Team: Specialist Intervention Service Therapy Team

Partners: Children’s Social Care, Foster carers, Young people, Parents, Social workers, Therapy Team

Main Submission:

Despite being the 7th smallest London borough, LBBD faces significant economic challenges, high child poverty, significant health inequalities, and elevated mental health issues with 1 in 5 young people ages 8-25 having a probable mental health disorder. According to the 2021 Census by the ONS, 44.9% of LBBD residents identify as White, making it the dominant cultural identity in the area (ONS, 2021). The remaining residents identify as Asian (25.9%), Black (21.4%), mixed or multiple ethnic groups (4.3%), and other ethnic groups (3.6%).

The aim of the project was to place a cultural lens on Play and Creative Arts therapy practise in a children’s social care setting in order to create incisive thoughtfulness around cultural attunement and sensitivity to ensure that therapists engaged with and were committed to considering painful unconscious bias and developing greater understanding of joining with children and young people around the understanding of culture in every therapy session. The therapy manager determined to increase and optimise the cultural and ethnical diversity of therapy staff, to sustainably affect the service and continuously attend to both personal and systemic racism. The project was also designed to theorise and conceptualise reflection, supervision, and practice. Three new staff members were specifically employed via grant funding. The results from the project showed a profound increase in cultural consideration and an expediential change in hopefulness with the children and adolescence as their cultural richness and complexity was explored.

The team were able to theorise and conceptualise around practises within play and creative arts therapy, to consider stereotypes, reduce play therapy practise bias, consider optimum cultural engagement with child, young person and parent and become more culturally inclusive. The project aimed to enhancem therapeutic services for children and young people in care and on the edge of care, by providing tailored interventions that considered the unique cultural needs of each individual. The therapy manager determined to increase and optimise cultural and ethnical diversity of therapy staff, to sustainably affect the service and continuously attend to both personal and systemic racism. ‘The culturally sensitive therapy project’ was designed to theorise and conceptualise reflection, supervision, and practice, and 3 new staff members were specifically employed via funding.

Between December 2023 and August 2024, 21 children and young people were referred for Play and Creative Arts therapy. 9 of those were offered a culturally connected therapy intervention with a culturally matched therapist. Extensive academic and clinical research was conducted alongside the interventions to ensure they aligned with current theories, neurodevelopment, multicultural thoughts, and clinical practices. The bond and trust building was exponentially increased as a result of cultural matching and ensuring attention was paid to race, culture and identity in every session. The project resulted in a psychoanalytically informed report which incorporated play and creative therapy techniques, strategies, and quotes from the children and young people involved. The pre and post therapy scores of the young people in relation to being culturally understood were considered. It focused on race as a concept, developing a culturally sensitive therapy space, considering the impact of culture and gender in relation to identity, the therapists engagement with culture and trauma, the importance of placing a cultural lens on systems and organisations, creating emotional awareness and shift in racist thoughts in the therapist and therapeutic space, considering cultural competency in relation to de-colonising of play therapy methods, dismantling internalised racial oppression, benevolent neutrality and the notion of cultural matching.

Two siblings accessed a group therapy intervention and said that “having had this safe space has helped us to understand our Pakistani cultural challenges and not feel judged. We can also now see our mother’s point of view since she has moved away from our faith beliefs, but we are now able to accept we can bear to see her again. We could not have done this without the therapy.” One young person said “I feel empowered in my therapy sessions because my therapist understands my position as someone who is a non-White British with the pressures of having to balance my parents’ expectations and be an ordinary teenager. I feel connected to my therapist as she is also Asian like me”.

9 young people were helped to navigate living in high-cost care placements, their internal emotional turmoil, and adverse external events. These factors destabilised their emotional maturation and capacity to understand their lives and explore new possibilities. They were considered holistically regarding physical, psychological, and neurological changes within their social and cultural context. Identity and culture were recurring themes in therapy sessions, as the young people sought to make sense of their traumatic lived experiences and the impact these had on their sense of self. Psychoeducation, as needed, helped children and young people understand their actions, provided theoretical context for their behaviours, and help them makes sense of their cultural identity.

Theoretical and therapeutic insights were shared with parents, carers, social workers, and decision makers, which enhanced the effectiveness of partnership working. This ensured the views, hopes, and experiences of the children were conveyed and understood by all, leading to better outcomes, increased stability, and lower risk levels, as the child’s needs were being met effectively and appropriately.

One case example is that of F 14-year-old trans adolescent of mixed ethnicity, who was offered 13 sessions of Play and Creative Arts Therapy. She was culturally matched with her therapist and together they explored her sense of identity and the intersectionality between culture, gender, sexuality, and race. By the end of the intervention, a CORE- outcome measure showed a 42% reduction is psychological distress. Alongside her therapy sessions, her mother also received therapy to explore her world and understanding of her child’s. By the end of the intervention, F said “I feel like I know myself for the first time. Having an Asian therapist who shares our cultural experiences makes it easier for us to open up, she gets where we are coming from. We feel like we can be ourselves in therapy as she has created a safe place for us to discuss our cultural challenges. I would like to thank my therapist whose Asian background gives us a special connection. It’s comforting to talk to her because she understands our background and values which makes it easier to discuss these really shameful and sensitive things”. Her mother said “the environment is like a normal therapy room, she has let me lead and gently speak.

I am so lucky to have had this support. We now spend time together. I am no longer overwhelmed, and I can see my children for who they are and can let them grow.” As a result of this project, bi-monthly systemic team meetings with a cultural lens had been implemented to discuss all casework with a cultural lens. This is a model which could and should be replicated across all local authorities to ensure that good culturally appropriate practice is consistently considered. By doing so, we can reduce racial disparities and tackle organisational and systemic racism in the workforce.

Team: Specialist Intervention Service Therapy Team

Partners: Children’s Social Care, Foster carers, Young people, Parents, Social workers, Therapy Team

Main Submission: Despite being the 7th smallest London borough, LBBD faces significant economic challenges, high child poverty, significant health inequalities, and elevated mental health issues with 1 in 5 young people ages 8-25 having a probable mental health disorder. As of 2023, there were over 600 children and young people were in care, showing a significant need for effective mental health provisions.

The Tenacious Teen Project aimed to enhance therapeutic services for LBBD adolescents by providing tailored interventions that meet their unique needs. Between December 2023 and August 2024, 15 young people aged 12-16 were offered 145 Creative Arts Therapy sessions. Extensive academic and clinical research was conducted alongside the interventions to ensure they aligned with current theories, neurodevelopment, and clinical practices.

The project resulted in an 8-part research paper detailing adolescent developmental stages, appropriate theoretical models, therapy interventions and skills, neurobiology, and creative arts therapy activities. It also included recommendations for improving therapy interventions for LBBD teenagers in care, or on the edge of care. Nine case studies were included as evidence of how academic research can be used to provide therapeutic insights that support the voice of the child, inform decision-making, and provide the best outcomes possible.

15 young people were identified, and the project aimed to help them navigate living in (high cost) care placements, their internal emotional turmoil, and adverse external events. These factors destabilise adolescents’ emotional maturation and capacity to understand their lives and explore new possibilities.

Each teenager entered the project at a state of flux, needing a safe space to organise thoughts, feelings, and consider life decisions. The project holistically considered physical, psychological, and neurological changes within the adolescent social and cultural context.

Identity and culture were recurring themes in therapy sessions, as the young people sought to make sense of their traumatic lived experiences and the impact these had on their sense of self.

Psychoeducation, as needed, helped adolescents understand their actions and provided theoretical context for their behaviours.

