Safeguarding adults: Mediation and family group conferences
Case study: Alice
Alice is 79 years old. She lives alone in her own home. She has three adult children, Tom, Lucy and Mark, and a sister, Annie. Mark suffers from mental health problems and is currently refusing treatment. Although Mark does not live with Alice, he spends most days with her at her home. Mark controls many aspects of her life, even refusing to let visitors in or to let his mother answer the telephone.
Mark’s mental health problems sometimes lead to violence towards Alice. On several occasions, Alice’s neighbours have telephoned the police after hearing Mark shouting and Alice crying. Each time the police have been called, Alice has indicated that she is fine and that things have calmed down. On one occasion, Alice was injured, and the local authority instigated safeguarding procedures.
Alice’s other children, Tom and Lucy, increasingly have become upset that Alice has not accepted their advice not to allow Mark to visit her. This has caused tension within the family, causing Tom and Lucy (who do not have a good relationship with Mark) to distance themselves from the situation.
Alice is afraid of the consequences for Mark if she tells anyone that he is frequently aggressive towards her and has hurt her. She does not want him to be arrested. Alice lets the social worker visit early, before Mark comes to the house, but refuses practical support at home.
Janet, the care manager in Adult Services, wishes to refer Alice for a family group conference (FGC).
Janet is clear with Alice about:
- why she thinks an FGC would be useful and what she hopes it would achieve
- the issues she would like to include in the FGC process (Alice’s safety and wellbeing, her relationship with Mark, her independence and Mark’s need for support)
- what alternatives there may be and what the consequences could be of taking no action at this time
- what information Janet would need to provide the FGC service with, to initiate the FGC process.
Janet is satisfied that Alice has the capacity to decide whether to engage with the FGC process. Having received information about the process, Alice agrees to take part as long as Mark is included in the process and his needs are addressed in the family action plan.
The FGC coordinator, Helen, visits all the family members and the professionals involved separately. Helen describes the FGC process and its underlying principles and considers safety, how the meeting is to be chaired and where it is to be held.
Helen decides whether an advocate or other supporter is needed by any of the participants. Annie (her sister) will support Alice and help to express her views.
Helen gains Alice’s trust by reassuring her that she will remain in control of any plan developed.
Mark agrees to attend, having been offered support by a health worker whom he trusts.
Tom and Lucy agree to attend, although they fear that Mark’s presence may limit what can realistically be achieved.
A police officer from the Public Protection Unit is identified and he agrees to attend.
Alice’s GP is invited and submits a report to the FGC coordinator, to be read out to the family at the FGC meeting.
The questions that the family needs to consider are clarified:
- What would help Alice feel safe in her own home, and increase her independence and wellbeing?
- What support does Mark need and who could provide this?
Janet and the police officer present on their involvement so far, their concerns, and what their actions are likely to be if the current situation continues. Everyone has an opportunity to ask questions.
Private family time
The family is left alone to discuss Alice’s needs and develop a plan. As he is not a family member, Mark’s health worker can only remain in private family time for a short period in order to ensure that Mark is settled.
Agreeing the plan
Helen and Janet rejoin the family to discuss and agree the action plan that the family has developed. Helen helps the family to consider the reality and achievability of the plan.
The family presents the plan, which includes:
- family support to help Alice gain more independence
- family support for Mark to seek treatment for mental health problems and to improve his own living arrangements
- an agreement by Mark to reduce the number of weekly visits he makes to his mother to three.
While she has some hesitations about Alice’s safety, Janet knows that Alice has the capacity to make her own decision about her relationship with Mark. She is satisfied that the plan will help keep Alice safe. The family is offered a review FGC to monitor how well the plan is working.
The review meeting
The plan is reviewed three months after the first FGC meeting. All of the participants except the police officer attend.
The plan is found to be working well. Alice feels more secure, happier and able to be clear with Mark about the days when he can visit her. Mark is receiving treatment for mental health problems. The wider family is providing a stronger network of support. Adult Services no longer considers Alice at risk.