This webinar follows on from the RiPfA Family Group Conferencing with Adults workshop (London, June 2017). The webinar content will be drawn from the workshop and is intended as a recap for those who attended, or as an overview for those who did not attend but would like to find out more about this subject. We strongly encourage you to book a training room to screen the webinar and use it as a space to discuss how you might develop a similar service in your area. The webinar will: Provide a brief introduction to the origins, principles and processes of FGCs with adults. Provide an overview of FGCs within the context of legislative frameworks which support adult social care (eg, the Care Act 2014; Making Safeguarding Personal 2010). Provide an overview of the research/evidence base on the effectiveness of adult FGCs. Share practice ideas for setting up an FGC service, or for further developing an FGC service which has already begun*. Share ideas for developing a simple framework to measure the effectiveness of adult FGCs in your organisation*. *These ideas will support the development of a RiPfA resource looking at evaluating the impact of a family group conference service with adults (to be published in October 2017). Aimed at: All those involved in adult family group conferences, including senior leaders, managers and coordinators who already run or are looking to set up a family group conference service for adults.

1. Family Group Conferencing
with Adults
Lydia Guthrie,
RiPfA Associate
12th July 2017
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2. Webinar objectives (1/2)
› To provide an introduction to the origins, principles
and processes of FGCs with adults
› To provide an overview of FGCs within the context
of legislative frameworks which support adult
social care
› To provide an overview of the research/
evidence base regarding the
effectiveness of adult FGCs
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3. Webinar objectives (2/2)
› To share practice ideas for setting up a FGC service,
or for further developing a FGC service which has
already begun
› To share ideas for developing a simple framework to
measure the effectiveness of adult FGCs in your
organisation
The evaluation of the impact and effectiveness of
adult FGCs will be the focus of a Practice Tool, to be
published in October 2017.
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4. Family Group Conference: origins
› A FGC is a formal process where the individual
concerned, family, extended family members
and members of the individual’s network, work
closely together with professional practitioners,
to make decisions that best meet the needs of
the individual
› FGCs were developed in New Zealand, following
conflict between the Western focus on the
nuclear family and the Maori focus on wider
community responsibility for raising children.
They became part of legislative framework in NZ
in 1989
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5. Family Group Conferences in the UK
› FGCs have been used in the UK since 1992, and are
now widely used in Children’s Services
› 84% local authorities now offer a FGC service in
their Children’s Services (Family Rights Group Survey 2015)
› FGCs are gaining momentum in adult services
For example, the peer-led practice network for FGCs
with adults was set up in 2015, and now has 25
connected local authorities and organisations
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6. Family Group Conferences:
Value base
› FGCs enable families to cope with problems in a
manner that is consistent with their own culture,
lifestyle, history and resources
› Traditional approaches are often ‘family-centred’,
but a FGC is ‘family-driven’ (Merkel-Holguin, 2004)
› The approach is not aimed at the family, but
achieves results through the family.
› Family Group Conferencing mobilises the natural
resources of the adult’s family, friends and social
networks
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7. Process of a Family Group Conference
› Every FGC has three stages, although there may be
differences in how long the process spends in each
of the stages:
− Preparation
− The Family Group Conference
− The review meeting (s)
› The service user is offered advocacy throughout the
process, and can be represented by a person of
their choice if they cannot/do not want to attend
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8. How can a FGC be used to address
risks and needs in Adult Services?
› Safeguarding
vulnerable adults
› Transition from
children’s to adults’
services
› Supporting carers
› Planning discharge
from hospital or prison
› Promoting
independence
› Support for adults with
unmet care needs
(e.g.: mental health,
physical health,
dementia, etc)
› Support planning for
long term conditions
› Best Interests decision
making
› Self neglect / risk of
homelessness 8

9. Poll
› How do you use FGCs in your local authority?