Theoretical and therapeutic insights were shared with parents, carers, social workers, and decision- makers, which enhanced the effectiveness of partnership working. This ensured the views, hopes, and experiences of the young person was conveyed and understood by all, leading to better outcomes, increased stability, and lower risk levels, as the young person’s needs were being met effectively and appropriately.

Additionally, collaboration with the LBBD in-house therapy team and external mental health provisions like CAMHS stabilised emotional disturbances caused by environmental factors, and ensured all stages of mental health challenges were being identified and adequately supported.

One case example is that of ‘A’, a 16-year-old cis-female of mixed ethnicity, who was referred for Creative Arts Therapy due to sexual abuse, sexual assault, grooming, self-harm, inappropriate online behaviour, physical chastisement, and difficulties with family relationships. ‘A’ started her intervention in June 2024, and although the work is still ongoing, by the end of the project she had received 6 therapy sessions.

She worked with a culturally sensitive therapist whose approach increased the bond and trust building as a result of cultural matching as they ensured appropriate attention was paid to race, culture and identity within the sessions.

Her case study focused on theory and research to better understand sexual development in middle adolescence, and the impact of sexual abuse, self-harm, culture, mixed heritage, and trauma on relationship and identity formation. Details of Creative Arts activities used within her sessions were explained, and 10 outcomes of the work were identified, which included an understanding and acceptance of her identity, increased feelings of hope, improved coping strategies, reduced self- harm, and enhanced safety awareness. She has been empowered to advocate for herself, knowing that her voice will be listened to. (see supporting materials for full case study).

A expressed deep appreciation for her creative arts therapy, recognising its profound impact on her life. She said “I have always felt like I was in a bubble and didn’t feel like anyone cared if I was alive or not, but therapy has helped me see the good things in my life. I have things and people to live for.”

Initially A was unable to identify anything good about herself, but through this safe and supportive intervention, she discovered that her past trauma had led her to build a metaphorical protective wall around herself. She was supported to explore this wall and eventually was able to identify positive qualities, strengths, and skills as the bricks her wall has been built with. This realisation boosted her confidence, empowering her to attend and even speak up in professional meetings. Her self-harm incidents have dramatically reduced, as she now wants to stop for herself, not just because she was told to. Due to high levels of risk, A started working with CAMHS but realised that her needs were being met by this approach and intervention, and she discharged herself. This not only empowered her to responsibly engage with an intervention that was working for her, but it also reduced the caseload of CAMHS, enabling them to use their resources accordingly.

Each of the 8 case studies follows a similar format, coupling theory, research, and adolescent development with areas such as death and bereavement, complex relational trauma, risk taking, substance misuse, attachments, gender identity, neurodiversity, life in care, masking, religion and spirituality, and disordered eating.

Key challenges of the project included difficulties collaborating with social workers due to systemic issues, teenagers’ reluctance to engage in therapy, and time-heavy administrative tasks. Solutions identified included clearer communication of expectations at the start of an intervention, amending the structure of therapy interventions to offer more choice and control to adolescents, and adapting the LBBD forms to reduce therapist admin while preserving therapeutic reflections. These recommendations are now embedded or in the process of being embedded in business-as-usual practice, but it not yet permanently funded.

Supporting Information:

Team: Barnet Specialist Autism Team

Partners: Owen Chiguvare, Tokunbo Agunbiade, Aisha Tijani, Geoffrey Kidega

Main Submission:

The Specialist Autism Team in Barnet was established to address the growing needs of children and young people with autism and complex associated needs, aligning with the ambitions set out in the National Autism Strategy 2021-2026 (The national strategy for autistic children, young people and adults: 2021 to 2026 – GOV.UK). Formed in 2020 with a small support team of two social workers, the team has since expanded to include 1 team manager, 1 advanced practitioner and 5 Social Workers. This team works to ensure every child and young person with autism, regardless of complexity, has the support they need to thrive in their communities.

By focusing on multidisciplinary collaboration and evidence-based interventions, the team tackles key barriers faced by children and young people with autism by:
• Primarily addressing gaps in care and support across the continuum of autistic and co-occurring complex needs.
• Improved understanding and acceptance of autism within society.
• Improved access to education, health, and social care services for autistic individuals.
• Reduced health inequalities and improved outcomes for autistic individuals.

• Challenges Addressed:
  a) High rates of hospital admissions for autistic children with complex needs.
  b) Children and young people with autism coming into care due to a lack of community support.
  c) Barriers to accessing inclusive education, often leading to school exclusions or emotionally based
  school avoidance (EBSA).
  d) Addressing the impact of unmet needs on overall wellbeing and behaviour.
  e) Limited access to evidence-based interventions tailored to the complex needs of autistic children.

• Ambitions:
  • To build a pioneering model of support that empowers children and young people with autism to live safely, confidently, and successfully within their communities.
  • To align local interventions with the National Autism Strategy by enhancing education, health, and social care integration for autistic children and young people.
  • To create a replicable, multi-disciplinary model of autism support, addressing pan-London as well as wider nation-wide challenges.

• Objectives:
  • Enable neurodivergent children and young people with high support and complex mental health needs to live safely within the community.
  • Reduce reliance on costly and often disruptive services, including out-of-borough placements, residential care, and emergency health interventions.
  • Improve education, health, and wellbeing outcomes for children, young people, and their families.
  • Reduce reliance on intensive services, including hospital admissions, residential care, and emergency health services.

1.Actions, Activities, and Initiatives to Achieve Objectives:

a) Initiatives Designed to Deliver Commitments. SAT core aims align with National Autism Strategy 2021-2026; further emphasis is placed on key learning reviews, reports from commissions of inquiries reviews, and latest research papers to ensure that the team is adaptive to the ever-evolving intervention landscape and dynamics.

b) Ensuring Staff Stability: The Specialist Autism Team benefits immensely from Senior management support and leadership; addressing staff retention; promoting job satisfaction; inviting external scrutiny and reviews. The reviews and inspections are used as mechanisms through which key learning is incorporated, internal research and knowledge transfer is promoted to improve the outcomes of autistic children and young people. A further emphasis is placed on promoting student placements within the team to harness an array of benefits like, the fresh perspectives that the students bring; building future workforce; holistic skill development; understanding of evidence-based work and promoting a culture of reflection and, perhaps most importantly, providing insight into systemic practice where students gain valuable experience in navigating local authority processes, statutory responsibilities, and partnership work with families, schools and health services.

c) Managed Caseloads: Prioritizing caseload sizes to ensure meaningful engagement with autistic children and young people.

d) Relationship Building: Strengthening trust with families and individuals to foster long-term impact.

e) Multiagency Collaboration: Bringing together health, social care, and education professionals to ensure a joined-up approach to complex needs.

2. Best Practices Implemented:

a. Public-private partnerships for Bespoke Support:
i. Autistic Peer Mentoring: Enabling children and young people to connect with autistic mentors to foster understanding and empowerment.
ii. Autistic Discovery Journey: Interactive, strengths-based programs that help children explore their identity and develop self-confidence.
iii. Bespoke mentoring for ADHD and associated needs: Supporting cooccurring condition with tailored interventions.

b. Health Partnerships:

i. Development of clinical pathways that include autism-specific interventions, such as ADHD therapy (CBT, DBT), family psychotherapy, and trauma-informed approaches.
ii. Incorporation, working in collaboration with the ICB, Dynamic Support Registers and an inhouse Complex Care Partnership panel to ensure coordinated care collaboration with Adult Services.
iii. Implementation of personalized Communication Passports for children to support consistent care across settings.
iv. Early Transition Planning

c. Social Care and SEN Partnerships:

i. Collaboration with autism advisory teachers to support children in mainstream and specialist schools.
ii. Dedicated social care support for families navigating the EHCP process.
iii. Provision of blended online learning and/or mentoring or 1:1 tuition (home, safe spaces) for children experiencing emotionally based school avoidance.

d. Promoting Awareness of Contextual Safeguarding:

I. Coproduced risk assessments in collaboration with families and professionals.
II. Strong partnerships with local police to address absconding behaviour and mitigate risks of criminal exploitation
III. Complying with the wider Pan London safeguarding protocols.

