Getting it right for every child (GIRFEC): case studies

Tackling child poverty

Emma, Olivia and Ashley’s story – a whole family approach to supporting wellbeing

Scenario

Ashley contacts her Health Visitor, who is Named Person for Ashley’s daughters

Emma and Olivia, and asks if they could arrange a home visit as she would like some support with her housing situation.

During the visit, the Health Visitor notices that the home is very cold and appears unheated. Ashley says the heating system has been broken for over a week and the landlord has said that they would come and fix it, but has not done so yet. Ashley says that she cannot afford to run an electric heater so has been using extra blankets to stay warm.

Emma and her older sister Olivia are dressed in layers of clothing and are sitting on the couch watching TV under a blanket, reluctant to play. Both children have “runny noses” and Ashley is concerned that they are constantly coughing throughout the night.

Assessment

The wellbeing of Emma and her sister Olivia is a concern. Ashley is doing what she can to nurture them, however they are in a cold house. By using the My World Triangle to assess each child’s wellbeing needs, the Health Visitor recognises that a whole-family approach to planning support, including advice on any financial support available for Ashley, will help to improve their family circumstances and the children’s wellbeing.

In considering which partners can support the children’s wellbeing, the Health Visitor supports Ashley to ask the family GP for an urgent appointment for the children and asks if she would like information on how to get advice from the local authority to address the heating problem. Ashley is enthusiastic to get any help she can as she does not have any local support network in the community and was unclear of her rights in relation to her landlord. The Health Visitor also discussed income maximisation options and where further advice is available.

The Health Visitor gives Ashley information on a local outdoor playgroup run by community volunteers which she and Emma can attend whilst Olivia is in nursery school. The Health Visitor knows the playgroup and colleagues who work there and offers to meet Ashley at the next session and introduce her to the team.

Actions

Supported by the Health Visitor, Ashley secured an urgent appointment for Emma and Olivia the next day. With Ashley’s consent, the Health Visitor contacted the local authority Family Wellbeing Service and was able to share relevant information of the family’s situation. Ashley was given an appointment with the Family Wellbeing Service later the same day where she would be able to discuss what support could be offered.

The Health Visitor also gave Ashley the telephone number for her local Citizen’s Advice service and a named contact who can help give information and advice on how to approach the landlord to accelerate repairs.

The Health Visitor considered Emma and Olivia’s opinions and perspectives throughout the assessment. This approach was informed by the Voice of the Infant Best Practice Guidelines and Infant Pledge, helping to ensure that Emma and Olivia’s voices were at the centre of actions taken by the Health Visitor to support the family.

Outcomes

Ashley met with the local authority’s Family Wellbeing Team and was able to access a grant to help purchase a temporary heater and top-up her electricity meter. They also arranged to carry out a financial ‘health-check’ for Ashley to ensure that she was accessing all of the support that she and her family were entitled to in order to maximise their income.

She also spoke to a Citizens’ Advice worker who provided her with some advice on what to say to her landlord, including advice on making a complaint and obtaining an environmental health inspection, if necessary.

Emma and Olivia visited their GP the next day who said that the children were generally in good health, however appeared to have common colds and prescribed liquid paracetamol.

Following discussion and agreement with Ashley, the Health Visitor called Ashley at the end of the following day as an initial follow up and arranged to call back early the next week, as they considered the family may benefit from additional advice or information around supports available in the local community.

Now that the urgent issue of heating had been addressed, the Health Visitor was also able to arrange Emma’s Child Health Review.

Reflections

This early offer of support ensured that risks to Emma and Olivia’s immediate health were minimised. Early involvement with the family also helped to establish what long term local networks Ashley might like support from to help improve the children’s wellbeing, helping create the trusting relationships between Emma and Olivia’s family and practitioners from a variety of agencies.

More information on the Health Visitor’s role as Named Person and how they support income maximisation for families can be found in the Health Visiting Pathway in Scotland.