It's a bright summer's morning and Ann-Marie Kirk, a family support worker at the Instant Response Team (IRT) arrives at a terraced house in north Liverpool. The family is struggling to cope. Kirk is here to help them with breakfast, check on the children's routine and take them to school.
The first member of the team arrives at the office, opens the shutters, unlocks the door and makes a cup of tea. The team is based at Liverpool City Council's children's services building in Croxteth, a suburb of Liverpool, that became front-page news in August 2007 when 11-year-old Rhys Jones was shot dead by gang members in a case of mistaken identity. Gangs are still a problem in the area and some of the team's sister services work with those. But the IRT is focused squarely on breakdown within the family. They aim to provide intensive support to families in crisis where children are at risk of going into care. "We try to do it as a whole-family approach because you can't just fix one person, you've got to fix the whole family," says Julie Rogers the team's manager.
There is a team meeting every Monday morning, where Rogers goes through the plan for the week. Her team is made up of a deputy, eight family support workers and a supervised contact co-ordinator. Cases are referred by social workers only. With urgent referrals the team aims to get its family support workers there within two hours.
Staff come from a wide range of backgrounds and have a wide range of skills - youth work, health service, psychology degrees, the building trade. To work as a family support worker staff must have a childcare qualification - the minimum is NVQ Level 3. New family support workers are mentored and shadow other members of the team. They must do mandatory training in subjects including safeguarding, neglect, cultural sensitivity, record-keeping, domestic violence, and child development.
The job is more hands-on than social work and is about getting results fast. They usually work with families for only six weeks so the support must be intensive. In the most demanding cases, it can be three hours a day, Monday to Friday. With such a short timeframe the support must be well planned. The Monday morning meeting is a chance to check when visits are taking place and who is available for emergency referrals. An emergency referral can come in at any time during working hours. Outside of these hours the council's Careline deals with emergencies. As well as direct work with families, staff are in close contact with colleagues from child protection. If there are any safeguarding issues, a social worker must be informed immediately.
Two family support workers, Lynette Sung and Amanda Doyle, visit a woman whom they suspect is the victim of domestic violence. She can't speak any English and her partner says she doesn't want to learn. The couple have a young baby and are struggling to cope. Sung and Doyle have to communicate with the young mother using an app. They hope to arrange for an interpreter when they return to the house tomorrow.
Sung and Doyle return to the office. They write up their notes and give feedback to Rogers. They are trying to get the partner onto a domestic violence perpetrators course.
A mother comes in to see family support worker Paul Cawley. Today is the start of her fifth week of support from the IRT. She had a nervous breakdown when her son, who has attention deficit hyperactivity disorder, became aggressive. Her case was referred by a social worker when the son was found trying to hang himself. Now the situation has stabilised. The son is at a new school and Cawley is working with him on exercise and diet. "He's not kicking off anymore," says mum. "He's recognising when he's feeling agitated. We feel like a proper family, we're having fun together."
However, she is worried about life now the team is about to end its involvement. "We don't feel abandoned by Paul," she laughs. "Because it was always made clear at the start that it wasn't going to last forever - it's to help with the crisis." There is a plan for her son to continue getting extra support at school and from mental health services. "If we hadn't had the instant response team in our family, me and my husband would have split up," she says. "They came in and put the jigsaw back together."
With only six weeks to work with families collaboration with other teams and services is crucial. The IRT fits into a menu of family support services in Liverpool. Angela D'Annunzio, service manager for children's family support, took over the service in 2000 and has seen it grow from six to 85 full-time staff. There are two mainstream family support teams that IRT refer to once a case has stabilised. There is an intensive outreach team that works with young people involved in gangs and organised crime and a family group conference service to encourage families to find their own solutions to problems.
Like all local authorities, Liverpool City Council is dealing with funding cuts. In the past these have affected the family support service, which lost 15 posts a couple of years ago. But since then investment has gone up, explains D'Annunzio. She points to money for a school family support service and investment in family group conferencing from Liverpool's Families programme. Meanwhile the city's Troubled Families programme has funded two therapists to work with the intensive outreach team. "I believe we've had investment because we are able to demonstrate positive outcomes," says D'Annunzio.
The stats for the IRT are impressive. Of 201 children worked with last year, 189 remained at home, with only 12 going into permanent care. The majority of the 189 did not require ongoing support after the IRT's support ended. A cost analysis by Rogers suggests the team saves anything between £3,500 and £5,000 a week to support a family of five in comparison with putting children into foster care.
Crucially, children prefer dealing with family support workers than social workers, says D'Annunzio. "It's understandable," she says. "Social workers have a very difficult job to do." Family support workers operate outside that statutory role and can build relationships with families "and we're seen to do a lot of the practical work".
Lunch is taken at any time between these times. Staff must take at least half an hour.
A team member calls a social work colleague to ask if one of the families has taken their child to the doctor. "We won't necessarily take a parent's word for everything they say. We check to see if it's happened," says Rogers. Data protection rules means that in these kinds of situations, it is the social worker who will have to do the checking.
