Standards and quality assurance: next steps in parent abuse work

I was at a meeting last week considering the need for practice standards in work with families impacted by parent abuse.

While it still feels uncomfortably random whether you are able to access help or not as a family or practitioner, it might be surprising to hear that there has been a real surge in the development of services across England at least. With a limited amount of research and evidence to base work on, it is perhaps less surprising that many of the services show great similarities, even when they have started from different places and within different agencies, but there is variety and this is both good (flexibility in design and delivery meets specific needs) and potentially problematic (how can we be sure that work meets the needs). Now that programmes are more established and have themselves worked through initial teething problems, it seems a good time to think about how to assure quality and safety in the work.

The question “why?” might seem superfluous, but there are a number of reasons, all valid.

  • We are working with often complex and deep-rooted problems, requiring intensive, expert support.
  • Families are investing in attending sessions and they need to be sure they are not wasting time or energy, and especially not risking escalation.
  • While families are already in a dire situation, it may still be that some work is worse than none.
  • Practitioners investing money and time in training courses need to be convinced it is well spent.
  • Those referring families for intervention need to be assured that the programme has credibility.
  • Funders MAY be swayed by accreditation of some sort.
  • Commissioners are actively looking to develop this work and to identify programmes with a proven track record of safety and effectiveness.

This last point opens up an important area of discussion, in terms of what standards can measure. At present there is still an insufficient base from which to judge one programme against another in terms of effectiveness. And indeed, with many different routes to parent abuse, it may be that some interventions are more or less appropriate in different circumstances – granted this is not much help if there is only one on offer in your area anyway!

Some programmes are sited within organisations already operating to strict quality standards, but this work often straddles agencies. Within either scenario, as the family situations encountered become more and more complex, it seems appropriate to develop a distinct set of service standards, relevant to this arm of family violence work. Standards should offer reassurance about safety and risk management. They offer an underpinning in terms of values and ethics, of what works, helps or hinders, and may offer a guide to what is OK, or “good enough”. Further research is still needed to make judgements about long-term effectiveness.

So who and how? Who holds themselves up as the arbiter of good? How is assessment made? What happens if someone falls short?

Fortunately this has all happened before with other organisations and programmes, so there is already a mapped pathway as it were. A coming together of interested parties seems to be a good start, and a drafting of a first set of standards before offering it out to consultation. Issues of funding for such a piece of work are an issue, and of course the time needed for the work itself (both development and ongoing assessment). A set of standards would need to be a living document, responding to changes in knowledge, legislation and practice; and they should open up practice, supporting the development of services, and facilitating access to help, rather than closing down the options available.

I leave you with a final quote, highlighted and underlined in my note pad:

“The purpose of standards would be to be as enabling as possible of other people’s practice”.

The work is at an early stage, but the meeting ended with a general sense that this was a good direction to travel. It will be good to have opinions and input as the work develops.

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