Family Group Conferencing: The ‘where’ and ‘how’ in Adult Social Care

Featured article - 16 November 2021
By Miranda Johnson, FGC Team Manager and Annabelle Stock, FGC Senior Practitioner, Birmingham City Council

Head-shot of the author, Miranda Johnson, FGC Team Manager and Annabelle Stock, FGC Senior Practitioner, Birmingham City Council

Adult legislation such as the Care Act 2014, Mental Health Act 2007 and Mental Capacity Act 2005 are very much aligned with the values and ethos of Family Group Conferencing, so why are we not seeing more of this in practice? The reason is not that practitioners in adult social care do not have a commitment to the ethos behind Family Group Conferencing (FGC) or that they do not see why it is good; there is an element to this style of working that ASC practitioners try to accomplish within their day to day working already.

The adoption of strengths-based models such as Signs of Safety, Three Conversations and others are being viewed as reasons for ASC to not have to consider the take up of Adult FGC. The discussion needs to become less about an either or when it comes to a social care and FGC co-habitation and focus more on the how FGC fits within and compliments strengths-based practice in adult social care.

The uptake of strengths-based models to take social work practice back to its value base needs to be applauded. However, the expectation of social workers to be able to do it all and considering the Care Acts call to local authorities to do more in the prevention arena means we are missing a trick. Enter Family Group Conferencing.

Family Group Conferencing facilitates an adult and their identified network to devise a plan that addresses the network’s outcomes These are often plans of how to meet need, reduce risk, plan for change or achieve aspirations (or elements of all 4!). The name itself, ‘Family’ Group Conferencing, can be misleading and tends to make potential referrers only think of its utilisation during situations that involve complex family dynamics. In fact, FGC is a solutions-focused approach and requires a supportive network (that is not reduced to the traditional definition of ‘family’) to be successful. So rather than only referring when there are family dynamics at play, FGC can be used in:

  • Disengagement plans
  • Multi-agency working plans (plans around the person)
  • Future planning – achieving a goal
  • Risk reduction and safety planning
  • When creating a plan itself might build resilience.

In short, FGC is a vehicle to practicing in an anti-oppressive way, valuing diversity and starting from the presumption that adults are the experts of their own lives. A plan created by the network itself will always be more relevant and likely to succeed than one created for them. As such, these plans are inherently preventative.

A study conducted by Metze and colleagues’ (2018) looking to explore the reasons why FGC uptake amongst social workers was low found that although practitioners seemed positive about FGC itself, they were reluctant to refer because they were already working with their clients’ social networks and feared losing control over the care process. They also questioned whether the FGC would have any additional value overall and worried that the FGC may result in a loss of family contact due to the overburdening of the FGC process.

This study highlights the ongoing issues around trying to implement FGC. Not only does the internal climate need to be ready to undertake FGC and its principles fully but there needs to be clarity and understanding on how it complements the strength-based practices that the particular organisation is undertaking.

Birmingham City Council has been quietly working in the background establishing their own in-house Adult Family Group Conference service. Their FGC service has been focusing this last year on helping to show how and where FGC compliments the day to day work of social care practitioners as well as how FGC sits comfortably in the prevention arena.

Plans created via FGC are:

  • Empowering
  • Strengths-based
  • Co-produced
  • Holistic
  • Person-centred
  • Helpful in promoting social justice.

Here are some examples of FGC being used in practice

Informing a Safeguarding Adults Plan (MSP)