Sheila Kenny and Danny McCluskey visit the "P family" in Anfield to talk to them about their concerns about inadequate accommodation. There are nine of them living in a two-bedroom house. Mr P's new partner has just had a baby. She agreed to take in his five children when his ex-partner died, which stopped the children going into care but she was struggling to cope at one point. "It was all just a big blur, I was pregnant and there were lots of emotions flying round," she explains. "Sheila helped me out loads. Without their help we wouldn't be where we are now." It has been tough, she adds. "Can you imagine nine people in this house? But I couldn't leave those kids in care." Sheila makes notes and says she will ring the local MP and the council to find out about more suitable accommodation in the area.
The support the team provides may be highly practical. For example, they helped Mr P clear and clean the rental property he and his children lived in with their mum before she died. "My colleague and I went in and decluttered it, filled a skip, painted the rooms," explains McCluskey. "It was a sensitive situation and we were careful to check before we threw anything away. He got his deposit back, which was helpful because the family's benefits are still in the process of getting sorted."
Kenny and McCluskey return to the office and on the drive back discuss the work they do. "It is very satisfying," says Kenny. "But some of the cases are hard. Children are removed because conditions at home are dire - faeces, animals, broken furniture, bedding full of urine." The trick is not to be judgmental and to look at the reasons why a family has fallen so far, the pair explain. But can you really make a difference in just six weeks? "If they see you're giving 100 per cent you get 100 per cent out of them," says McCluskey. When they see you cleaning a house, taking away rubbish, making improvements they get onside, he adds. "Then you can work on structure, routine and get them involved in the community. Some of the families we've turned round in six weeks, it's been really amazing." It is not just the families who are grateful, says Kenny. "Social workers are really appreciative - it takes some of the pressure off them."
At around this time family support workers may collect a child from school and bring them back to the building to work on issues including anger management, internet safety, conflict resolution and relationships. They use a clock exercise to find out about a child's routine - the same exercise is done with parents.
Back at the office Kenny calls the council's housing department to find out about housing options for the P family. The team works closely with council colleagues and partners who say their work helps across the board with schools seeing better attendance and children turning up to appointments with health services. "The team's main aim is to reduce our numbers of children coming into care, which are too high and have been for quite some time," says Fiona Waddington, assistant director of social care. "They'd be even higher if we didn't have the IRT." The team's experience and local knowledge is key, adds councillor Barry Kushner, cabinet member for children's services. "They know the hinterland, the communities they're from, the relatives of the families they're dealing with and that gives you a bit more nouse," he explains.
It is that ability to engage with families that is the key to the team's success, says Waddington. "They get that engagement from families even when there are many barriers being put up by the family."
The authority's latest Ofsted inspection, which praised improvements to "front door" social work yet rated children's services "requires improvement" overall, highlighted the strength of family support services. "The immediacy of the intensive family support, including edge-of-care support, provided to families by the multi-agency instant response team is impressive," said the report, published last month.
A restructure of children's social care in Liverpool is on the horizon and D'Annunzio says she will work with Waddington to ensure the IRT's work is aligned to that of social work colleagues. "We'd like to develop a domestic abuse perpetrators programme and also do more at the ‘low end' to work with families on how their behaviour and emotional wellbeing impacts on children," she says.
An emergency referral comes in requesting support for a family with three children with mental health issues and a father who can be violent. Rogers allocates the case to a keyworker who will arrange to meet the social worker at the family home to assess the situation.
When team members first go out to a family, emotions may be running high. Rogers recalls responding to a referral one afternoon to find a mother and her 13-year-old daughter at loggerheads. Mum said she wanted her teenage daughter out. The team took the girl back to the office to try to find somewhere safe for her to stay for the night but time was running out. "She was terrified and really upset. ‘I'm not moving, I'm not moving,'" says Rogers, who explains this was one of the most challenging situations she has had to deal with. Luckily they knew the girl felt comfortable in a car. So Rogers and her colleague ended up driving around Liverpool making calls. The girl refused to stay with a foster carer but eventually - at 11pm that night - her aunt agreed to take her in. She went on to stay with family for a few weeks and with the team's support eventually went back home.
Staff not meeting families head home at about this time. Family support workers are not expected to take work home. Usually if they get a call from a family out of hours they must give them the out of hours Careline number. But sometimes family support workers will keep their phone on until an agreed time to offer telephone support.
Team members do sometimes work outside their core hours of 8am to 6pm and have stayed with families up to 9pm if a referral has come in late in the afternoon.
It can be emotionally exhausting work. But McCluskey is in no doubt of its worth. "I feel we're very privileged to be part of a child and family's journey," he says. "All the workers in the team go above and beyond. Luckily we've all got very understanding partners. The majority of families we work with are on the bottom rung of the ladder. Our role is to get them back up that ladder."
FACTFILE: INSTANT RESPONSE TEAM
When did it start?
The team launched in 2010
Where is it based?
Liverpool City Council's children's services base in Croxteth
How many staff?
The team is made up of 11 staff - eight family support workers, a deputy team manager, team manager and one supervised contact co-ordinator
How are children referred?
Social workers refer children according to "imminent risk of accommodation" criteria - essentially the risk of a child going into care. Referrals come via email to the team manager outlining the reason for referral and basic information. Because it is a crisis situation, this more informal style replaces the need to complete a referral form
How many referrals per month?
The number of referrals varies each month but the team get roughly six to eight on average
How many families?
In 2016/17 the team worked with 94 families in total. In 2017/18 it was 79
How much does it cost?
In 2017/18, it cost £435,000 to run