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10. Family Group Conferencing and
current legislation in adults’ services
› Family Group Conferences sit well with current
legislative and policy frameworks:
− Making Safeguarding Personal (2010)
− Mental Capacity Act 2005
− Care Act 2014
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11. FGC and Making Safeguarding
Personal
› Key themes of safeguarding and personalisation
› Focus on empowerment of individuals, person-
centred ways of working, and strengths-based
approaches
› FGCs are recommended as a useful approach in the
MSP toolkit (2015)
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12. FGC and the Mental Capacity Act
2005
› The MCA enshrines the right of adults to make
decisions, unless they are specifically assessed as
not having the capacity to make a decision
› The right of individuals to make unwise decisions is
enshrined
› FGCs can support individuals to make decisions, to
use their networks, and to make plans
› If a person lacks capacity to make a particular
decision, a FGC can be used as a best interests
meeting
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13. FGC and the Care Act 2014
› FGCs fit well with all six principles of the Care Act
− Empowerment; prevention; proportionality;
protection; partnership; accountability
› FGCs promote personalisation, and are wholly
focussed on the service user’s wellbeing
› The FGC model is rooted in strengths-based
practice, and enabling the service user to best use
his/her resources and networks
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14. Family Group Conferences:
Outcomes
› Measuring outcomes in FGCs is complex, because
there is no single criteria for a positive outcome
› For example, an adult with capacity may choose to
make an “unwise decision”, but there could still be
benefits if the process led to increased awareness of
risks, or increased support, or communication, or
improved relationships
(Daybreak evaluation report, 2010 – 2012)
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15. FGCs – a wide range of positive
outcomes
› Produce safe plans (Forsyth et al 2013)
› Help individuals feel more in control and groups
more resilient (SCIE 2012; Malmberg-Heimonen 2011)
› Can be restorative (De Jong and Schout, 2013)
› Can be more culturally sensitive (Forsyth et al 2013;
Camden evaluation 2015)
› Increased family involvement in ongoing support
(Camden evaluation 2015)
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16. FGCs – a wide range of positive
outcomes
› Are valued by the people who use them (Marsh 2007;
Camden evaluation 2015)
› Produce personalised plans drawing on resources
from family and friends (SCIE 2012; Forsyth 2013)
› Can save agency resources (Marsh 2007; Daybreak
2011)
› Build trust between agencies and service users
(SCIE 2012; Forsyth 2013)
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17. FGCs: Outcomes for service users
(RCT study based in Norway)
› Service users’ “Life satisfaction” increased almost a
whole point on a 5 point scale
› Mental distress and anxiety/depression measures
decreased significantly
› Positive trends on measures of emotional social
support and social resources
› Service users evaluated the experience positively
Malmberg-Heimonen, 2011
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18. FGCs: Financial Implications
› Each FGC costs £1500 - £2000 per cycle on average
› FGCs have the potential to save on care package
costs, especially when a family co-produce a plan
which can be supported by professionals
› This can prevent escalation, and avert the need for
more intensive interventions (SCIE 2013)
› Kent evaluation: FGCs reduced budget expenditure
of Adult Services by around £7000 per FGC (Marsh
2007)
› Hampshire analysed 49 FGCs (2007 – 2010) and
estimated a total saving of £77360 (Daybreak, 2012)
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19. Evaluating a FGC service: challenges
› multiple definitions of a successful outcome
› The process is so individualised that it’s difficult to
compare FGCs with each other
› The outcomes of a FGC may be complex, and may
only become apparent over a long time period
› It’s difficult to define which outcomes can be
attributed to the FGC process
› Long term conditions may worsen, which can affect
outcomes
› Even FGCs which “fail” may have remarkable,
unintended outcomes (De Jong, 2015)
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20. Poll
› Which aspects of the FGC service in your
local authority would you want to
evaluate?
−Service user experiences?
−Family/network member experiences?
−Professionals’ experiences?
−Financial implications?
−Other (please type into chat pod)
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21. Challenges in delivering FGC in Adult
Services
› The model is very well developed in Children’s
Services, where there is a stronger legal framework
which provides impetus to reach an agreement
› Working in Adult Services poses additional
challenges, for:
− service users
− family members
− professionals
− senior managers/commissioners
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22. Challenges for service users
› Not wanting to “cause a fuss”
› Reluctance to be open about their situation with the
family network
› Complex relationships with family network
› Wanting the continuation of service provision
› Shame and vulnerability
› Potentially limited social network
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23. FGC and Shame
› “with the help of Family Group Conferencing,
downward spirals of social exclusion can be averted”
› ...shame on one side acts as an engine for
withdrawal and avoiding contact with family and
friends but, on the other hand, can also act as a
catalyst of breaking through deterioration and
isolation.
DeJong and Schout, 2013
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24. Challenges for family members
› The root problems may have become very
entrenched, and relationships may be strained
› Family members may be fearful of being asked to
take on more responsibility than they feel able to
accept
› Family members may feel that they are already
doing everything they can, and be reluctant to
engage in another process
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25. Challenges for professionals
› There needs to be a genuine offer to share power
with the service user and the network
› It would be a corruption of the FGC model to
attempt to pressure networks to rubber stamp a
plan which was largely devised by a professional
› Social worker reports to the FGC must be truly
neutral and factual, naming risks, describing
resources/services, and outlining the legal position
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26. Challenges for senior
managers/commissioners
› FGCs, properly resourced, cost £1500 - £2000
› The savings may accrue over a long term, but the
costs are immediate
› There can be a temptation to cut corners – such as
by removing the independent co-ordinator role, or
asking social workers to act as co-ordinators
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27. FGCs: Issues of risk and group
process
› Family relationships can be very fractured, as
difficulties may have persisted for many years.
