We spoke to Phyll Hamilton, Practice Manager at NEST who developed the service after working as a social worker and manager for a number of years.
The NEST (Nurture Empower Safe Together) service aims to enable parents to provide safe and consistent care to their children. If parents show a capacity for making positive changes, the team will work tirelessly to empower and educate parents to support them on their parenting journey. The team believes fundamentally in an individual's ability to change, taking someone at face value, rather than writing them off based on what is on paper. The model was developed with those who use the service in mind. Operational groups took place where mothers who had previously experienced having a child removed from their care, were invited to share their views, concerns and experiences. Funded by Rochdale Borough Council, the service began in 2020 and offers three pathways, A, B and C depending on the type of support parents need.
The NEST team consists of Phyll, the Practice Manager who oversees the team; two social workers who are the lead practitioners; two family support workers, known as family practitioners and a midwife. Each has their own role within the service, but everyone works through a trauma-informed lens to ensure positive trusting relationships form between the parents who use the service, the team and other professionals. Adverse childhood experiences (ACEs) are taken into consideration to understand the bigger picture. Parents who have been through repeat removals often lack trust in social workers and so the team directs a considerable effort to forging solid relationships by visiting frequently and being honest and available. The NEST model is high intervention and high monitoring by nature which means that the team can manage very high-risk cases.
Pathway A is an adult-only pathway. The service is voluntary and is available to parents who have had a child removed through care proceedings for up to 2 years following the final hearing. Support is offered for up to 2 years. The criteria for pathway A is the mother must not be pregnant, parents must not have any children living with them and final care proceedings have concluded. This is due to the unique issues an individual faces after the final decision has been made. Once a child has been removed, housing often becomes an issue, so the team works closely with the housing department. The parent is also signposted to adult services including mental health and domestic abuse organisations. Often, parents will go on to have subsequent children, so it is imperative to offer support, including advice on contraception, prior to any planned pregnancies. This gives parents a chance to make the positive changes necessary and break the cycle of recurrent removals where possible.
Pathway B surrounds the prenatal stage. To be eligible a mother must be pregnant at the pre-20-week stage and either the mother, father or partner must have previously had a child removed through care proceedings. The team carries out a pre-birth assessment with the parent and the earlier this is completed the better. Because a midwife team sits on the NEST team an earlier referral is possible. The team aims to complete the pre-birth assessment by 26 weeks. This allows plenty of time for the mother to prepare for what the assessment recommendations are and gives her a much better chance of success.
Pathway C supports parents who are able to keep their children through achieving a positive pre-birth assessment from the NEST Team. The support given in the pre-birth period continues after a baby is born, up until the child is 5 years old in the most appropriate arena (CIN/CP/PLO/Early Help). This long-term support is in line with the school readiness agenda which encapsulates attachment and child development. This ensures that positive change is sustained, and support is available if required. The team works closely with adult services including mental health teams, drug and alcohol services, early years providers and early attachment services (PIMHS) to support parents through difficulties.
The service is yet to be evaluated but the evidence from the team itself shows a positive impact. Since the NEST service was launched three years ago, they have had 60+ referrals across all three pathways out of which 20 babies are now at home with their parents. This demonstrates the impact of support and intervention from the team who aim to prevent recurring care proceedings for these families. Phyll reported that most cases working with NEST have now been de-escalated, with the majority being managed in the Child in Need arena. This is significant considering most cases start out as PLO (public law outline). This is when the local authorities are concerned about a child's welfare and are considering making an application to the court to have them removed from the parent.
The team has been granted permission to undertake additional training in ParentAssess, which is the successor of the PAMS assessment. This will support them with the pre-birth assessment as it is designed to work with parents who have vulnerabilities which may impact on their parenting capacity. This assessment framework tool helps to ensure that parents with additional needs and vulnerabilities can fully understand and participate in the process. Previously NEST had, in some cases, commissioned an independent social worker to undertake these assessments. Having the team trained in using this model is not only financially beneficial but more significantly, supports Rochdale’s commitment to being trauma informed. This prevents parents from having to retell their story to another professional, which can be re-traumatising.
The aim of the NEST model is to prevent repeat removals, which not only has societal and emotional benefits for the parents and babies, but it is financially sensible, due to the huge costs associated with a child entering the care system. Cared for children and care experienced young people are disproportionately represented in teenage pregnancy figures and they often have a limited or risky network of support. The NEST team are hoping to develop NEST and extend their current criteria to include this cohort of parents in 2024.
For more information about NEST, please contact Phyll.Hamilton@rochdale.gov.uk
Case study by Leontine Gnaly, 2023