3. Evidence of Impact:

In 2024, Research in Practice ( Supporting evidence-informed practice with children and families, young people and adults | Research in Practice) was commissioned to provide an independent evaluation of the team to inform its future direction. Across the evaluation, evidence highlighted them unique approach the team adopts to support autistic children and young people. A copy of the report is herein attached.

Research in Practice Evaluation Outcomes Highlighted in the Report:
i. Preventing Tier 4 admissions and entry into care. and improved crisis response.
ii. Improving access to education through successfully working with schools to understand individual needs and where possible implement reasonable adjustments to support attendance increased access to education and reduced rates of school exclusions.
iii. Behaviour and mental well-being where the team work with families to implement predictable structures and routines, supporting development of healthy coping strategies, thus improving functioning, self-esteem and wellbeing.

Key in all these circumstances was children, young people and families benefitting from the team’s expertise and capacity to help them in navigating complex health, social care and education systems

4. Ofsted Inspection October 2024: Outcomes Highlighted:

In June 2024, the Ofsted Inspection of Barnet Local Authority Children’s Services rated the ‘experiences and progress of children in care’ as outstanding with the report highlighting the expertise of the Specialist Autism Team as a key strength. A copy of the report is herein attached.

5. Feedback and Testimonies:

a. From parents

• ‘All we were told was that a residential provision was the best option for our son. But the Social Worker was very thorough in his assessment, looking back, we now understand why keeping our son at home was the best decision, this is down to the expertise and guidance of the Social Worker’. – Mother

b. From the young people

• ‘A young person also valued the benefits of an Autistic Led Program […] I really like how it (ADJ) was run by (Autistic) adults, i think this would be beneficial for younger autistic people who may struggle to see how they’ll do in adult life, it helped me in that way.’ This theme reflects another of the outcomes or impact of the project, ‘Improve access to education, employment and training and supporting positive transition into adulthood (National Autism Strategy 2021-2026)’.
• ‘It is very rewarding to work with young autistic people and be a part of helping them to understand more about themselves and their unique strengths and challenges, as well as learn about cultivating autistic joy and self-soothing activities’. Priscilla- Autistic Young Person)

c. From other agencies and professionals

• ‘We actively are able to, not only listen to one another challenges and actively seek solutions, but we have also been able to actively share our knowledge and experiences in our respective areas. The team are able to actively listen and give effective feedback when jointly working on cases that involve both Health and Social Care’. – Children’s and Young People’s Commissioning Manager
• ‘The joined-up working has had a significant impact, supporting students to stay in school, preventing exclusions and prevent students becoming NEET (not in education, employment or training). The correct support has been offered through CETR’s, Team around the Family, and other joint meetings, leading to some exceptional outcomes. It is a pleasure to work alongside this dynamic and passionate team’’. – Head of Service for the Specialist Inclusion Team

d. Metrics and Data:

Further information regarding the performance of the team can be found in the evaluation report from the Research in Practice Report herein attached:
The team has taken on board recommendations from the evaluation reports specifically within the context of collecting more administrative and quantitative data; however, qualitative data from interviews and case studies suggest that the team is having a positive impact across the key areas of preventing Tier 4 admissions; reducing use of residential care and improving participation in education.

6. Voice of the Child and Family:

• a) The Specialist Autism Team integrates the voices of children and families into every stage of its
• interventions. Examples include:
• b) Children co-designing risk assessments to ensure their safety and preferences are considered.
• c) Families participating in Child in Need and CIC review meetings.
• d) Where risks are high and dynamic, parents are invited to participate in regular ‘Amber’ and ‘Red’ review and coordination meetings support planning, giving them ownership over therapeutic pathways.
• e) Young person’s experience of Autistic Peer Mentoring Project and the Autism Discovery Journey Projects

Conclusion:

The Specialist Autism Team exemplifies how the goals of the National Autism Strategy can be implemented at a local level, offering a blueprint for other local authorities to adopt. By fostering inclusive education, reducing health disparities, and improving community-based support, this initiative
contributes to national ambitions while addressing shared challenges faced by children and young people with autism in London and across the UK.

Supporting Information:

Barnet_Inspection of local authority childrens services_Jun24

Team: Brent Children and Young People Service

Main Submission:

Introduction to the initiative and motivations for action; description of exceptional challenges, ambitions and objectives for undertaking the work.

The London Borough of Brent entered into a 5-year strategic partnership with Barnados in 201S called Brent Care Journeys (BCJ) which aimed to bring about transformational change in the children’s social care system, leading to better outcomes for young people, and to provide learning for the wider social care system. BCJ aimed to achieve these goals through collaboration with care-experienced young people and professionals based on a robust partnership. The project started in late 201S with agreement between Barnardo’s and Brent Council on a set of project

goals, a timeline, and expectations around the roles and responsibilities and resources of each core partner. Barnardo’s provided funding for a team (two project workers and one service manager, with support from an off-site Assistant Director) to be based on Brent Council premises where Brent would provide ‘in-kind’ resources like room facilities and staff support. The three key outcome areas were:

• Outcome 1: Strategic Partnership with Care-Experienced Young People
• Outcome 2: Viable Partnership Working Towards Outcomes
• Outcome 3: Improvements in Children’s Social Care Systems

The ambition, and ultimate aim, of this partnership was to improve the children social care system to support young people to achieve “positive destinations”, a broader concept of positive outcomes for care experienced young people which went beyond the traditional focus on education, employment and training.

The partnership with Barnados ended in mid-2024, and this Practice Spotlight is focused on the successes, achievements and learning from our BCJ programme between 201S-2024 which has inspired and led us to introduce BCJ 2.0, the next phase in our “participation” journey with care experienced children and young people.

Our vision for BCJ 2.0 has been to use “co-design” as a foundation methodology for our ongoing participation work, using the key principles of relationships and investing time and resources in building trusting relationship, valuing lived expertise, sharing power, enabling reciprocity, supporting young people’s agency, setting realistic goals and sharing the outcomes of the work.

The challenges that have presented in the transition from BCJ to BCJ 2.0 are summarised below:

• Maintaining the identity of BCJ to not lose momentum created and continue the legacy of BCJ
• Young people responded positively to the ‘independence’ of BCJ from the local authority Participation Offer which struggled to increase membership during the initial stages of BCJ and moved towards more joint work later on.
• How we were going to incorporate an offer for 25+ young people.

Governance of BCJ 2.0- what should this look like, what teams/services should be included, and how decisions would be made.

