06 APR 2017

Picking the ‘right’ cases for FDAC – is it possible?

Picking the ‘right’ cases for FDAC – is it possible?
Mary Ryan, FDAC National Unit and Independent Consultant

When evidence of promising outcomes for families began to emerge from the evaluation of FDAC this prompted a further question about whether it was possible to predict which families were going to be successful in FDAC and, linked to this, which were the ‘right’ cases to select for FDAC. This question became particularly important once government funding for the FDAC pilot ended in 2012 and the burden of funding the FDAC specialist team fell onto children’s services departments in the participating local authorities.

As FDAC has been rolled out to more areas across England the FDAC specialist teams continue to be primarily funded by children’s services, with some areas receiving contributions from Public Health commissioners. In each site commissioners set out the number of cases they anticipate will enter the FDAC process each year. This varies between 35 and 6 cases, depending on the area and whether the team is funded through a consortium of local authorities or by one or two only. The limit on numbers necessarily involves senior managers and/or local authority lawyers having to make decisions about which cases they will refer into FDAC.

The question about which families are likely to be successful raises yet another question, which is ‘what is meant by success in FDAC?’ FDAC aims to help more parents control their substance misuse so that children can return home safely, so an obvious and measurable success is parental substance misuse cessation and the care proceedings concluding with a supervision order and the children returning home. Over time, those involved with FDAC have identified other successes, which include early completion of cases where there is clear evidence that the child will not be able to return home, parents making great strides in their journey towards recovery even when they cannot complete this within their child’s timescales, parents feeling that they have had a fair chance to prove themselves and have been listened to by professionals and the judge, parents understanding and accepting why a decision is being made that their children must live elsewhere and parents better able to ensure that contact with their children is a positive experience. Apart from early completion of cases, these other successes are harder to measure in an objective way.

All FDAC sites are now collecting data on their cases using the same data tools and systems for analysing outcomes. The aim is to build up the evidence base and one spin off from this will be the possibility of identifying whether there are particular case characteristics that predict different types of ‘success’ or better outcomes for parents and children.

The evaluation of the FDAC pilot did look to see whether there were particular characteristics in the parent or family background that predicted success in the sense of cessations of substance misuse and reunification with children. The researchers identified 25 factors that might predict outcomes, based on research findings from similar courts in the United States and risk factors identified through longitudinal studies in the UK. These factors included parental experience of domestic abuse, parents having been in care themselves or having previous children removed, length of drug or alcohol misuse, type of substance misused, length of family contact with children’s services, age of children and number of children involved in proceedings, children with developmental delay and children with emotional and behavioural difficulties. Checking each these factors individually did not produce any predictors of parental success in controlling substance misuse and family reunification as a result.

In addition to carrying out this exercise with individual variables the researchers did the same with a combination of seven characteristics for mothers and children. These seven characteristics were a mother’s history of being looked after, the family being known to children’s services for more than 5 years, domestic violence, maternal physical ill health, children born with developmental delay, children born withdrawing from drugs, and children with emotional and behavioural difficulties. These particular factors were chosen because when looked at individually there was some indication that they might have an impact on outcomes although larger sample sizes are needed to reliably establish this. The findings from this exercise, carried out on both FDAC and comparison cases, indicated that if a family had fewer than three of these specific characteristics then the rate of substance misuse cessation and reunification was significantly higher in FDAC than in comparison cases. The researchers concluded from this that in such cases FDAC was significantly better than ordinary proceedings in harnessing parental capacity to change. In cases with more than three of these characteristics there was no significant difference between FDAC and comparison cases in relation to the proportion of families who were successful (see 2014 evaluation here).

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This is a complicated area because the absence of some of the selected seven variables in cases did not mean that those cases were less serious. The background characteristics and history of all the FDAC and comparison cases were compared and found to be very similar and to be serious cases, well within the threshold for care proceedings. All cases involved parents with substantial substance misuse problems and around 40% of parents in both samples had had previous children removed. It is possible that the length of family contact with children’s services and the presence of children with emotional and behavioural problems might indicate families who had engaged on and off with children’s services over time but where underlying problems had remained. It is also true that other research has indicated that it is not so much specific risk factors but cumulative risk factors that predict persistence of problems and poor treatment outcomes and these may also be cases where it is harder to establish the threshold for proceedings at an early stage.

The message that the FDAC NU has taken from this is that it is hard to predict which cases will do well in FDAC. The hope is that as FDAC teams continue to collect data on their cases it may in future be possible to identify predictors more clearly. In the meantime it is also worth bearing in mind a comment from the researchers that cases with long histories of children services involvement might benefit from entering FDAC sooner rather than later, given the combination of intensive treatment and support that is provided within the FDAC model.

Local authorities using FDAC discuss whether or not a case should be issued into FDAC at legal planning or gateway meetings which consider cases which are heading towards court proceedings. Conversations with FDAC sites indicate that local authority lawyers and senior managers are involved in this decision. In some areas the possibility of referral into FDAC is a standing agenda item, in others social workers indicate whether they think the case will be suitable for FDAC and in others there is a brief checklist of issues to consider. In the majority of areas the first criteria is the presence of parental substance misuse and other factors that may influence decisions are the length of substance misuse, parents’ experience of treatment in the past, views about parents’ capacity to change and, in some areas, other issues in the case which may benefit from the intervention of the multi-disciplinary team. In some sites there are discussions with the team about the possibility of referring the case before the proceedings are issued. In all sites choices about referring cases are also affected by the capacity of the team and the court to take on a new case at a particular point in time.

So there are a number of factors which impact on whether or not a case is referred into FDAC and there are also a number of different sorts of ‘successes’ in FDAC. This point about different types of success is important because the evidence to date is that although parents going through FDAC have a greater chance of controlling their misuse and having their children returned, the majority of parents will end up being separated from their children. The advantages of the FDAC experience will be that in many cases parents will understand court decisions better and have benefited from their experience of intensive support and regular meetings with the Judge and the team, as the quotes below illustrate:

‘FDAC supported them to acknowledge that they could not do it in time for their son [control their substance misuse] which led them to accept the plan for permanency ... if the case had not been in FDAC the usual substance misuse assessments would have been undertaken and would have probably reached the same conclusions as FDAC. But FDAC enabled the parents to reach this conclusion themselves and so to think positively about substitute care. They did not feel alienated by the court process and they continued to attend contact meetings regularly.’ (Guardian)

‘It is effective. It is how care proceedings ought to be … and if parents have all the services they need offered to them, but still cannot control their substance misuse, this helps them accept that they cannot care for their child.’ (Lawyer)

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