The Space Project, run by Cambridgeshire County Council in the UK, works with women who have had children permanently removed from their care and aims to support these mothers to build more stable lives.
Traditionally, once a child is removed, support to the mother from services such as children’s social care, health visiting and midwifery ceases. This can leave the mother to cope with the loss of her child or children on her own and research shows this void is often filled by having another child. Unfortunately, very often, subsequent children are also removed and the pattern continues at great cost to the mother and children emotionally but also at cost to children’s social care and legal services.
Based on a successful project ‘Positive Choices’ in Suffolk, Space launched in December 2015 with 12 month funding via the LAC Commissioning Board, which has been extended to 18 months. One of the first challenges to consider was that the mothers have often had a negative experience of working with professionals over many years, and some have totally disengaged from services - a new approach was required to encourage the women to work with the project. The Council’s Chronically Excluded Adults Service have a tried and tested approach to working with people who are considered to be “Chronically Excluded” and with lessons learnt from Positive Choices, Space was able to develop an approach of working with the mothers at their own pace, giving them the control in the interaction and relationship.
Engagement – both initial and on-going, needs to go to the client, rather than expect her to come to us, and allow the woman to engage in a way that she feels comfortable with. Space needs to be flexible, and not take it personally when she isn’t able to meet with us. It can be like trying to get a butterfly to rest on your hand, any sudden movements and they will be gone, but with gentleness and patience, and being there, the butterfly can come to you when they feel safe. The project has found that this works really well, with women who we were told ‘would not engage’ accepting and working with the project.
Partnership working has been key to the success of the project so far, with positive relationships built with key professionals such as housing, benefits, domestic abuse and substance misuse services, as well as the iCASH service, with whom a ‘fast track’ system has been developed to enable the women on the project to access long-acting contraception swiftly.
The project runs with two experienced project workers. Management support and clinical supervision has been provided from existing resources from experienced professionals within the County Council which has reduced costs usually associated with a new project. In terms of cost savings, the project is currently working with 24 women, these women have had a total of 62 children removed from their care. Utilising known research, it can be predicted that 13.2% of these women will become pregnant again within 1-2 years, therefore statistically 3 of the women working with the Space project could be expected to become pregnant. The legal costs of each child removal are estimated at £75,000 (this does not include social worker time). If the project prevents only 2 recurrent removals, the costs of the project would be covered in terms of the legal costs of removing a baby, however there are also savings to the health economy in terms of improved mental and physical health and reducing reliance on public sector support. The emotional costs to the mother and children are immeasurable.
Feedback from a Client via the Refuge she was supported into:
“I was a real mess when I first met Sarah, but now I am in a better place because she helped me realise that I needed to look after my physical health (which I wasn’t doing) but she never judged me about my drugs and alcohol. I have had a smear, got a full health screen and have some tips and hints on how to manage my anxiety better. She talked to me about the possibility of moving away to get away from ‘him’ but she never forced or rushed me. She let me decided to come to refuge and now, here I am!”
Other early successes include a 20-year-old woman who spent a number of years in care and who had had two babies removed by age 20 was homeless when referred. She was described by professionals as “almost impossible to engage”. She is now in supported housing, has a contraceptive implant and is moving on with her life. This was achieved because her worker developed a relationship with her by driving her where she needed to go and buying her lunch, and engaging at a pace with which she was comfortable.
For another woman, who had a history of suicide attempts and hospital admissions, the joint working with mental health services prevented a crisis at a key moment; she didn’t attempt suicide or become hospitalised as was feared she would.
The Space Project is still in its infancy, however, we are ensuring we are measuring outcomes to be able to demonstrate value. Cambridgeshire is currently supporting Bedfordshire to set up a similar scheme and will be presenting at national conferences over the next couple of months.