Supporting children and families during the pandemic: A conversation with NSPCC

[Introduction]  

This is a Research in Practice podcast. Supporting evidence informed practice with children and families, young people and adults.   

Susannah: Hi and welcome to this Research in Practice podcast with our colleagues from NSPCC (National Society for the Prevention of Cruelty to Children). I'm Susannah Bowyer, I'm the assistant director on the child and family side of Research in Practice. And today we're going to be talking with a team of colleagues from NSPCC about some of the learning that they've gained around helping children and families during and after the pandemic, across 2020 and into 2021. We've lined up the recording and release of this podcast to coordinate with a spotlight that NSPCC are putting on key learning that they've done in this pandemic period. So, there are a number of reports being released and a number of really important messages that are very valuable to share. And of course, we at Research in Practice and all of us really across the country in different sectors but within the local authority part of our network, we've also been talking to people very much about some of these challenges. What we've learned and some of the adaptations that we've had to make. So, there's a lot of joining the dots and shared learning that we can do between the work that NSPCC has done and the rest of the Research in Practice membership as well. The big focus in some of this spotlight programme is around the complexities, challenges and opportunities of developing blended working between face-to-face and virtual practice activity. But it's also a really important factor, I think, that NSPCC are focused in on thinking about responses to immediate needs arising for children and families and communities and the learning that they've drawn from that. So, we're going to spend a bit of time thinking about that as well initially. But before we get into that, let's just introduce the colleagues who are on the podcast. So, I'll ask you to introduce yourselves going across my screen, where we're recording online here. So, Deborah first.   

Deborah: Hi, my Deborah Radford. I'm a service manager working for the NSPCC in York.   

Susannah: Lovely. Aisling?   

Aisling: My name is Aisling McElearney. And I work as senior development researcher within the development impact team.   

Susannah: And Matt.   

Matt: I'm Matt Ford. I'm development director at the NSPCC.   

[Gathering those insights from children and families]  

Susannah: Lovely. Great, so let's start then by thinking about what you've learned about helping children and families. And in doing that obviously you've been listening and talking to the children and families that you're working with. So, Aisling will you tell us a bit first about how you've been gathering those insights from children and families. And from your practitioners to try and understand their experiences of the support they've received from the NSPCC over the last year or so?   

Aisling: Yes, of course Susannah. So, I guess April time we recognised very quickly that it was important that we capture as much learning from this experience as possible because that will be used to inform and shape our practice going forward and the share it with others across the sector. So, what we did was, we pulled together a research and insights project. Using a range of different methods really, to try and capture as much or as full of a picture as we could from the perspective of not only those who were working directly with children and families, but to engage the children and families as much as possible themselves. And we also did it in a way that we wanted to collect that data from basically April, May right through the summer so that we would have-, recognising the things we want to develop and evolve as time went on. So, what we set out to do was really to document and describe the journey and what that felt that, not only for our own staff, but also for the families. We wanted to identify what had worked well and what hadn't worked well. And we wanted to engage our service users directly in telling their own story. And as well as that, looking towards the future in terms of identifying some staff training needs. So, we did a range of focus groups and interviews with our staff and also a survey with them. Looking at their attitudes and beliefs around using virtual and digital methods to deliver services. And then, later on in the autumn time we did a series of interview with service users.   

And I suppose within the context of all that was going on around us and the external environment, we interviewed twelve children and young people, aged between eight and 18 who had used our services right across the countries of the nations that we work in. We tried to ensure that we spoke to children with a range of experiences across all our services. Whether that be therapeutic recovery from sexual abuse or whether it would be early help services. And of those twelve children, we spoke to three with special education needs and disabilities. And two looked after children as well. The majority of the children, ten of them, were female or were girls. And we also spoke to three external delivery partners who had worked with us, and I think Matt and Deborah will share some examples of some practice in that respect later on. And we also used our case service data, the routine data that we normally collect and data that in many times and many organisations we collected but we don't make the best use of it. So, we wanted to make sure that we captured that, we had a look at it and to see what we could learn from it. So, we looked at all of the children and young people and parents who had accessed our services between March and July and in this case, it was over 1800. To look at who they were and what the nature of their engagement was and how we had responded in terms of the service that they'd accessed.   