Details of actions, activities and initiatives designed to deliver on this commitment; description of the best practice implemented and delivered; securing buy-in across relevant teams, obstacles overcome, leadership, structures and budget to achieve the objectives, being sure to emphasise the relevant common themes referenced above

During the course of our BCJ partnership the following activities and initiatives were delivered:

• ‘Test and Learn’ projects, using a co-design methodology, resulting in tangible resources and tools that have been inspired, developed and championed by care experienced young people. This has included: Welcome Packs for young people moving into semi-independent placements now part of commissioning agreements. Activity budgets for relationship building between key worker and young people. Pre-birth Assessment tool designed by Care Leavers who were parents which are now used within Brent’s pre-birth assessment work.
• Social, educational and leisure activities
• Co-designed and facilitated training for staff, carers and Ofsted
• Power Groups: workshops or group activities that were designed and delivered directly by young people for young people, e.g. Vibes in the Kitchen, Brothers, Therapart
• Events: Kiln Theatre-BCJ Showcase “Dear Social Services”, Listen Up, BCJ Fun Affair

As a result of our BCJ journey so far and the foundation established, our BCJ 2.0 have continued with a commitment to the key principles described in Ǫ1. Our achievements to date have included:

• Brent Participation Strategy has been developed using similar ideological framework to broaden out this approach to participation across the wider CYP department and council.We have prioritised the retention of BCJ staff to create consistency for young people in the transition from BCJ to BCJ 2.0
• We have developed and delivered paid employment opportunities for care experienced young people in different CYP roles: Ǫuality Care Ambassadors, Commissioning and Recruitment, Participation
• BCJ 2.0 members have led changes to the way in which Corporate Parenting Committee (CPC) functions and engages with our care experienced young people. This started with a workshop led by young people for CPC members and BCJ 2.0 members to think about how CPC could change to create a space that fulfils its purpose and encourages collaboration with young people in a friendly, participatory, and relaxed way.
• BCJ 2.0 members have made representations at CPC for Brent Council to support a motion to recognise ‘care as a protected characteristic’. This was agreed by members of the CPC and a motion was drafted and taken to Full Council in November 2024. This motion was unanimously passed.

The BCJ journey in Brent has been championed and supported by senior leaders from the very beginning, which has set the tone for the strategic partnership in the first instance, and now our transition into BCJ 2.0. This commitment has been instrumental as a driving force throughout

Delivering a programme like BCJ 2.0 requires buy-in from a range of teams and partners, including the Leaving Care service and individual Personal Advisors as direct coduits to providing information and encouraging young people to sign up and get involved, the Participation Team, the Brent Virtual School, and external partners from health and education.

Evidence that the best practice is having an impact; description of the effect on outcomes and how the best practice has made/is making a difference

BCJ 2.0 represents our commitment as a local authority to relational and anti-oppressive practice by being willing to shift power dynamics, value lived experience, and be present in shared spaces with care experienced young people as collaborators and equals. This has been evidenced in the recent changes made to our Corporate Parenting Committee structure led by care experienced young people and supported by Counsellors, our successful Care Leaver led campaign for recognising “care as a protected characteristic, and in the recent refresh of our Care Leaver Local Offer.

Outcomes reported included improvements to:

Social connections, relationships and support networks.

Many of the young people who were interviewed talked about the strong, meaningful relationships that they had developed with other Care Journeys peers throughout the course of the projects, and how important these had become to them. For several young people, this was the first time that they had been able to develop social connections with peers who shared their experience of the care system and for this reason they felt more understood and accepted within these new friendship groups.

“You all see each other for who you are rather than what’s happened to you.” (Young person)mental and physical wellbeing, confidence, sense of identity and self-esteem.

There is strong evidence that when young people established trust with Care Journeys staff, were entrusted with responsibility, and engaged in group activities and projects, they experienced increases in confidence and self-esteem. For example, in a survey conducted among young people in Brent, the majority stated that Care Journeys had helped them become a more confident person and enhanced their ability to advocate for themselves. Furthermore, there were examples demonstrating that young people felt more assured speaking up in group settings and during meetings with professionals.

“And when I stand back, especially there’s one particular young person, where before I’d seen her in a participation session […] she wasn’t that confident. And then fast forward, she’s involved in Care Journeys and I can see her, just the growth that she’s done. It’s really good. She’s going to go places.” (PA)

Skills, knowledge and understanding.

Young people who had been involved in projects like Alpha Labs said that they had developed a broader knowledge of issues that are present throughout the care system at a national level. Furthermore, they were not only aware of what problems exist, but had also developed an understanding of how their skills and experiences put them in a good position to help tackle these problems, which fed into a greater motivation to do so.

“You’ve got a unique ability to be able to help with these things cause you’ve lived it, it’s lived experience.” (Young person)

Pursuit of personal goals (education, employment and training and other positive destinations).

Care Journeys has also helped some young people to find out what they want to do in the future, guiding them towards clarifying their aspirations, supporting them with their motivation to pursue their goals and revealed opportunities that they had not previously considered available to them.

“It’s opened my eyes up to different opportunities. I now believe if I wanted to, I could start my own project like this.” (Young person)

The formal evaluation, Positive Destinations, found a range of positive outcomes for the young people who were substantially involved (such as attending several activities or being involved over a long time period), as these were the people who were interviewed or surveyed. Direct feedback from the young people involved is found in the final digest and outcome reports attached.

‘Young people participating in Care Journeys reported having developed more positive relationships with peers and staff, though there was mixed evidence regarding the impact on relationships with peers and professionals outside of Care Journeys. Increased confidence, self-esteem, and wellbeing was reported by many young people. Many also developed a better understanding of the care system and acquired useful skills. Some young people reported an enhanced sense of purpose and future goals, with anecdotal evidence suggesting support for transitions into EET.’

“We always are listened to […] They always went around in a circle, and they always made sure that each young person is given a chance to speak. […] They have definitely shown that we can work together towards a common goal, so it was a very positive experience for me.” (Young person)

‘It was not possible to directly evidence the impact Care Journeys had on the wider population of young people that were not involved or only marginally. There was the perception from staff, however, that Care Journeys inffuenced attitudes and behaviours among local authority staff and that care leavers were higher on the agenda.’

“In terms of raising the profile of young care-experienced people nationally and opening up these conversations, I think Care Journeys has done a really good job of that.” (Staff member)

Supporting Information:

• Positive Destinations final evaluation documents- Learning Digest 4 and 5
• Pre-birth Assessment Tool
• BCJ Activity Budget and Memory Boxes flyers
• BCJ Welcome Pack video made by young people- BCJ | Welcome Pack (vimeo.com)

Team: THRIVE Therapeutic Social Work Team

Main Submission:

THRIVE, which stands for Trust, Hope, Respect, Inspiration, Vision, and Empathy is the London Borough of Bromley Children’s Services internal therapeutic service.

The THRIVE Team provides therapeutic intervention and support to any child or young person and their caregivers known to Bromley Children’s Services who for whatever reason do not live with their birth parents. This includes adopted children, children looked-after (including those ‘stepped down’ from residential to foster care) and children cared for by special guardians, connected persons and private foster care arrangements.

Drawing upon a range of therapeutic modalities and utilising a trauma informed, systemic approach, the Team’s principal role is to provide direct work to children, young people, and their caregivers in instances where there is no recourse to alternative services such as CAMHS.

THRIVE’s principal role is to

• Support children and young people to develop and strengthen attachment bonds to their adoptive parents and caregivers
• Support caregivers to develop insight into and empathy in understanding the impact of early trauma and to develop ‘trauma informed’ parenting approaches
• Support children and young people in moving from foster care to adoption, from residential to foster care and from foster care to birth parents via individualised transition plans

Team Development and Growth

The THRIVE Team initially developed from one therapeutically trained social worker providing therapeutic intervention to adopted children. In 2019, a second part-time social worker and team manager were also appointed, resulting in the forming of a team identity, and formalised with a clear Terms of Reference, referral criteria, referral pathway etc. with the THRIVE name also being adopted at this time.

As a care experienced adult, the THRIVE team manager was acutely aware of the need to provide therapeutic intervention to support the considerable number of traumatised children looked-after within the Borough, particularly given the lack of any alternative joined-up provision locally. In early 2021, CAMHS agreed to fund an additional THRIVE post for a year, specifically to work with Tier 1 and Tier 2 children looked-after to offset CAMHS waiting list.