Ms and Mr X are a mother and son who are both perpetrators and victims of high-risk domestic abuse. Both want to remain living together. Ms X’s case is open to Adult Social Care at S.42 Enquiry and their case had been heard at MARAC. Relevant professionals are already involved. FGC was asked to support in creating a personalised plan relevant to their situation which would reduce the risk. The FGC coordinator created an agenda prior to the conference day by finding out from Ms and Mr X what they wanted to discuss. She also found out from each professional what they thought would be useful to discuss. These outcomes were not necessarily related to the domestic abuse but conducive to building self-esteem and focused on empowerment. Professionals wanted to address such things as how to tackle boredom which was considered to be impacting negatively on Mr X’s mental health, what to do should Ms X disengage from alcohol support, and what to do should either Mr or Ms X wanted to buy alcohol. Crucially, Mr and Ms X were also of the opinion that alcohol was a trigger and they wanted to plan for what to do should either identify that alcohol had been brought into the house. At the conference, the professionals were able to reiterate their non-negotiables and what the likely consequences would be were there to be further incidents. Ms and Mr X and their network were then able to plan how they would work together to support Mr and Ms X to achieve each outcome on the agenda. The result being that Mr and Ms X felt empowered following the FGC, with a plan of what to do should either feel at risk and with a self-directed plan to promote ongoing engagement with support services and empowering activities. All parties agreed to their actions and the FGC plan was used to inform a Section 42 safeguarding plan and other professionals’ work. The professionals around Mr and Ms X were working in a coordinated way that Mr and Ms X wanted and the plan itself was personalised and relevant to their unique situation.

Preparing for the future

Mr X is a young man with a learning disability who has always been supported by his grandparents. Grandparents contacted Adult Social Care to question what would happen for Mr X should they no longer be able to support him. Whilst there was no current need for a service from Adult Social Care, the worker recognized the opportunity to work in a preventative and empowering way and made a referral to enablement services and FGC. The FGC coordinator worked with Mr X and his grandparents to identify his network and set an agenda for the conference that included:

  • Areas that grandparents would be concerned about were they not able to support Mr X
  • Outcomes that Mr X wanted to achieve

At the conference, armed with information from professionals, Mr X’s network were able to make a plan that included:

  • A coordinated plan with future, long-term timescales to meet needs should grandparents be unable to support Mr X (and avoid crisis)
  • Immediate actions for involved professionals and Mr X to start to build independence (to reduce, prevent and delay future need)
  • Short-term but ongoing actions for grandparents to gather information to inform a possible future best interest decision

It was made clear to grandparents that the plan would not be legally binding but could be saved on the system to be included in any best interest decision and inform personalised support plans should they be unable to support Mr X.

Addressing gaps in services

Ms X is an adult who lives in Exempt Accommodation. She is an independent but vulnerable adult who wanted to move to live in long-term permanent accommodation. There was no one clear agency with a responsibility to support Ms X but a referral was made to FGC to explore and mobilise her network into a coordinated plan of support. From Ms X’s point of view, she wanted a meeting to discuss how she could be better supported at her current accommodation to maintain her strength, how she could be supported to apply for long term accommodation, how she could get back into work/volunteering in the community plus any areas that she would need support in. On the day, professionals were able to reiterate what they could/could not help with. Then Ms X and her network were able to plan how they could work together to achieve the outcomes.

The versatility of FGC can be a blessing and a curse to those for trying to promote it. Practitioners often want clear answers around when and how to refer and its integration is dependent on a culture change and brave practitioners and citizens who are willing to engage. For Birmingham’s FGC service, it is not a question of ‘either/or’ when it comes to FGC cohabitation with other services but ‘where and how’ it can compliment their achieving strengths-based practice. FGC proponents are hopeful that stories of difference such as those above help people to see the added benefit and value that FGC brings to strengths-based practice.

About Birmingham City Council

Birmingham City Council’s Adult Social Care department serves 10 constituencies covering a population of 1.1 million. The council has dedicated itself to the prevention agenda, celebrating the idea of place and working to utilise localised knowledge and developing solutions to achieve meaningful change. To support this, since March 2018 Birmingham has adopted a system of strengths-based models and frameworks which now includes 3 Conversations, Community Network Support Officers and, the subject of this article, Family Group Conferencing. Establishing the first permanent independent ‘in house’ team in the country, Birmingham’s Adult Family Group Conference service has been quietly developing itself since March 2019, focusing on how and where the service can support social work practice, where it fits in the wider system of support agencies and where an FGC inspired approach can produce meaningful and useful outcomes.

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