Care experienced young parents were also unclear how to manage the boundaries for social work support for their child and for them as a care leaver and felt that they needed additional support in this respect.
4.16.5 Access to education, training and employment was of critical importance to young parents;
· With additional care responsibilities, young parents noted the importance of advancing training and work opportunities to support their family;
· There were mixed responses as to the range of support provided, greater access to local apprenticeship programmes would be beneficial;
· Access to childcare and support was critical to them developing education and training opportunities, but not all were made aware of the Care to Learn programme.
4.17 The Chair noted the specific concerns of care experienced young parents and how growing up in care had impacted on their relationship with statutory care services and how uncomfortable issues could be raised, for example, issues around their own mental health. Young parents were anxious that such concerns would be dealt with and possible wider implications for their family.
Questions from the Commission
4.18 Given the complexity of the needs and service response needed to support this cohort of young parents. Is there a shared understanding of the needs and the service priorities of young parents across the local partnership of services? Where does effective oversight of the partnership of services which support young parents sit and does it ensure that services are working together effectively to support the needs of young parents? How is Hackney working to ensure that young parents have access to a consistent service? Specifically, what are the current local priorities for supporting the needs of young parents?
· It was acknowledged that it can be challenging overseeing support for care experienced young mothers, particularly when they may be living outside of the borough. The children and families service (CFS) was working to extend the reach of local services to support this cohort, to ensure continuity of support and maintain connections with Hackney. CFS also welcomed proposals to extend peer mentoring and would follow this up with Public Health, particularly if this programme could be used to support care experienced young people. CFS was also cognisant of its Corporate Grandparent role and it was encouraging to note the practice of social workers in supporting care experienced young parents.
4.19 The Commission welcomed the commitment to extend peer mentoring support to help develop emotional resilience among young parents, and requested further information on the scope and priority for this work and timeframes for implementation.
· It was acknowledged that young parents may face difficulties accessing services because they lack knowledge or confidence to do so. Building trust was also a key aspect of working with young parents. Support for parents on the vulnerable parents pathway was focused in 3 areas: signposting, crisis support and peer mentoring. The latter was a relatively small part of the service at present, helping around 35 women per year, but there were plans to extend this within a new provision which would help to break down barriers to accessing services. It is hoped that the newly commissioned service will support around 180 women per year. There will be a mobilisation period from September 2023 which will take time to recruit and train peer-mentors. It will also be important to ensure that peer mentors reflect the demography of local service users. There are no time-limits on the service as the service will be ‘needs led’.
· FRG noted the work that Camden Council were doing around peer mentoring and advocacy. It was felt that this could be a very powerful tool to assist young parents in very challenging contexts.
4.20 In its corporate parenting role, does the council provide sufficient training for care leavers to support positive and effective parenting? Would this be possible to introduce some form of training?
· Children’s Centres already have a universal support offer to parents, but through the establishment of Children and Family Hubs would provide a more universal offer for 0-19 year olds, and there would be scope to include parent training within that. It was possible that a linkup between Young Hackney, Secondary Schools and Family Hubs could be used to extend training and development support to parents. It was also emphasised that placed based partnerships such as those between local children's centres, Public Health midwifery and wider family support offered seamless and integrated support to young and other vulnerable parents in accessible and safe spaces.
· This also related to local ambitions for the development of a care leavers hub to provide integrated multi-agency support from a singular setting, and this would be an opportunity for parenting training.
4.21 What were the FRG views on best practice for engaging and supporting young fathers? If peer mentoring is not open to young fathers, what engagement is happening?
· The Start for Life model which is part of the Family Hubs programme does have a work stream which acknowledges the need to engage and work with fathers. One of the Children’s Centres (Ishan) had recently undertaken some developmental work with fathers and learning from this would be shared across the wider children centre network.
· The FRG noted that fathers details are often not recorded in children's social care records, and when these were recorded there was very little detail of the nature of their engagement and support to the family, contact details were out of date. Unsurprising, fathers were less likely to be involved in later proceedings around the welfare decisions of their children. One of the models of good practice was St Michaels Fellowship in Lambeth which identified the need for father specific work and for those activities which helped to build trust and confidence among fathers. There was also an acknowledgement that to be effective, interventions need to be sustained.