Susannah: That was incredibly, sort of, quick off the mark, brilliantly quick off the mark, really, that you developed a research programme in the midst of all of those challenges that we were all facing. To actually be attuned enough to think, well, let's come and capture this live learning. I mean that was very…   

Aisling: Yes. I mean there are other services where we did, such as the Pregnancy in Mind virtual service, where we're actually about to report on the outcomes evaluations again using routine data. Because the model was adapted and we felt ‘let's get as much learning from this as we can’. And we had fantastic collaborations from our teams in terms of compiling that data and learning from it and there's a real sense-, I think, of all of the data, the thing that sticks out most for me is really about the real commitment of our practitioners and our teams to really being flexible and agile in adapting what they were doing to meet the needs of families in a way that worked for families. And then to take as much learning from that as possible, whether that be contributing to the research. Whether it be supporting the inputting of data, when they had so many other things on. Or whether it be coming together in groups within their own teams or across teams to share learning on an ongoing basis throughout the response to the pandemic. And that, in a sense, was really one of the key things that comes out of this. About that commitment and putting children at the heart of, and being really flexible and going those extra nine yards to do the very best we can.   

[Key messages from the research]  

Susannah: It really is incredible isn't it. And we value and recognise our NHS and arguably, probably given enough airtime to this incredible sort of commitment that people have been working with over this period. So, what would be a couple of key messages from that body of research? And obviously that's a really rich body of material and the reports that you're putting out will give much more detail on that. But what would be a couple of the key messages from that, that you'd like to share.   

Aisling: I think one of the key things that have come out of this, really, in terms of looking at virtual and digital delivery, like, had we considered this time last year would we use technology to deliver services to vulnerable children and families. We most likely would've said that that wasn't possible. And I'm not saying that it's always possible or it's always a thing to do but, in some circumstances, in some services and for some people and some children and families, it does work well. And there are significant benefits to be gained from that. We know that in some of our services for example that they were able to extend their reach and engage with parents of children who otherwise they wouldn't have been able to engage. Because, whether that was to do with geography or whether it was to do with some of the barriers to engagement. Maybe parents being too anxious to attend, or for someone to come into their home. Finding that too stressful. But what we know is that, parents were able to build relationships with practitioners virtually and remotely at a pace that actually suited them. And I see that coming out of some of the literature that's coming out, in terms of the academics that are publishing. Whether that's Mary Baginsky and Jill Manthorpe in the early days or whether it's more recently Jenny Driscoll both from Kings College talking about how actually, they're building a relationship in some circumstances and actually opened up where children were able to engage more where otherwise they wouldn't. One of the key things we must remember that it's not a one size fits all. It doesn't work for all families. It doesn't work in all circumstances. But anything that helps us meet the needs and address the barriers for engagement for some families is worth considering and taking forward.   

Susannah: And it doesn't work even for one person all the time, does it?   

Aisling: Absolutely and I think that was-, Deborah and I were chatting the other day and I think that was one of the surprises that maybe as an adult maybe there was an assumption that children and young people would be happy and would be keen to engage via technology and certainly for some children that wasn't the case. I spoke to one young woman who did not want to use technology to engage in her therapeutic recovery journey. It wasn't just about technology; she didn't want to do that work in her home. She wanted to go to the safe place of the service centre where she felt comfortable. And then go back to her home, which had nothing. She didn't want to have those difficult conversations in a home context and bring that kind of stuff into her home. So, it's very much something we need to consider in an individual context about what suits and what works for, I mean, one of the phrases that came out was place and space. Most appropriate place and space to do the required work to provide the support for children and families.   

Susannah: Yes, and I think the work that we've been doing, colleagues of mine at the moment have been through consulting with practitioners and quality assurance leads and a whole range of people and children and families as well, is to start to shape a practice framework to think about the principles and values underpinning those decisions at any time in the course of working with somebody about when digital and face-to- face practice is and isn't the best way round things. So, you know, there's a lot of learning then also for us to share back.   