The THRIVE team began to embed itself and was readily accepted by other teams as it grew reputationally, for example, to prevent placement breakdowns or support children successfully move from foster care to adoption and demand also continued to grow exponentially (the Team received 15 referral in 2020 and 74 referrals in 2023) and in 2022 and 2023 an additional three full-time practitioners were recruited and currently the Team consists of a team manager and 4 full-time and 1 part-time practitioners.

From the outset the THRIVE Team received formal therapeutic training to provide both validity and professional credibility and includes Dyadic Development Psychotherapy, VIPP, Therapeutic Life Journey Work (Richard Rose model) and Theraplay. The Team have received further training to deliver the Foundations for Attachment training.

All THRIVE staff receive monthly case supervision in addition to monthly specialist external supervision commensurate with the requirement to practice using DDP.
In January 2024, the Borough’s OFSTED inspection achieved ‘Outstanding’ in all areas across Children’s Services and included the following comment regarding THRIVE ‘The in-house THRIVE service provides effective therapeutic support for children and their carers, helping to offset long waiting times to access specialist child and adolescent mental health services’.

Additional Services and Roles
The THRIVE Team provides support for birth parents of adopted and looked-after children via its Birth Parent Support programmes and runs a Duty system two days per week to provide informal support to caregivers in addition to running yearly training programme for Bromley’s social care staff and caregivers.
THRIVE staff are actively encouraged the further develop their skills and knowledge by pursuing relevant professional interests both internally and externally.

Currently this includes:

• Training and monthly supervision to mentors to support Bromley’s Virtual School Year 6 children looked- after Mentorship Scheme.
• Monthly group supervision to Bromley’s Children’s Services Staying Together Team
• Specialist CSA Consultation to safeguarding to colleagues regarding CSA and harmful sexual behaviour.
• Supporting NHS England to develop and project manage specialist resources for children under 8, children 8 – 12 who have been victims of sexual abuse and harm plus a support resource for parents and caregivers (see attached).
• Running a monthly evening support group for adoptive parents in Bromley
• THRIVE Team Manager acting as Clinical Lead for Bromley for the LIIA/IFS Your Choice programme

Training Provision
The THRIVE Team additionally run a yearly training programme both for colleagues within Children’s
Services and adoptive parents and caregivers as follows:

• Trauma Informed Practice training days
• DDP Awareness training days
• Thinking Therapeutically for Social Work Practice training days.

The THRIVE Team runs the 6-week DDP/PACE based Foundations for Attachment training programme for adoptive parents and caregivers.

In addition to the above, a THRIVE practitioner leads on delivering Trauma Informed Training via the use of virtual reality headsets. This has included working in collaboration with the Virtual School to deliver training on trauma and attachment to a pastoral team at a local primary school and is due to be rolled out to both other teaching staff and school police liaison officers within Bromley in summer 2025.

THRIVE’s Effectiveness Example

The Team recently concluded a piece of work with four children who were placed in the care of their grandparents having witnessed their mother stab her partner. The mother was charged with attempted murder and remanded. The grandparents had planned their retirement and were non-committal regards caring for the children longer term, particularly as the children were displaying dysregulated behaviour in response to their trauma and distress. The grandparents were concerned not to further exacerbate this and chose not to discuss the incident and effectively silenced the children from raising the issue.

Two members of the Team co-worked the case via a combination of individual and group sessions over a period of nine months. DDP was undertaken in enabling the grandparents to understand the impact of what the children had witnessed and to utilise trauma informed parenting strategies in addition to encouraging them to give the children ‘permission’ to talk and ask questions about this. A combination of DDP and therapeutic life story work was undertaken with the children in enabling them to develop a consistent shared narrative about, and make sense of, the incident and begin to process their trauma. Whilst the children were reconciled that they could not return to their mother’s care, they were reassured as to her well-being when contact was reestablished.

This resulted in a significant reduction in the children displaying trauma response behaviours and increasingly secure attachment bonds to their grandparents. The grandparents were positively assessed as connected carers and chose to care for the children long-term.

The above cites one example of the positive impact of THRIVE’s intervention, which is measured qualitatively via feedback, however we have recently begun to administer SDQ’s and going forward will additionally have a quantitative measure of THRIVE’s effectiveness.

Benefits of an In-House Therapeutic Service

• Management oversight and operational control – quality and effectiveness of service.

• Potential for greater integration into wider LA operations and aligned with corporate plans.
• Dual Therapist/Social Worker experience of THRIVE staff – positive support and influence with colleagues to practice from a ‘trauma informed’ perspective
• Trust – referring social workers know who and what they are getting – increased social capital/knowledge sharing.
• Flexible and responsive to need – can ‘parachute in’ to provide immediate support.
• Clear and effective communication inc. using same recording system.
• Potential savings cost and time – reduced bureaucracy and operational duplication.

Supporting Information:

Please see below as examples of the contribution THRIVE made to the development of booklets for children who are victims of CSA and supporting guidance for caregivers.

Whilst this is not THRIVE’s ‘bread and butter’ work, it does provide an example of THRIVE’s commitment to support other initiatives both internal to Bromley and externally with both the THRIVE Team Manager and a staff member having a significant degree of involvement in the development of the booklets.

Main Submission: Brandon Centre developed Systemic Integrative Treatment (SIT) in 2017 to support families of young people aged 8–16 with persistent, moderate to severe behavioural challenges. Building on the Centre’s 14 years of experience delivering Multi-Systemic Therapy (MST)—including leading the UK’s first MST clinical trial in 2003—SIT was designed to address complex behaviours such as violence, school refusal, absconding, substance misuse, criminal and sexual exploitation, self- harm, and harmful sexual behaviour, within the context of the UK’s social and healthcare systems. SIT empowers parents/carers, including foster families, to reduce the young person’s behavioural challenges, thus preventing them from entering costly and often traumatic out-of-home care placements. Additionally, SIT facilitates family reunification for those already in care, enabling safe, sustainable returns home.

SIT stems from an urgent need to address the root causes of severe behavioural issues while mitigating the emotional and financial toll of high-cost out-of-home placements. Residential placements such as foster care (£30–70k/year), children’s homes (£150–250k/year), and mental health inpatient units (£100–150k/year) can be expensive, traumatic and disruptive. In contrast, SIT offers a cost-effective alternative, with annual treatment costs ranging from £13,780 to £19,512, aiming to keep the child at home.

SIT is successfully delivered in Camden, as part of Brandon Centre’s ‘Minding the Gap’ contract. It is also delivered in several other London boroughs.

Model:

SIT was developed in accordance with NICE guidelines for treating conduct disorders and harmful sexual behaviours. SIT empowers parents to regain control over their child’s challenging behaviour, focusing on building upon existing strengths while equipping them with the tools and confidence to deal with challenges.

SIT works across multiple systems—including schools, peers, and the wider community—where these behaviours occur, creating a holistic and integrated approach.

The SIT model incorporates a range of evidence-based therapeutic approaches, including structural and strategic family therapy, behavioural therapy, cognitive behavioural therapy, solution-focused therapy, and psychoeducation. SIT is delivered through two-phases across 12 months:

Phase One (6–8 months)

During this phase, a bespoke, home-based treatment programme is provided. Therapists visit families two to three times per week, working flexibly with families’ schedule. Sessions focus on understanding and addressing the root causes of behaviours, implementing strategies to de- escalate crises, and reinforcing positive behaviours. A 24/7 telephone support line is available to parents/carers, providing real-time guidance for managing challenging situations and adhering to behaviour plans. SIT takes the clinical lead for addressing the young person’s behavioural issues and works closely with other services, such as social care and CAMHS, to coordinate comprehensive care and ensure the young person can remain safely at home.

