Working together to support disabled parents

Case 4: Mother who is recovering from surgery and living in unsuitable housing with her baby

Without an inter-agency protocol in place

A mother with a small baby has had emergency surgery on a hip problem that had first appeared during pregnancy and became worse after the birth. Although technically a success, the operation has left the mother for the time being unable to drive, unable to climb stairs, unable to walk more than a hundred yards and with reduced balance. She is sleeping downstairs with the baby and is unable to venture out of the house. She has become depressed and she and her partner are finding it difficult to plan for an uncertain future. She is told that she is not eligible for housing adaptations or re-housing in a bungalow because her difficulties are, technically speaking, temporary. Her partner is considering giving up his job to help his wife look after the baby and get the two older children to school.

It could be argued that the local authority is responding to a medical diagnosis/prognosis rather than looking at the critical risks to the baby's and mother's physical safety in the short term, the considerable risks to the mother’s mental health and the family's financial viability in the immediate and long term.

With an inter-agency protocol in place

When the mother's needs are considered in isolation she does not appear to meet the eligibility criteria to receive services. Nor are the children considered to meet the criteria to receive services directed at children. However when the mother's needs are considered alongside the baby's and children’s needs in the context of the family's overall welfare and security, it is recognised that the needs are substantial and even critical.

Adults’ and specialist services carry out an assessment of the mother's needs and a coordinated plan of action prioritised. The need for equipment, and adaptations to the house, are prioritised and at the same time an arrangement is made involving social services and the education service to make sure that the older children can get to and from school without their father needing to give up his job.

The mother is visited by the NHS-funded community physiotherapist who works with her on an exercise routine that she is able to carry out at home. She is also offered counselling at a parenting centre with crèche facilities. Because the mother develops a particularly good relationship with the community physiotherapist, this professional becomes the key worker for the case, liaising with the other services and agencies involved. When the case is closed to adults’ services, the mother retains the physiotherapist's contact details and is encouraged to contact services through her if further difficulties occur with her walking.

A prompt and flexible response across adults’ and children's services with involvement from the health service and the voluntary sector is facilitated by the existence of the inter-agency protocol. The development of a 'key worker’ relationship with the physiotherapist simplifies the family’s contact with services and ensures inter-agency coordination of care.