Aisling: Absolutely. I think there was one really lovely example from a young girl who was engaged in one of our therapeutic recovery services who had begun and completed all of her therapeutic work in an online context and had worked. And her mother had been involved in some of the sessions and they took place at home and it was just a really rich example of how, for some children it can work very well. And she had-, when buildings became Covid secure she had gone in and met her worker in a face-to-face context but actually decided that she preferred to complete the work online. And so, we do hear sometimes that it's not possible to do some therapeutic work in an online context, but really creative examples of practice undertaken on one of the video conferencing things, were very practical creative activities. So, for some children in some context again it can work.   

[Together for Childhood]  

Susannah: So, we'll come back and hear a bit more about the digital, the hybrid practice. That's one of the things we're challenged with. What's the terminology we're going to use? Okay, great. It'd be great to hear a little more about, you know, the kind of ground level experience and understanding that you and your colleagues have gained in this period of working alongside families in communities. And what I picked up from the briefing note that you shared with me was that there's some particularly strong messages from the Together for Childhood areas, where NSPCC is embedded in local communities. So, Matt might you tell us a little bit about what is a Together for Childhood area? And why you think perhaps there's been some really strong learning to come out of those areas in this pandemic era?   

Matt: Together for Childhood area is a programme we have which is about developing police-based partnerships in communities across the country. So, far we have four of them in Glasgow, Grimsby, Stoke and Plymouth. And, you know, what it's about is, us getting involved in a meaningful partnership with local people, with community organisations and public agencies. All around how is it that we can work together to make the community a good place for children to grow up. And how we can improve children's wellbeing and keep them safe. And they've been running for a few years now and in all of the places that we're working are developing very much in a locally-led way. So, it all looks slightly different. But what they have in common is that we're alongside and working with and sharing learning across with local people, local organisations. And we're kind of really embedded in community life. So, it meant that at the start of the pandemic we were in the community and really in a place to understand and see first-hand the impact of the pandemic and the lockdown on children and families.   

[The importance of relationships]  

Susannah: So, it's once again, as it so often is in this area of work, it's back to relationships? You started out in this pandemic with some strong existing networks and relationships in those local areas.   

Matt: Yes, so right at the start, and I think along with many, many people all across the country in all sorts of walks of life we were asking ourselves, 'How is it we can step up and be there for people in the community?' And to come up with childhood areas we thought, 'This is an extraordinary situation, we don't know what's going to happen next and how things are going to turn out, but we need to do what we can to be there for children, along with other people.' So, our first port of call was actually our colleagues in children's services, to really understand how it is we could work together along with them and the community organisations that we were alongside. So, for example, to give an example in Glasgow we started right at the start and we looked at a few families who are getting referred to that you can't get to because your resources are so stretched. We're there, we'll go beyond our normal service and boundaries and get in touch with families and whatever we really can and see what we can do to support them. So, that was kind of what we intended to start with. Another thing that we did that I think was really quite important was these projects are kind of based on a kind of ethos of sharing learning that we learn together, that we create solutions together. So, obviously for instance we'd get a big emphasis on getting a learning out of that so we have evaluation teams working within these partnerships. So, we were able to turn the evaluation of colleagues' efforts into actually extracting them from what was going to unfold. So, from the start they worked alongside our practitioners and got them to provide a regular output through reflective diaries of their experiences. And then to get really rich analysis of their experience and to understand through the practitioner's eyes what they were learning about children's lives but about experiences of families in particular who are the most vulnerable families. So, that was the context, along with everyone else we were also thinking about how is it we shift to working online. Because at the beginning, face-to-face work was suspended along pretty much every other service. And so, we were able to continue some planned work.   