Phase Two – (up to 12 months total)

This phase includes booster sessions and check-ins with families and professional meetings and consultation. These activities reinforce the progress made during Phase One and provide continued support to maintain positive outcomes over time.

Structure

Given SITs complexity and intensity, therapists maintain a small caseload of four families at a time. Therapists receive weekly one-to-one and weekly group supervision to collaboratively address challenges and develop strategies. These support structures are integral to managing the high-risk nature of the service and maintaining a consistent standard of excellence.

Obstacles and Buy-In

For many families, particularly those whose children are on the edge of care with social service involvement, there can be a deep mistrust of services or feeling overwhelmed. SIT helps to build trust with parents/carers through our collaborative approach, ensuring their active participation.

Cross-agency collaboration has been critical to SIT’s success, enabling a unified approach to addressing complex needs and reducing fragmentation in service delivery.

Systemic Collaborations

SIT adopts a holistic, systemic approach by engaging the broader network of those involved in the young person’s life. SIT collaborates with schools, social workers, peers, communities, shops, police, and sports clubs, working to secure buy-in, address challenges, and align efforts to support the young person effectively and consistently.

In Camden, strong partnership working extends to commissioning and referral processes. Camden commissions 10 families annually, with Brandon Centre working closely with NHS ICB commissioners, Social Care and CAMHS to identify young people on the edge of care with behavioural difficulties. Together, we address barriers preventing progress, such as issues with education placements, housing, or other systemic challenges.

Evidence

SIT’s effectiveness has been independently validated through a comprehensive evaluation conducted by the University of Hertfordshire in July 2023, funded by the Youth Endowment Fund (YEF). This study confirmed that SIT delivers significant and measurable improvements in child behaviour, family functioning, and overall well-being. Key outcomes include enhanced family stability, reductions in youth offending, and reduced emotional and behavioural difficulties— critical areas for those on the edge of care.

Recent outcomes data for 2023-24 reinforces these findings:

• 87% of young people were in full-time education by the end of treatment, despite starting with significant educational disengagement or attendance challenges.
• 88% of young people who had been placed in out-of-home care due to challenging behaviours successfully returned to their families.
• 100% of young people engaged in SIT treatment had no further offenses during SIT intervention.
• 84% of families reported their child remaining at home, attending school, and actively participating in education during a six-month post-closure follow-up.

Voices

We receive outstanding feedback from families and professionals through our service questionnaires. 100% of families report they would recommend SIT. They felt heard, respected, and believed the therapist worked them effectively with them to address the problems.

Families Feedback

• “The intervention has resulted in such a massive transformation, it’s extraordinary”
• “I am eternally grateful for SIT. It has transformed my child’s life and changed their entire trajectory”

Professionals Feedback

• ‘The SIT therapist working with this family has made more progress than any other professional involved with this family and they have had a long history of professional involvement.”

Conclusion

SIT addresses the multifaceted behavioural challenges faced by edge of care young people. It reduces family breakdown and the young person’s behavioural challenges. Camden’s whole system working and collaborative approach puts the best support in for young people while also avoiding very costly out-of-home placements.

Team: Housing and Outreach Support Team (HOST) – Targeted Support

Main Submission: The Housing and Outreach Support Team (HOST) works innovatively to provide creative and tailored support where children are on the edge of care. The Targeted Support Service provides outreach services to young people, children and families who require additional 1-to-1 support for a time-limited period. This may be a one off session of support or for a few weeks.

Our ambition is to empower young people and families to develop the strategies and skills they need, often at a time of escalation or crisis. Our outreach workers are not social workers but work in close partnership with social work colleagues to address specific goals and tasks. We are able to meet with families, working alongside them during their day to support their routines and see how family life is as it happens, whether this is early morning with school run, throughout the day, or with bedtime routines. Having a different role to a social worker, our workers find families can sometimes build a different rapport and be open to several hours of support during the day. We provide support across the evenings and weekends if needed, where we then give feedback to our social work colleagues to give more detailed account of what is working well, as well as highlighting continued safeguarding concerns.

We provide tailored and creative support solutions, working with our colleagues in social care to discuss the goals and tasks required to ensure families are empowered to develop skills needed. We offer:

• Respite for carers (parents and foster carers) by taking child(ren) out of the home environment, often over the weekend and to give children positive experiences during this time to support with their social and emotional development
• Unannounced home visits – which include weekends and evenings or supervised contact
• Supporting excluded children back into positive re-engagement in their school environment or alternative provision.
• Escorting children to and from school and help managing behaviour in the home
• Accessing and engaging with mental health, physical health and/or drug & alcohol services

There were ongoing concerns for two siblings who had experienced trauma from a domestic violence relationship and mother’s substance misuse. They were placed in their grandmother’s care under a Special Guardianship Order. However, the mother, who also had significant mental health issues, was still staying in the grandmother’s home, and she was facing homelessness if asked to leave the property.

Concerns around the chaotic home environment with mother still living there continued, with the grandmother struggling to meet the children’s basic needs. It was due back into the court arena for removal of both children under neglect.

Outreach enabled the mother to present as homeless and supported her to access food vouchers and to settle into hostel accommodation. They then also worked with the community mental health team to ensure a care package when mother’s mental health declined after having to leave the family home. They provided support to apply for Housing Benefit and Council Tax as well as Universal Credit.

Outreach liaised with schools/health/sensory smart/GP to get all assessments booked and supported grandmother to ensure attendance. They also also ensured access to holiday clubs for respite and provided practical support and strategies to provide new routines in attending school after the mother left the home to work on stabilising the home environment.

Outreach finally worked with the local housing department, requesting appropriate housing having been notified of an empty property on the estate. This meant no big transitions /change of schools for children.

When the case was reviewed, the court was happy that the mother was supported to be placed in a hostel with support in place and that the toxic environment due to mothers’ manic episodes and substance misuse had significantly reduced. School attendance had risen and medical appointments were being met meaning grandmother was again meeting the children’s basic needs with the support put in place by the outreach worker.

The court agreed for the grandmother to have ongoing support by the outreach worker and recognized the huge difference this support had made.

Testimony from allocated social working in partnership with the outreach worker:

• “There are no words to describe the amazing work done by [the worker]. Thanks to her, this family was offered a 3 bedroom house. She really did a fantastic job in putting support in place”.

Team: Fostering and Adoption Service

Partners: Leyton Orient FC and Leyton Orient Trust

Main Submission: The Mockingbird Family Model is a well-known fostering model which was popularised in the US. Under licence, the Fostering Network has delivered the scheme in the UK in partnership with organisations such as local councils. Waltham Forest is one such council and we have implemented this scheme to help meet our unique fostering needs.

Since 2019, we’ve launched five constellations totalling 43 families and 52 children and young people. Each constellation consists of a group of satellite families who work together to support the young people in their network, embodying the principle of “it takes a village to raise a child.” The Mockingbird constellations are made up of diverse groups of carers. Many foster families are of Black Caribbean, Black African, or South Asian heritage, while their children are from an even more diverse range of backgrounds, broadly reflecting the largest demographic groups in our community.

The most recent constellation was launched in September 2024 following the success and uptake of previous constellations. The constellations are regularly reviewed against their size, activity, structure, and feedback from carers and children. Each constellation consists of a Hub carer who leads the constellation and manages the relationships between the satellite families and young people. The Hub home provides opportunities for sleep overs for children and young people. The constellation families, led by the Hub carer, organise activities and share caring responsibilities to enrich their children’s lives as well as their own. There is also a liaison worker attached to each constellation who is a Waltham Forest social worker overseeing the network, ensuring the arrangements and support for the foster children are robust.

