How do we help the “hardest to reach”? A visit to Gateway Family Services for the Birmingham Social Inclusion process.

Suwinder Bains and Richard Browne  of the social inclusion process

Suwinder Bains and Richard Browne from this fairbrum social inclusion process have been visiting gateway Family Services this morning.  The Chief Exec here – Vicki Fitzgerald – invited people to go through some of their cases. She wanted them to get a sense of what people face when they’re lives are most chaotic – how Gateway helps and where/if there are gaops in public services.

This post will outline the case studies – that Vicki talked about and try and cover some of the conversation around it.

Case study 1  Janet

Janet referred herself to the gateway pregnancy outreach service – some things about

  • mid twenties
  • has been in prison frequently
  • diagnosed mental health problems
  • on methodone
  • smoker
  • was a sex worker
  • misses lots of appointments – doesn’t have a scan.
  • sometimes misses medication

Vicki Fitzgerald said (almost verbatim):

one of the words we used to describe her was wild/feral, which sounds bad but she made a lot of accusations against people who tried to help her.  Equality and human rights means we have to find away do adapting to who she is to give her proper care, for her circumstances.  The biggest issue is that she has not been referred to Adult Social care – because she doesn’t meet the criteria for being a vulnerable adult.  The child has a social worker – she doesn’t.

Vicki FitzgeraldWhy isn’t she vulnerable enough to have a social worker of her own was the question that followed. Vicki:  “She has mental capacity – the ability to make a decision for herself.”

so “Does this definition need challenging – a lot of people fall through the net because of it.”

Vicki Fitzgerald: “If you change the definition we would have to have more supporting services”  The main difficult here is that adult social care and child social acre are separate – if there was a social worker for the mother they would be able to help stabilise the mum life and help inprove the chances of the baby being born well – this is partly what our POW’s help to do”

“For the child to be vulnerable when it’s born but the mum not to be vulnerable at the same time seems a bit absurd” – was one reflection from the group in the room

How has Janet’s life changed?

  • POW’s helped her organise her diary to get to appointments (she refused that at first now accepted that)
  • Caused problems in her hostel and now has been found a flat with a social landlord and now much calmer.
  • Gateway had a professional meeting with psychiatric nurse, drugs worker, social worker for the baby and pregnancy outreach worker.
  • Section 47 enquiry to anticipate what will happen to the baby if there’s a safeguarding issue.  Baby will have drug withdrawal at birth from methodone – so will be a special needs baby.
  • Case will be reviewed at Birth

VF “she’s made enormous progress from being uncooperative and in a hostel to a home of her own and much calmer”

Thoughts from the room:

“It seems counterproductive to get her stabilised and then maybe pull the support from her once the baby is born”

“I see an extremely vulnerable women – all this support when you’re pregnant and then it goes – or she thinks they’re bothered about the baby not me.”

Some thoughts from Vicki

We decided she needed an older POW – someone a bit no nonsense. We try to match the keyworkers for what the women want.

POW’s end up acting as the conduit for communication with the social work team.

If she wants to keep the child what conditions must she satisfy – f we can agree those with her perhaps we can then we can help her do that.


Case study 2 Ruby

When gateway met her:

  • Early 30’s – this is her first baby, her biggest issue was drug use and her partner is a drug user.
  • Part time job.
  • No heating/hot water at home,
  • Bailiffs chasing debt
  • In court for non payment of council tax

Vicki said: “Mid-wives very unlikely to make a referral to adult social care. It just isn’t part of how they are used to working.”

Her Pregnancy Outreach Worker  (POW) got heating restored – it hadn’t been working because the boiler had been stolen and they hadn’t reported it to police. Boiler replaced and the couple paid for it on a weekly plan.  POW also arranged a payment plan with the bailiffs.

Vicki Fitzgerald said she  “Had some problems with her social worker – including we found cut and paste from other reports (including sometimes when the wrong name was cut and paste into her report)   – these clients don’t complain or write letters to complain.”

A positive drug tests triggered a referral to social services for the baby.

Drug taking (she said)  was to do with her social network – she was afraid of missing out on the people she new.

So what happened next


  • family advised to go to relate to get legal advice – although relate is £25 for the first appointment
  • she left work for maternity leave but it took several weeks for benefits to kick in – so she received food parcels and then a crisis loan – which is taken back all in one go.
  • baby born – took time to get registration for the birth – which means child benefit is delayed.


  • Drug free during pregnancy and beyond
  • Remain with baby’s father
  • Parenting, health and safety and breastfeeding classes
  • Attended all appointments
  • Debts under control
  • House in suitable condition

285 hours of support from Gateway at a cost of £5524 –  maybe the baby would have gone into care without this support?


Case study 3:  Anika

  • Recent miscarriage
  • Left abusive relationship
  • Lost her family support network as she did so
  • Declared homeless  – rehoused ina hostel where everyone else was a man, pestered by them.
  • Rent areas and debt problems
  • Past or present mental illness
  • Income below £200 a month – including losing her Job Seekers Allowance (because she volunteered to support victims of domestic violence)

Offered a property when she was pregnant – that offer was withdrawn when she miscarried.


  • she has a job with the government
  • debt advice
  • learning new languages

82 hours altogether –  cost  £1696

Case study 4  Jacqui

Came to us through one of Gateways employment programmes…

  • Unemployed more than 4 years
  • has a child
  • domestic abuse – left an abusive relationship.
  • declared debt relief – insolvency service to protect her from her debts – they were written off
  • her two debts were from brighthouse  (30% apr) – plus car load for buying a car at £39% apr for a car.


  • She volunteers with victim support
  • She needed to do 6 days training for her volunteering but coudln’t get child care – ended up getting a grant. – got the grant from the “social action fund”  – job centre had said no.
  • completed 15 months training in counselling
  • wants to start her own business supporting women wiht childcare when they go to court but because she’s on income support not job seekers allowance means she isn’t eligible for any support.

Now volunteers with a company in Birmingham
Waiting to be re-housed
Still trying to set up her social business


Some key thoughts:


Before, during and post recession there are people who have stubborn problems in their lives. These are the people we work with. For us welfare reform is greatest cause for concern.

How does it relate to social inclusion? Vicki

In terms of change public services are the first place to start – f they are messing you up and stopping you achieving

We let the client decide what’s good enough – where many public services start with an prescribed idea of what is needed.

Simple issues that could/should be changed

Birth registration – the process is too slow and leaves family struggling for money when they need it most.
Income support means people are not able to get enterprise allowance support
There is an economic argument to invest at the right point – put effort in when people are showing signs of changing.

Bigger issue:

Childrens social services and adult social services don’t work together to look at long term trajectory for the family.

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