We were able to adapt some of our programmes and we were able to put in place a much more basic level of care. Seeing of ways of contact and checks with families. And we were able to contact families who'd never been in any, kind of, formal input from any agency who had suddenly been tipped into crisis as a result of the lockdown. So, for example we worked with a significant number of families where they had one or more child with additional needs, for example, ADHD (attention deficit hyperactivity disorder) or autism spectrum disorder diagnosis. And those families which were families that had seemed to be coping perfectly well in normal times were suddenly faced with a situation where the supports that were vital for their children's ongoing wellbeing suddenly disappeared overnight completely and were tipped into crisis. So, we were thinking about how is it we support those families. This also then threw up other issues that emerged. So, working online is fine if you've got access to a good internet connection and you've got reasonable devices and you've got enough devices for people in the household. But many of the families we were dealing with didn't have that. So, it wasn't so much online, remote contact was a phone call. But this sort of value that we could see because a young person, for example, who may have agreed to a phone call with a regular allocated worker when they phone the young person, they're answering on the first ring because they're waiting for that call because it was really important to them. So, we kind of understood from the start that we were going to have to, you know, venture out to new territory, necessity being and the mother of invention as Aisling has said, 'If you'd asked us before the pandemic could we deliver the things that we delivered online.' We'd say, 'Well, we need to do a piece of work on that it may take a long time.' You know, no we actually had to get going with it.   

I think the next thing that really proved to be absolutely vital as well was the existing relationships we had with community organisations on the ground. I think because, you know, in the face of what could have been really quite disheartening to learn through the families we were working with, but the hardship that we were facing, the lack of access to absolute essentials of life. One member of staff was saying how it affected her so much to realise what anxiety families were experiencing about being able to have enough nappies and the relief when, you know, when they were provided with a supply of nappies. Food and being able to eat, bills, these things were hugely challenging for many, many families, but because of our relationships and different places, we were able to step up and respond. So, on one of the sites, we formed a partnership with a local food bank and a local environmental charity, we established a kind of one-stop-shop where families got access to food, we ran toy library which gave developmentally appropriate toys for the families and they could exchange them week on week. And they could get access to other services and they could also get information about where services were still operating because basic information wasn't there for some of these families. That kind of being able to respond we couldn't have imagined that if we didn't have a pre-existing relationship with these local organisations who had the connections right through the community.   

Susannah: And one of the things that we heard in talking to children's services departments in London was that kind of reaching out with practical help and support to families who they might have considered that rather ungainly phrase hard to engage which may often actually mean that, you know, we’re perhaps not using the right mechanisms to try and reach out and meet people where they are. But that forward-facing practical hand of support really changed the kind of dynamic of the relationship between those families and children's services departments. Did you see examples of that too, that people felt seen and supported in a way that they might otherwise have felt wary or anxious of service involvement in their family life?   

Matt: Yes, I mean, you know, families were very positively engaging with the support that they were getting and I think it's a, you know… it was a turn on its head. The kind of the sense that, you know, we often have about families being wary of children's social care, of children's social workers as it is in Scotland and actually really responded very positively to the opportunity to connect, not just with workers but with other families and to have some kind of outlet. The kind of isolation that people were feeling, it was quite striking and what we did see was parents who were quite evidently struggling with their own mental health and in the context where the things that would help them with that were just not available, access to families, access to support services. And, you know, the concerns, staff were hearing from parents that they were struggling and turning to drugs and alcohol and, you know, our staff then were picking up concerns about actually the children being more at risk in that context. So, you know, what can you do about that, it's got to be about practical supports and being able to respond to alleviate some of the pressures that families were experiencing and the kind of experience of delivering that wasn't always straightforward for staff, it was very challenging because you're not always sure what's happening.   

Susannah: So, you've talked about these on the ground level offers of support and abilities to connect people with each other and of course we know that social isolation and a feeling of shame and stigma is something that goes along with the experience of poverty pandemic or no pandemic. Any thoughts about how you might keep some of these elements going into 2021 and as we move, hopefully, out of the kind of lockdown and tier world, but also into, you know, what is definitely going to be a hugely economically challenging period?   

Matt: Yes, so I mean, you know, take an example that I've already spoken about, the toy library we established in partnership with other organisations, the dialogue has moved on now with local community organisations about we make a kind of community resource permanently available and how we find the right home for that in terms of the right community organisation to lead it. How the community representatives involved are leading that and get it onto a sustainable footing because it's a really positive contribution to family support in the context of the community they were working in, so that's a very tangible example of the kind of legacy of what we've done in a very, sort of, pragmatic, reactive way in the context of a crisis. I mean there was also a sense of when to learn about those elements of online or remote support that actually worked quite well for people and how to retain them as well as moving back to face and face and contact in the family home as soon as for as many as possible of the situations where that really matters. And we were very conscious, I think, of the hidden impact on children, so things that we couldn't see, so, for example, children age zero to five who were missing their normal health visitor assessments, they work with children who have got communication or language difficulties or other developmental issues which have not been picked up.   

