Throughout the COVID-19 pandemic and lockdown, many services (statutory and third sector alike) stopped all face-to-face contact with service users and started working remotely. This shift in support was especially difficult for clients experiencing multiple and complex needs (MCN), including learning disabilities (LD), where the right type of communication is vital for understanding.

This article is about the importance of collaboration between services and an example of good practice when supporting women with MCN and LD through care proceedings.

We, at Fulfilling Lives South East (FLSE), together with Brighton & Hove Speak Out (BHSO) are currently working with the same mother, who has MCN and a LD. This mother’s child is subject to care proceedings and is currently living in foster care. This collaboration has highlighted some obstacles in the system for the mother from a front-line perspective, as well as advocacy point of view.

The FLSE Women’s Specialist Worker and BHSO Advocate agreed that it was much harder to build a trusting relationship remotely, and that effective communication was impaired

Whilst FLSE continued face-to-face support throughout the pandemic; the BHSO Advocate and Specialist Adult Social Worker were only able to offer remote support. When reflecting together, the FLSE Women’s Specialist Worker and BHSO Advocate agreed that it was much harder to build a trusting relationship remotely, and that effective communication was impaired. In some instances, the client’s mistrust of professionals and their misunderstanding of her and her partners’ behaviour, led to them making assumptions, which the FL Women’s Specialist Worker needed to challenge.

During the client’s pregnancy and post-birth, all Children’s Services meetings were held using video-conference facilities. Court hearings, parenting assessments and support, were also remote during this period. Children’s Services enabled digital access for some of the meetings at their premises; at other times the FL Women’s Specialist Worker had to provide equipment in alternative locations. Where the physical equipment was available, the FLSE Women’s Specialist Worker supported the client to use the technology, and to understand, communicate, and regulate their emotions. The BHSO Advocate was able to support the understanding of information before and after each meeting and feed the client’s voice back into the process. Without FLSE’s support, the client risked complete exclusion from the care proceedings.

Unfortunately, digital inclusion does not always reach the most marginalised people, including people experiencing MCN. The push for digital inclusion when providing essential services, for example health care appointments, adult social care support and court proceedings, has demonstrated just how many vulnerable adults do not have easy access to laptops and the internet. Even when digital access is available, communication via this method offers challenges to all participants. Non-verbal communication is much harder to recognise, multiple voices can be hard to follow, and a large number of participants can be intimidating. This type of communication is additionally difficult for those with a LD who have additional communication and processing needs and requirements.  With the parenting assessment and support also being conducted on-line, this again creates a further barrier for those with MCN.

FLSE would like to call for a person-centred approach for key meetings, to enable professionals to meet clients in a safe way to reduce the impact of exclusion and reduce the infliction of further trauma

FLSE would like to call for a person-centred approach for key meetings, to enable professionals to meet clients in a safe way to reduce the impact of exclusion and reduce the infliction of further trauma. In this case, the Local Authority applied for the child to be removed from the mother’s care at birth. The FLSE Women’s Specialist Worker supported the mother at hospital just after her birth, to make sure her voice was heard in meetings, medical exams and at the virtual court hearing. As the mother had a diagnosis of LD, she had access to a Specialist Adult Social Worker who was able to arrange this support and other reasonable adjustments whilst she was on the ward. Without this collaboration between the Local Authority, NHS and FLSE, the event of having a child removed at birth would have been even more traumatic for the mother.

When reflecting with BHSO, we agreed that the child protection process is very child focused – and rightly so. However, we would like to see an improved understanding and implementation of the communication and support needs of parents with LD, at the start of Local Authority interventions. Easy read documentation of the processes, key reports and assessments are rarely made available by children’s professionals, yet they are essential for the vast majority of MCN and LD mothers, as is, allowing additional time for processing and understanding information. Advocacy at the earliest opportunity is also essential within the tight child timescales, along with referral to adult services and other 3^rd party support as needed.

FLSE and BHSO, would also like to see specialist support for parents with LD going through child protection and care proceedings. This includes conducting parenting assessments in a more LD friendly way, focussing on what parents can achieve, rather than just their struggles. Where support needs are identified, commissioners should ensure that services are available and accessible. This includes longer-term parenting support options, (such as Shared Lives- a scheme that matches someone with care needs to an approved carer), relationship safety support and awareness, and a holistic approach as provided by FLSE.

The right support and a trauma informed approach with the time and care put in at early stages can have a lasting positive effect on their recovery and reduce the likelihood of another pregnancy

We know that women who are going through child protection processes and care proceedings are likely to be experiencing MCN and LD. These parents often face increased stigma, and without advocacy to challenge professional behaviours, this will continue to exacerbate harm. However, the right support and a trauma informed approach with the time and care put in at early stages can have a lasting positive effect on their recovery and reduce the likelihood of another pregnancy.

Throughout our client’s journey and together with BHSO, peer support between the FL Women’s Specialist Worker and BHSO Advocate was appreciated and this collaboration has shown that a flexible and trauma informed approach can lead to positive relationships, not only for organisations but most importantly for the wellbeing of the mother.

Authors: Michaela Rossman, Gemma Harfleet & Nicola Johnson