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SafeCare: Evidence from a Home Based Parenting Programme for Neglect

SafeCare is a preventative programme working with parents of children under 6 years old who are at risk of experiencing significant harm through neglect. The programme is delivered in the home by trained practitioners, over 18 to 20 sessions and focuses on 3 key areas: parent-infant/child interaction; home safety and child health. SafeCare originated at the National SafeCare Training and Research Centre at Georgia State University and has been evaluated by the NSPCC in six sites across England.

The evaluation has incorporated quantitative and qualitative methods, and considered evidence from a number of perspectives (referral agency, practitioner, parent).This report presents the analysis of outcome data to consider the extent to which SafeCare’s intended outcomes for parents have been achieved. In addition, the results of a survey of referrers is presented and analysis of programme attrition.

The key findings from the analysis presented in the report are:

• Outcome data taken from inbuilt programme assessments, practitioner assessments and parent self-ratings suggest the programme has been effective in improving parenting skills and reducing neglectful behaviours. Before receiving SafeCare, 32 families were assessed by practitioners to be presenting difficulties significant enough to warrant a statutory intervention for neglect. By the end of the programme, 23 (66%) of those families had improved to a point where statutory intervention was no longer considered necessary.

• All referrers responding to the survey had seen positive changes in the families they had referred, particularly in the areas of home safety, parent child interaction and health. 91% of referrers said they would refer similar families to SafeCare in the future. Some referrers would have liked more feedback about progress so they could more effectively co-ordinate the provision of services for the family.

• Families referred to SafeCare (in common with many other social care programmes) exhibited high rates of programme attrition, with only 27% of parents completing it in full. Although attrition is commonly associated with negative connotations, practitioners recorded a range of positive outcomes that were achieved by families who exited the programme prior to completion.• The average case length for families who completed the programme was 42 weeks, which is significantly longer than the 18-20 weeks delivery period anticipated when the programme was implemented. It is important that future studies of SafeCare consider the reasons for extended periods of delivery as well as the implications, both for the families receiving the service and for the organisations implementing the programme.

In the absence of a comparison group, it is not possible to attribute the changes reported directly to the SafeCare Programme. However, SafeCare has been the subject of various studies examining its efficacy and effectiveness in the US, including impact studies using randomised controlled trials (e.g. Chaffin et al., 2012). The NSPCC evaluation supports the existing body of evidence that SafeCare can be an effective way of promoting positive parenting knowledge and behaviours and reducing child neglect. Based on the analysis presented here, there do not appear to be any significant barriers to SafeCare having an impact within a UK context for parents who engage with the programme.