Susannah: So, in terms of what you've learnt about families need, immediate need and the kind of need they might be facing coming out of this pandemic what would be your reflections there, Matt?   

Matt: Well, I think there's no doubt that what we've seen is that children have suffered through this pandemic, the most honourable children have suffered the most, they've experienced the most enormous setback in all sorts of ways, so we think it's absolutely vital that there's recovery services for children especially mental health services, that they provided them with the therapeutic support that they need to recover. I think also we can't forget what we've learned about the digital divide and about the lack of access to the basic connections that matter pandemic or not pandemic and the financial hardship that families are living in with daily is something that needs to be addressed and lastly the strong local communities is the past way of helping children have healthy, happy childhoods.   

[Opportunities arising from the change in context]  

Susannah: Lovely, thank you Matt. So, some really sound grounded practical examples and some real possibilities and potential for continuing to build on that work into the future. So, we want to come to Deborah now and kind of build on that and obviously Aisling and Matt have both talked about the challenges and the opportunities of this different kind of working that we've been forced into by the pandemic. But having been forced into it, it would be interesting to hear from you from the, sort of, NSPCC service centres perspective what kind of opportunities you see arising from these changes looking forward?   

Deborah: Thank you. Yes, I think the opportunities perhaps arise from a wider range of ways to engage with children and families, as other people have said, a year ago we wouldn't have imagined that it was possible to work remotely or online. So, I think we need to build the skills and the confidence of staff to continue to understand how to use some of the tools for example that we would use in a face-to-face session when we're working online. So, if you just think about something that a lot of social workers would use in their practice like genograms or eco maps, if you're sitting in a room with somebody, you're, sort of, having a conversation, you're writing, they're writing, you're supporting that child or that adult. When you're doing things remotely, it's very difficult. So, I think there is a space for continuing to develop or knowledge and our confidence. I think we need to make a careful assessment about when is the right time to work online and when is the right time to be in the same space as a child or their family, so for example, if we've been asked to work with a child of four who's been sexually abused, I would imagine the opportunities going forward are that we can do so much more now with their parent and caregiver, the safe carer. But there will always be a need to do trauma-focused work on face-to-face basis with a small child like that because although a lot of children are familiar with devices children at certain ages are not comfortable to talk about certain things.   

And even children that we thought would want to engage with us online have said they didn't want to do that, not for all of the work anyway, so they were really thrilled that they could-, I think the important thing was staying connected. And the opportunities going forward I think are about, so different stages of children's lives, children often perhaps cancel appointments because they've got to work or their parents have got to work or they've had an operation or they just can't come in or it's too expensive or something like that. This means that we can say, 'Okay, you can't come for your planned session but I could see you for half an hour, virtually see you.' And I think that level of flexibility will really help families to see that we're walking alongside them. So, I think there are lots of opportunities, I don't think it's a one size fits all, I really do think blended, we call it blended approaches, will offer lots of opportunities we found particularly working with parents. So, we've had to put a lot of planning and thought into how we work with parents and children online, so the opportunities are great and probably endless but also workers have got to spend a lot of time prepping properly. So, they have to send things out, they have to have a conversation with a parent, if they're going to try and replicate something that they would have done face-to-face and they’re asking a parent to use that space with their child they have to really support them to do that because parents haven't got the script to be a professional.   

And just as we didn't have the script about how to work with parents remotely or children, we've had to learn a lot of things, so we have to spend that time I think working with parents and we have to make careful judgements, whatever the opportunities seem that they might be to actually have those conversations about does it feel safe to do the work, is there confidential space. For our workers who might be maybe back in an office but if they're working from home can they work safely at home, you know, what are their home circumstances and also what's the impact of staff of working with quite difficult subject matter in their own home? In the past they used to be able to put their coat on get into the car or get on a train or a bus or something. So, there's lots of opportunities but we also have to do careful risk assessments, I think for the children, for the parents and for our staff and recognising that in the online world we don't see everything. We see some things and we don't pick up as many things potentially as we might if we were actually having face-to-face and sitting with silence sometimes or watching what's uncomfortable. So, I think there's lots of opportunities but there's still a very big space for developing our knowledge and our skills and our experience.   

