West Sussex Council’s substance misuse service has set up a dedicated family team to help ensure the needs of children whose parents are under the care of the team are properly catered for.
The service has also developed a close relationship with local NHS services working with pregnant women and new parents.
Drug and alcohol misuse is a factor in a significant number of children in need and child protection cases with research suggesting it is linked to up to 70 per cent of care proceedings.
Overall an estimated third of all adults in drug treatment have childcare responsibilities. For some, this encourages them to seek treatment – and means that treatment is more likely to be successful.However, substance misuse services need to make sure children in these situations are not at risk of neglect or are not taking on inappropriate caring roles.
Like many areas, West Sussex Council’s substance misuse service follows safeguarding children policy, which requires home visits when there are children living in a service user’s home.
Priority is given to households with under fiveyear-olds, where the service user is pregnant or where there are children with disability or other vulnerabilities.
The policy also covers safe storage of medication and where very young children are present the team aims to prescribe buprenorphine rather than methadone.
But the West Sussex Council service – run by Change Grow Live – has gone further than this. Last year it signed a joint working protocol with the two hospital trusts and three CCGs in the areas, covering the perinatal period – pregnancy and the first year of the baby’s life.
It means there are clear criteria regarding referrals and information sharing and joint strategy and operational meetings.
The dedicated family team is core to much of the work that West Sussex does on safeguarding.
There are three family workers, each with responsibility for a third of West Sussex. They are there to offer advice and support to the rest of the substance misuse service and can carry out home visits and help with the needs assessment.
For the most complex clients, they also take responsibility for co-ordinating their care. Impact The family team hold approximately 40 complex cases between them. This number allows them to be able to have more time to liaise with other professionals – and ensure the right support is given.
Kelly Pierce, the Consultant Midwife in Public Health for West Sussex, said the work that had been done meant maternity and drug and alcohol services were “closely aligned” and as a result the pathway between the two was “robust and smooth” and did not leave pregnant women feeling stigmatised if the needed help.
“That is essential as thresholds for using substances are considerably different in pregnancy due to the risk to the unborn baby,” she added.
There are other examples of the benefit this expertise and close working relationship brings.
For example, children are welcomed to attend treatment services, with careful consideration taken of other potentially volatile service users.
The family team is also in a position where it can train older children in how to administer the anti-overdose drug Naloxone under certain agreed procedures.
In one recent case a young person was given training, at their request, as they had previously needed to call an ambulance for their mother following her experiencing an overdose.
The family team was set up two years ago, but the way it works has changed over time.
Initially it did not do the case holding. Instead, the team was solely there to support the rest of the service.
Katherine Wadbrook, who manages the family team, said: “The case-holding came later. We developed that side of it.
“Two of the three members of the family team are social worker trained so it seemed the right use of skills and experience to get them doing the most complex cases.
“They might take on clients who are pregnant or where there are lots of children. They tend to have smaller caseloads and can spend more time on these cases where appropriate.”
How the approach is being sustained
As a result of having experienced staff working on child protection issues - as the family team does - the substance misuse team has been invited on to the local MultiAgency Safeguarding Hub (MASH).
Just one member of the team has been trained to sit on the MASH, but in the future Ms Wadbrook wants to get the other two members trained to share the workload and responsibility.
Rachel Tandy, the council’s Early Help MASH Manager, said there was a number of positives to having the substance misuse team represented. “It enables vital information to be requested and supplied in a timely manner.
“The information is part of wider picture so all factors can be considered and help to form part of the decision making.
“In addition, it enables case consultation about the support that can be offered not only to adult but to children and young people if this would be appropriate.”
Katherine Wadbrook Service manager West Sussex Young Persons and Families Services firstname.lastname@example.org