4.22 The report indicates that 29 young people accessed an evidence based parenting programme - can further details be provided on this scheme and the outcomes?
· In relation to the evidence based parenting programmes a number of models were used including Strength Through Families and Through Communities. These were 12 week programmes which were evidence based but which did require a sustained level of commitment from families.
4.23 Young parenthood can be difficult to talk about in some communities (such as Middle Eastern countries) which may inhibit young people from obtaining the help and support that they need. What is the council doing to ensure that its support offer to young parents is accessible across all communities? Similarly, what are the maternity needs of young people in the Orthodox Jewish Community and are they any different to the wider community and if so, is there any dedicated support for this community?
· It is important that vulnerabilities are picked up by universal services, irrespective of their community background and ensure that they are referred onward to more specialist services. This is the aim of the new Enhanced Health Visiting Service which will exist in wider universal health Visiting offer. The new provider has been made aware of the vulnerable groups locally and the range of other services which are available to collectively support them.
· The HV service is the universal offer and the first port of call for many families and the route into more specialist services as needed. In relation to the Orthodox Jewish community there is a dedicated Children’s Centre (Lubavitch) which provides a range of family and parenting services to the community.
4.24 Continuity of care is often cited as a key factor in better maternity outcomes for mother and baby. What can we do as a local authority to promote continuity of care for young parents pre and post pregnancy?
· Continuity of care is important for better outcomes and there was evidence to suggest that some vulnerable groups were less likely to receive it. It was therefore important that the local offer to young parents and other vulnerable parents was integrated, which would be exemplified in the new Enhanced Health Visiting Service which was embedded within the wider universal health Visiting offer with the same provider and would therefore allow young parents to step-up or step-down care as needed.
4.25 In terms of the existing family visits offered by the Family Nurse Partnership, how would the new Enhanced Health Visiting offer compare? Is there not a risk that the expertise of supporting young parents within the FNP might be lost within the EHVS? How can this specialist knowledge and offer be retained within the universal service?
· The mandated visits (x 5) and the additional visits (x3) detailed in the report relate to the lower parenting support offer. The intensive tier (equivalent to FNP) has been left open in terms of visits as the intention is that the service was to be ‘needs led’ and could be more or less than 64 sessions.
· Family Nurses were experts in supporting young parents, and where possible it was hoped that these progressions would be retained within the new EHVS and the service was in negotiations to TUPE this cohort of workers over into the new services. This will not only help to retain knowledge and experience within the service and wider HV service, but also extend specialist knowledge through training other HV staff.
4.26 Can young parents be further involved in helping to shape the EHVS offer?
· The new service model has already been developed and put out for tender and commissioning, so in this context, it would be difficult for young parents to shape new provision planned for September 2023. Whilst the outline model has been agreed, the service was engaging young parents and family nurses alike to further guide and inform the development of the new EHVS. It was important to capture the insight from what works in the FNP model and replicate this in the new EHVS.
· The Cabinet member for Families, Parks and Play noted that Parent Carer Panels had been established to support the development of family hubs and would ensure that these contain representation from young parents.
Agreed: The Commission would liaise with Hackney of Tomorrow and Parent Carer Panels to ensure representation of young parents.
4.27 The Group Director reported that high quality universal services were important so as to have sufficient reach to across varying levels of need in the borough, and the new EHVS would be dependent on the intelligence and insight of these services (e.g. Health Visiting, Midwifery) to effectively target young parents in need. The Group Director assured the commission that a focus on the needs of young parents would be retained within the new EHVS.
4.28 The Family Rights Group made the following concluding remarks in terms of good practice which may be considered in Hackney. It was reiterated that where young parents are involved in the planning and development of local services it helps to ensure that the needs of this group are met and helps to maintain engagement with local services. It was recommended that the authority review the service offer at Hertfordshire to help benchmark local provision for young parents.
4.29 The Chair thanked Cathy Ashley for attending and to officers for the preparation of the paper and responding to members of the Commission. The Commission would prepare a summary of the key issues to emerge from the scrutiny of this session and forward conclusions and recommendations to the Cabinet member for consideration.
Supporting documents:
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Item 4 - (Coversheet) Support for Young Parents, item 4.
PDF 55 KB -
Support provided to young parents - CYP Scrutiny commission - 20-3-2023, item 4.
PDF 343 KB