Cliciwch yma am y Gymraeg
As set out above, our report does not directly seek to evaluate the success of services in Rhondda Cynon Taf at preventing parent-baby separation. Instead, we seek to highlight the potential benefits which could occur as a result of providing such preventative service. Magu is the only service whose primary focus is preventing parent-baby separation specifically, thus our focus is on potential outcomes of this service.
In sections 5 and 6, we reviewed outcomes of services similar to Magu and how their delivery models and core principles contributed to four categories of outcomes. We now aim to determine the extent to which Magu aligns with these core principles and models of delivery. To do this, we ran a workshop with practitioners from Magu, Children’s Services colleagues, an NHS midwife, and a service user to map the journey through the service from a service provider and user perspective. Participants were asked to describe each stage of the journey through the Magu process, from referral to closure. Findings from this workshop were then combined with internal documents outlining how the service intends to work, and testimonials from other service users. In this section, we discuss how these activities align with the key principles and models of delivery used in the provision of services elsewhere.
Service summary
For both the service and user perspectives, we identified five stages of the process: referral, contact, pre-birth, post-birth, and closure. The summary below provides a written narrative as to how the service works: a visual summary of the user journey can be found in Annex 1. This highlights user involvement, key touchpoints, and feelings at each stage.
Referral
Referrals to Magu can be made for care-experienced parents, those who have been separated permanently from children in the past, or young, vulnerable or inexperienced parents where reaching the threshold for statutory intervention is likely. Referrals are typically initiated by the submission of a C1 referral form to the Information, Advice and Assistance (IAA) team as part of statutory safeguarding procedures (Cwm Taf Morgannwg University Health Board, 2024). Usually, this is done by a community midwife, at the point where they believe Children’s Services may require involvement; however, the form can also be submitted by other professionals such as probation officers, housing workers, or 16+ services for those leaving care. At the point of referral, the professional should discuss this with the user and obtain their consent. A Magu leaflet is always provided and posters are displayed in health settings to raise awareness of what the service offers.
Once received, referrals are reviewed during an unborn interface meeting, where it is decided if the unborn child will be placed on the child protection register. C1 forms are screened to identify parents’ motivational factors and support networks, and an initial assessment is made to align a practitioner whose skillset fits with the outlined family need. Contact is made to other services to ensure the family can access support, if required. If held, information within Children’s Services is collated to develop an understanding of the family’s previous experience.
Contact
If referred to Magu, initial contact is made through a phone call followed by a face-to-face appointment. This is arranged in conjunction with the family, at a time and place suitable for them. Support networks are identified and encouraged to attend. Depending on the nature of the referral, contact may involve joint visits with other services such as 16+, mental health, or substance misuse teams.
The service works to offer early reassurance and support to parents, separate from statutory services. Focus is placed on providing a support pathway that encourages voluntary engagement with services, shifting from the power imbalance that is typical of a family’s relationship with statutory services. Appointments have no time restriction to allow careful, trauma-informed management of highly emotional situations, with parents provided opportunities to be heard and understood.
During the contact stage, an “All About Me” form is introduced which is a strengths-based tool completed over a period of sessions. The outputs from this help to identify needs and determine personal outcomes and goals. This informs the personalised intervention plan which can involve delivery of a wide range of parenting programmes to build on skills and knowledge. The emphasis is on creating a self-focused plan and Magu works collaboratively with other service providers. Support is tailored to the family’s preferences, ranging from daily to minimal contact, aiming to reduce pressure. Magu’s provision of support is available to both parents even if they have separated.
Pre-Birth
Supported offered in the pre-birth stage is flexible and can deviate from the original plan but is typically guided by the individual learning needs identified in the contact stage. Reflections are completed around every eight weeks to identify progress and ongoing support needs. Individuals are also given opportunities to explore triggers which may negatively impact them, including through listening visits.
The educative support delivered may include practical support including keeping the house clean, healthy relationships and how to make up bottles. Formal educational courses are also provided including the Grow Brain course which works to understand the importance of early brain development.
Where statutory services are involved, practitioners use their knowledge of statutory procedures and support the parents during an emotionally challenging time. Previous assessments are also revisited if there has been a history of child removal. Magu workers also consider all assessments made by statutory services, and the risks identified, to work with the individual on all their needs.
Magu workers can provide support and accompany parents to attend antenatal appointments, Children’s Services meetings, and community support. This can also include practical help, such as access to baby items. The team also provide photo frames for baby scans and a first picture. Magu also refer service users to a variety of services, to help meet the parent’s social, emotional and physical needs during pregnancy including the Resilient Families Service midwifery pathway offering specialist antenatal support and advice.
Post-Birth
The Magu worker assigned to an individual remains consistent from pre-birth to post-birth, which can mark a significant difference from statutory services. Workers are often present at maternity discharge meetings and can help with hospital visits to ensure consistent support between the hospital and home. If the baby is separated at birth, Magu can provide transport home and continue to support parents emotionally throughout this period.
Educative support continues building on the support needs identified pre-birth, with reflections still completed to look at progress and areas for future work. Listening visits focus on perinatal mental health and attachment.
Magu’s support continues for the parents, regardless of the status of the statutory intervention. This may include daily supervision or more flexible support depending on the family’s needs. The team works to keep parents engaged, making judgement on a continuous basis about the level of support needed, weighing observed changes against perceived risks. Magu helps navigate tensions that can arise between parents and statutory services, especially when there are differing views on the parents’ capabilities. If the legal threshold for separation is met, Magu remains involved, offering emotional and practical support to help parents cope with the trauma of separation, and offering family time, where appropriate.