Outside of the constellations, our Mockingbird Project Lead liaises closely with an assigned “Mockingbird coach” from the Fostering Network to organise Mockingbird Awareness Days and to progress the launch of further constellations.

In the last year, birthdays were celebrated, activities were enjoyed, and difficult conversations had. Some highlights were:

• One constellation had their annual weekend away in Bournemouth, giving time for the constellation to bond away from the city.
• Another constellation hosted a neighbouring borough’s Mockingbird lead and one of their Hub carers to show them how monthly meetings take place; their feedback showed it was an empowering learning experience.
• One Hub carer provided support to a satellite carer and a young person which saved their alternative home living arrangements, reminding us of the importance of a proactive Hub carer.

To ensure carers have the skills to care for their foster children, constellations have the following support in place which their liaison worker can help facilitate:

• Monthly meetings to reflect on the health of constellation and to coordinate future plans. These have occurred online and in-person, including at a Hub home.
• NEST Project: our young people can join activities organised by the Foster

Network to meet with other youth in the national Mockingbird programme. This is facilitated by a liaison worker completing a form on behalf of the interested person.

• Learning and development: our CORE training includes essential modules on Family Time, Child Protection and Safeguarding, and Delegated Authority, which foster carers are expected to complete at least once. Additionally, we offer training on topics like Autistic Spectrum Disorders and the PACE Model of Attachment.
• The Fostering Network also provides the Skills to Foster course, available both online and in-person, mandatory for all foster carers during their approval process.
• Foster Carer Forums: These are quarterly in-person discussions open to all foster carers, Mockingbird or not, focusing on anything from the Alternative Home Referral process to our MOSAIC case management system, among other topics. Refreshments are offered and it is an opportunity to learn with and meet other carers.
• Mockingbird Champions: These are foster children who have signed up to be involved in the recruitment process of the Hub carers before they are appointed, giving them a voice in the process that translates into suitable constellation leaders.

There are three particularly distinct elements of the fostering service existing alongside our Mockingbird programme. The first is our strategic partnership with Leyton Orient FC and its community arm, the Leyton Orient Trust. As a Fostering Friendly employer, the club has adapted its HR policies to support foster carers employed there, while also furthering our foster carer recruitment efforts, including a high-profile campaign where their stadium became a platform for fostering awareness. During a match, the Cabinet Member for Children and Young People, a local foster carer, a care experienced young person, and our Corporate Director spoke at half-time, while the club amplified the message through social media and press releases to their substantial 100k follower base. The impetus of this partnership was when we both joined the Fostering Friendly scheme hosted by the Fostering Network.

Another unique aspect is our innovative use of Department of Education funding to improve foster care recruitment and retention. Waltham Forest leads the Local Community Fostering (LCF) recruitment Hub for Greater London East, a collaboration of six northeast London boroughs. The benefits of an inter-borough body include maximising outreach and improving our ability to match potential foster carers to the right child for them. DfE funding was also used to launch its newest Mockingbird constellation, which the DfE visited in October 2024. The DfE noted that Mockingbird supports placement stability, fosters a sense of belonging, and provides peer support for both children and foster carers.

Finally, Waltham Forest provides comprehensive financial support for foster carers, including up to 66% Council Tax reduction for borough residents and a payment toward Council Tax for non-residents. Additionally, foster carers receive weekly remuneration of up to £582.50 and a fostering allowance of up to £310 per child, depending on age. These benefits, approved by Cabinet, are designed to address financial barriers and enhance the recruitment and retention of foster carers during challenging economic times.

Statistical results are clear: from April 2023 to September 2024, we’ve had a steady average of 117 foster carers, and five new fostering approvals from April this year with more in assessments before the end of the approval year March 2025. Further, there has been a 70% increase in enquiries which, while only a small percentage convert into foster carers, increases the awareness of fostering services which may lead to future carers through word of mouth.

Quantitative results are even clearer. One Hub carer said this:

• Managing S, a 16 year old young person to move from one family to another within our constellation is a real testament to Mockingbird in operation. Without having this set up of support, there would have been no consistency and stability in the alternative home arrangements

Three children shared these comments:

• I like living with my foster family. They look after me, make me feel special and like a member of the family. My foster carers help me understand my feelings. They make me laugh and help me see things aren’t as bad as I thought

• Living here is genuinely homely. It feels like my home and is my home. I feel understood through hard times and I know I’m always going to loved and supported

• They (foster carers) are a nice friendly family who make you feel comfortable as if it’s your own family. They take care of you as if you’re their own blood child and I get to meet other children too

Mockingbird is now an essential feature of our fostering service, enriching the lives of both children and carers in the constellation, and given the national and local data available we can only see one direction: expansion.

Supporting Information:

Team: Edge of Care team

Main Submission: The Edge of Care (EoC) service at Waltham Forest started in 2022 to address the complex needs of children in care or at risk of entering the care system, including by supporting their families. Our Edge of Care practitioners initiate daily conversations with young people and their families to understand the barriers they face to a positive home environment, providing various interventions to realise healthier outcomes. The team also makes recommendations to the social workers serving the residents, complementing their interagency work with deep personal insights into the individuals that make up a family. An Out of Hours service recognises that, as one practitioner put it, “families are not in crisis from 9am to 5:30pm… weekends and holidays are when problems are most likely to flare up.” Staff are therefore on-hand over weekends and evenings to deescalate conflict on short notice, including by working closely with the Emergency Duty Team.

Last year, 97 young people had been referred to EoC. Black ethnicities were overrepresented in this group, although the overall demographic was broadly reflective of users of social services. Serving these referrals is an efficient team of ten, recently expanded to meet the increased yearly demand since the service’s inception. Their success was recognised in the 2023 Waltham Forest Staff Awards, where a cross- organisational board recognised the manager and his team for their service:

Francis will endeavor to go the extra mile to support and encourage his staff and families alike, to empower them to achieve their full potential. Francis works to create positive attitudes within our team which impacts positively on boosting team morale.

This enthusiasm and commitment of the team is reflected in their results. Our 2023 annual report counted 31% of closed cases stepped down, including reducing the number of child protection cases by 44%. 59% of closed cases remained at the same level of risk, while only 10% were stepped up. Another way of expressing our team’s success is through our recent Ofsted inspection: our Children’s Services received an overall “Good” assessment from Ofsted – rising to “Outstanding” in the experiences and progress of children in care. The external inspectors commented:

• Children and families benefit from a highly flexible and creative edge of care service. Practitioners work closely with the emergency duty team, providing a crisis response out of hours alongside a wide range of planned interventions and activities. Edge of care plans are well coordinated, complementing wider child-in-need and child protection planning. Parents take part in a range of workshops, helping them to better understand and support their children’s needs.

Further, our proactive management identify areas for innovation:

• Leaders respond effectively to areas for further development, gaps in services or new challenges. They have commissioned a further evidence-based intervention in recognition of the need to further support the needs of families of primary school-aged children. This complements the long-standing support for adolescents and the work of the edge of care service.