Susannah: Yes, I mean Harry Ferguson, who's been doing this longitudinal study through the pandemic building on work he'd done before, has written a lot about this, hasn't he? About touch and smell and those important aspects of being with people that obviously we're missing in this kind of situation. And the kind of issues about the workforce reflective supervision online is also another whole area isn't it, how to build that.   

Deborah: Yes, and staying connected with your colleagues, it's very different this way but trying to have sufficient supervision, staying-in-touch time, virtual cups of tea, developmental opportunities to share, 'I tried this and it really seemed to work.' You know, and building up the resource bank at home as well as in-service centres because at the moment everyone we work with has their own little box of things because people can't share toys and resources and things like that. So, we've even had to, sort of, bring in, like, little fleecy blankets which are just for one child or one parent because we have to have the windows open and it's cold, so there's just really practical things that we need to be thinking about as well as the emotional health and wellbeing of staff and of our service users through this period up into the autumn and beyond, I think.   

Susannah: Yes, no, I think so, but we are and I'm sure you are, hearing, you know, really interesting opportunities in all of this especially, you know, and always where, as you're suggesting decisions about when and where are driven by what the child or the adults that we're working with wants at that particular time, for instance, especially in the earlier part of 2020 about social workers and young people feeling that their relationship had deepened by shorter WhatsApp calls or connections more frequently rather than the, sort of, planned visits with long gaps between. Have you been hearing about that kind of stuff as well?    

Deborah: Definitely, definitely and that's been about trying to be child-led, not making assumptions about what all children will feel comfortable to do and at first that felt a bit uncomfortable for us, yes, a phone call is not the same as seeing a child, you know, a text message. One child didn't want to speak on the phone she just wanted to text and we had to live with a certain amount of risk around that, that risk assessing that whilst they're in contact with us and they have a trusted safe adult we're hoping to build on that. And we have seen that happen as well, that sometimes it's about a toe in the water, build that relationship slowly and then maybe eventually go to actually seeing somebody and for us to be thinking we didn't all feel comfortable looking at ourselves or looking at each and actually we're only about, you know, we're often a meter away from each other when we're looking at laptops or devices. We'll we'd never sit that close to somebody in an actual real space would we, so it's not perhaps surprising that people felt uncomfortable about it, but just going back to the opportunities I think building on what Matt said, I think communities want to be proactive and help.   

So, at the beginning we were very aware of poverty and the impact issues for families and we put one little request out and we were inundated that day with practical things to do with toiletries. We were also looking particularly at sanitary products because we became aware that the usual avenues for support for young people that they were not there. And there were people arriving at the service centre with things to donate, they might not have been able to give money but they were very connected with the idea of how the pandemic was affecting children who couldn't access normal services. And I think it's about telling the lived experience of children and families and people started to talk to us about their own childhood experiences of poverty, of abuse and neglect and how they really wanted to help and do something and some of them they didn't want to leave their name and address, they didn't want a thank you card they just wanted to do something. So, I think how we bring more people in to help children and families and communities there's an opportunity through this process and I think actually people are interested and how do we engage people at the right level for them to support the work that we're doing on the front-line.   

Susannah: I think that's a really positive note to, sort of, come towards the pandemic… end of the pandemic, end of the podcast, hopefully, the end of the pandemic as well before too long. Kind of building on that empathy and community, that sense of communities coming together as we come out of it and, you know, there will be opportunities for division and decisiveness as well, but to try and keep building on, you know, the sharing that you've all kind of talked about in those community initiatives and yes, grow the work that you've been doing together. So, brilliant to hear about the commitment and passion and hard slog that people have brought to this, brilliant to hear that you were so off the mark as to be, you know, capturing with research right through this period and I hope this podcast is a good addition to the spotlight material that you guys are releasing and that that will be a great learning to share with the rest of the sector. Thank you very much.   

Deborah: Thank you.   

[Outro]  

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