› FGCs are not a therapeutic or mediation service. The
goal is to solve a problem / meet the adult’s needs
› The offer is to put aside conflicts in relationships,
and come together to solve a problem
› Relationship repair / mediation is never the focus,
but can be a side effect of a FGC
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28. FGCs: Balancing the roles of the
service user and the network
› “There is an amount of ‘compassionate interference’
from the informal network which is to be embraced,
while at the same time paying mind to the
autonomy and identity of the adult”
Metze et al, 2015, p75
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29. FGCs: Abuse and vulnerable adults
› There can be advantages and disadvantages of
involving perpetrators of abuse in FGCs
› FGCs have a focus on the future, rather than the
past, so can help with recruiting the support of the
network for a safety plan, and widening awareness
of risks
› Need to monitor attempts to use the FTC process to
continue abuse/controlling behaviour
› The service user’s wishes are very important
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30. Developing a FGC service for adults
› Extending existing Children’s FGC service
Can be cost-effective, but there is a need for
additional training, and adaptations to the
management structure in order to work with
adults
› Providing an in-house FGC service
It can be tempting to ask social workers to take on
the FGC role in addition to their jobs, but this
carries many risks and is likely to compromise
their efficacy
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31. Developing a FGC service for adults
› Commissioning an independent provider
−This could either be an existing provider of FGCs
in Children’s Services, or a new provider.
−The costs will be higher at the beginning of the
contract
−Consideration should be given to starting with a
pilot scheme
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32. Developing a FGC service for adults
› However the service is delivered, there will be a
need for adequate training for FGC coordinators,
and for existing social workers (to ensure that they
make appropriate referrals and understand their
role)
› Two recognised training routes for coordinators:
− Daybreak (Hampshire)
− Family Rights Group
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33. Next Steps
› Practice Tool: October 2017
−This will focus on the theme of
evaluating the impact of FGC with
Adults
−Webinar – to launch the Practice
Tool, 18th October
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34. Any questions?
Please type in the chat pod….
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35. References
Camden Family Group Conference Service (2015) Evaluation of
Adult FGC work. London Borough of Camden
Daybreak Family Group Conferences (2011) Family Group
Conferences for Adults: Pilot Project for Elder Abuse Evaluation
Report 2007-2010. Daybreak Bluebird Project
Daybreak Family Group Conferences (2013) Family Group
Conferences for Adults: Hampshire. Evaluation Report 2010 -
2012. Daybreak Project.
De Jong, G. and Schout, G. (2013) Breaking through
Marginalisation in Public Mental Health Care with Family Group
Conferencing: Shame as Risk and Protective Factor. British
Journal of Social Work, 43 (7), 1439-1454
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36. References
De Jong, G., Schout, G., Pennell, J., Abma, T. (2015) Family
Group Conferencing in public mental health and social capital
theory, Journal of Social Work, 15 (3), 277 - 296.
Forsyth, K., Górska, S., Harrison, M., Haughey, P., Irvine, L. and
Prior, S. (2013) Family Group Conferencing for People with
Dementia: Evaluation of the Midlothian Pilot 2012/13
Local Government Association (2013) Making Safeguarding
Personal: Sector-led Improvement. London: Local Government
Association
Malmberg-Heimonen, I. (2011) The Effects of Family Group
Conferences on Social Support and Mental Health for Longer-
Term Social Assistance Recipients in Norway, British Journal of
Social Work, 41(5), 949-967.
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37. References
Marsh (2007) Kent Adult FGC Development Research. With Kent FGC
Service
Merkel-Holguin, L. (2004). Sharing power with the people: Family
group conferencing as a democratic experiment. Journal of
Sociology and Social Welfare, 31 (1), 155–173.
Metze, Kwekkeboom, Abma, (2015) The potential of Family Group
Conferencing for the resilience and relational autonomy of older
adults Journal of Aging Studies, Volume 34, Issue null, Pages 68-
81
Social Care Institute for Excellence (2012) Safeguarding adults:
Mediation and family group conferences [Online]. Available at:
http://www.scie.org.uk/publications/mediation/
Social Care Institute for Excellence (2012) Safeguarding adults:
mediation and family group conferences: Information for directors
and senior managers [Online]. Available at:
http://www.scie.org.uk/publications/mediation/files/informationfor
directorsandseniormanagers.pdf?res=true 37