The service conducts its challenging yet impactful work through specific interventions:

• Delivering highly interactive sessions tailored to the families’ needs, refreshing their understandings of healthy communication, individual trigger points, de- escalation techniques, and their relationships to one another (genogram work). These sessions are interwoven into other council programmes showing a high degree of collaboration between EoC and other services. For example, the Healthy Relationship Awareness presentation is given quarterly as part of Youth at Risk workshops run by the Youth Offending Service and our team help deliver parenting programmes as part of the Strengthening Communities’ project run by Early Help.
• Providing advice directly to parents and young people including on helping young people continue education or enter work.
• Facilitating positive activities in line with the mantra, “Leading through interests.” This recognises that sensitive conversations, especially involving young people, are made much easier when done alongside activities which bring people together – whether that is tennis, boxing, or sharing a particular food
• An impactful part of our offer is giving young people free access to Leytonstone Leisure Centre, a local council-owned facility with a state of the art gym and pool. This was arranged through an agreement between our service and the Centre’s management, and the discounted membership fees are paid from our budget. Given the financial climate and the principle that exercise is a healthy outlet for youth, this free-of-charge provision is a core feature of our strategy to improve the mental wellbeing of our youth and even forms part of their exit plans from the service. As stated above, Ofsted has recognised the quality of our planning
• An Out of Hours service underpinned by a rota system ensuring consistent staffing. There are permanent sessional workers who cover weekends, and our family support plans include signposts to the Emergency Duty Team to ensure as close to round-the-clock support as we can manage

• Referring families with historic domestic violence trauma to trauma and counselling therapies after the EoC team was appropriately trained
• Mediation between parents and their children, and welfare checks both as part of EoC plans and as needed

Alongside these unique strengths, there is a proactive desire to improve as pointed out by Ofsted’s comment on our leadership.

• While we have established key metrics for measuring our success3, and record the actions taken during a case including signposting4, more nuanced data analysis is needed to inform service planning
• We should establish more defined referral pathways to partner organisations, whether they are local clubs and community groups, charities, the DWP, or specific NHS services

The below testimonial is a good summary of our hands-on work, showing the fruits of our robust planning, close working with families, and the perceptiveness of our staff. This testimonial was written by a social worker of 5 years, praising how the severity of the case was stepped down and a positive outcome for the youth attained.

“I have to commend the hard work that you and Edge of Care worker Angelique have done on this case. You have analysed D’s needs, escalated to PLO, and the intervention correctly addressed the issues of concern, you have also evidenced progress via observations and feedback of D’s behaviour, wishes and feelings and some alcohol testing of the mother. In addition, the after care plan of seeking a short break for the mother, and the plan to support the mother’s abstinence and parenting skills is most appropriate. The outcome of your intervention has led to exiting the PLO, stepping down to CiN but more importantly a positive change in D’s lived experience. Well done!”

Equally important is the voice of the family, and two testimonies speak to the hopeful and informative interventions conducted by our staff.

“We as a family very much feel that Angelique has made such a positive difference to our home. We are so happy to have had her in our lives. The future is bright!”

“Angelique has made a huge impression on T in particular. We have all learned a lot during our sessions. Thank you so much for all your help.”

Supporting Information:

• EOC Relationships Awareness Workshop PowerPoint
• ILAC 2023 Ofsted Report
• EOC-Intervention-Template

Team: Edge of Care Team

Main Submission:

The challenge of recurring removals of infants from their parents is a particular issue for Tower Hamlets where 40% of care order applications involve parents who have previously lost custody of at least one infant.

These parents face complex and interwoven challenges. Their histories are often marked by childhood trauma, neglect, and repeated interactions with the care system, leaving them distrustful of professional services and hesitant to engage. Because their children are removed, these parents often become ineligible or untrusting of long-term support. The cycle of infant removal perpetuates their exclusion from essential services, reinforcing patterns of crisis and instability. The Diamond Project was designed to break this cycle by providing the support necessary for parents to improve their lives and future parenting prospects.

Consideration was given to using the Pause Programme, but this is a costly option and imposes some conditions upon the mothers. Tower Hamlets aimed to create a similar, cost-effective project within an established service, ensuring sustainability and innovation at a smaller scale. The Diamond Project was integrated into the existing multi-disciplinary Edge of Care Team which allowed the project to leverage pre-existing relationships and networks within Children’s Services.

The name of the project was chosen because diamonds are strong and unbreakable, qualities we wanted parents to see within themselves so that they felt empowered to make changes in their lives.

The project aims to help referred parents to achieve the following four objectives:

1. Being a parent -Staying in contact with their children and contributing to their lives.
2. Staying healthy – Improving their health, including mental health, self-regard, and safer sexual practices.
3. Staying safe – Avoiding abusive relationships and building safer ones.
4. Being in control – Building security, accommodation, income, employment, and self-confidence.

The project was developed from the ground up as an innovative initiative funded by Tower Hamlets Council (LBTH) and the London Innovation and Improvement Alliance (LIIA). This was in consultation with the East London Family Court and with support from local stakeholders (RESET/CGL, The East London NHS Foundation Trust, OCEAN Mental Health Service and Perinatal MH Service, EAFC Positive Change, Adult Services Community Learning Disability Service, Adoption London East, and Tower Hamlets Housing. Parents who themselves experienced the repeat removal of their children have been consulted to be active partners in the development of the offer.

The Manager for the Edge of Care Team led the project, which was integrated into her team. This setup facilitated trust and effective working relationships, ensuring that referrals were appropriate and timely. This allowed the practitioner to be part of the multi-disciplinary team, providing support and containment.

In the first year, the project faced challenges with limited capacity of one practitioner, but we resolved this by increasing staff and leveraging partnerships. The Better Together Framework provided a consistent language and approach, fostering collaboration and resource-sharing among diverse stakeholders and allowing the project to build a robust network of partner agencies, facilitating the development of our offer.

To date the project has received 23 referrals for support for parents, and we have worked with 16 of those mothers. Some referrals were not accepted as parent was living outside the borough, or they had older children living in their care, or were already pregnant and did not meet the criteria. Where we could, we sign posted them to other services.

In light of a positive evaluation, the project has been extended for a second year, with two workers. This extension provides enhanced stability, enabling more parents to benefit from the program. Additionally, the group offer has been implemented to support as requested by parents from gathered feedback. The group will provide peer support to parents, specifically focusing on addressing the loss they have experienced. This is planned to be a tri-borough initiative, coordinated with Ocean Mental Health NHS service, supported by a clinical psychologist.

Due to our project’s small scale and capacity, our support has primarily focused on mothers, though we recognise that fathers also face recurrent care proceedings. While some joint support has been extended to fathers, it has mostly involved activities like writing letters to their children or referrals to relevant services. Recently, we decided to trial working with a father who has agreed to receive support. This approach is not yet tested, but we hope that with a larger project in the future, we will be able to expand this support

In Year 1, the project worked with 10 parents who had a total of 39 children removed from their care. None of those has had any further care proceeding at this point two years on.

The pilot service achieved several positive outcomes for the 10 parents in the 12 months of the project. Some examples of our first-year impact taken from the evaluation are:

• All 10 women are now registered with a GP
• 2 women facing homelessness are now moved to permanent housing
• 3 women were supported to rebuild family relationships
• 4 women have received counselling or advice around drug and alcohol use
• 7 women have had some advice and support intervention around partner violence

One woman was assisted in accessing the Adult Community Learning Disability Service (CLDS), where she was diagnosed with previously undetected learning difficulties. She now receives support from this service and has been working effectively with its staff, enabling us to conclude our involvement. One partner of a woman was referred for Autism assessment.

Feedback from parents was positive:

“The worker is lovely. She listens to me, and she visits me at home and gives me time. I wanted to understand why my children were taken away. I looked at my papers with her, she helped me to understand it better.”

“She helped me write letters to my children and attends appointments with me as I have learning difficulties.”

“She helped me to be in contact with my children. I didn’t have the letterbox contact but now with support I have the contact and up to date information.”

“If it wasn’t for the worker, I’d be on the streets now”

“My confidence was very low when my children were taken, I didn’t take very good care of myself. She just picked me up and helped me to get on with things.”

Partners have said:

“I cannot over emphasise the importance of having a social worker who is alongside and working for the mothers. She understands her clients’ needs and is able to advocate for them to access the right support.” – Clinical Lead

“This is a service that has been needed for a long time” – CLDS