Closure
Closure within Magu is a gradual, needs-based process. As statutory plans are shut down Magu continues to offer support, tapering this based on the family’s readiness and ongoing needs. Magu formally offers support until the child is one year old however many families feel confident and independent within a year, marking a natural point for Magu’s involvement to step back. Individuals are provided with safety plans and contact numbers for other professionals, with a planned exit that involves a phasing out of support, and ensures the user is aware.
Magu also makes referrals to community groups and other services to promote independence and resilience, along with a ‘goodbye’ pack of support. Individual evaluations are completed to consider achievements throughout the duration of support and to emphasise capabilities. If other services are involved, joint introductions are made to support ongoing relationships. Cefnogi Rhieni, a second stage of Magu, can provide support to parents whose child has not remained in their care: if this is provided, then the same Magu practitioner is assigned, to ensure further continuity in support.
Alignment with core principles and models of delivery
Table 6 below summarises the key activities and practice decisions which form part of how Magu operates at each stage. These are categorised across the four key principles of service delivery: relationship-focused, strengths-based, trauma-informed, and holistic. Magu clearly aligns well with all the core principles embodied by similar services, with focus on each of these principles across service delivery, from referral to closure.
In addition to these key principles in delivery, Magu also embodies the principles of early referral and ongoing support which are core to other similar services. There is a clear emphasis of intervening as early in the pregnancy as possible, with this mostly done through midwifery pathways. While service provision is offered for 12 months after birth, closure remains a gradual process, with Magu offering support based on family need, similar to other models, including those found in Wales (Research in Practice, 2022). Evidence of how these principles are applied can be found in multiple categories at the referral and closure stages respectively.
Table 6: Alignment of Magu to core principles at each stage of service delivery
| Referral | Contact | Pre-Birth | Post-Birth | Closure |
| Relationship focused | - Initial assessment made to determine worker skill alignment with outlined family need
| - Phone call and face-to-face appointment – arranged with the family
- Emphasising difference from statutory – reducing power imbalance
- Exploring individual needs and learning style
| - Building trust through clear, consistent and honest communication – advocacy for the family and consistency in support
- Understanding, empathy and safety rather than judgement
| - Consistency in practitioner
- Navigating tensions between parents and statutory services
- Transport and emotional support if baby separated at birth
| - Continuous relationship after end of formal support
- Joint introductions to external services
- Ongoing work with continuity of worker if Cefnogi Rhieni support implemented
|
| Strengths based | - Screening of C1 form to identify motivational and protective factors and support networks
| - All About Me form to identify collective focuses – shared with family afterwards
- Family encouraged to identify their own goals
| - Tailored support – flexible but guided by the outcomes in All About Me – can deviate to meet individual need
- Reflections to identify progress and ongoing support needs
| - Support builds on the acquired skills in the pre-birth stage
- Identification of positive parenting and protective factors
- Reflections to determine progress – parents identify areas for future work
| - Parent typically identifies stepping back point
- Referral to community groups and services to promote independence and resilience
|
| Trauma informed | Collating information held in Children’s Services to explore negative/challenging experiences had by the family | Reassurance about the process – many apprehensive of Children’s Services
Time taken to explore parental thoughts and feelings
No time restrictions for appointments | Working to explore and address ACEs and barriers to parenting Individuals can explore triggers that may negatively impact them Listening visits | Listening visits offered to focus on perinatal mental health Support to reduce likelihood of meeting PLO threshold and break cycles of recurring proceedings | Ensuring individuals have safety plans and contact numbers of other professionals Planned exit utilising phasing out of contact |
| Holistic | - Range of routes into the service
- Contact and discussions with other services to ensure the family has the right support
| - May involve joint visits between services
- Support offered to both parents even if separated
- Exploring support networks- encouraged to attend initial meeting
| - Refer to RFS midwifery and other services to meet social, emotional and physical needs
- Work on identified risks highlighted in assessments
- Support to access baby items and photo frames for scans/first picture
| - Involved in discharge appointment
Help with practical tasks
Support continues if parents and babies placed in foster/residential placement
| - Feedback is obtained from individuals to help shape future service delivery
|
In terms of models of delivery, there is clear evidence that Magu provides support in a similar manner to other services. There is an emphasis on providing one-to-one sessions in a strengths-based, trauma-informed manner, with significant holistic and practical support, with multiple examples found across Table 6. There is emphasis on working with parents, although some other services do have a specific focus on working with fathers, enabled by male practitioners. The service area informed us that there was a desire to do this, but implementation is challenging.
Practitioners highlighted the flexibility in their job roles, with understanding from management that they best understand nuance in individual cases. Moreover, they highlighted significant work in developing a mutual understanding with statutory services about their role and support they can offer. This also extends to other agencies, with the relationship with midwifery also highlighted. While perinatal mental health support is available across the Cwm Taf Morgannwg region, accessing general mental health support for other family members remains challenging, but practitioners mentioned that this was not a challenge exclusive to Magu.
The key difference between Magu and the other services studied as part of this work, is that Magu does not utilise group sessions in its service delivery. Other services offer voluntary educative sessions on specific topics, which also aim to strengthen support networks. Practitioners stated that they would like to provide this type of support, but funding did not currently allow for this. Instead, they aim to utilise existing relationships with the voluntary sector and other community networks and refer service users to these to reduce self-isolation and increase individual resilience.
Given the strong alignment between Magu and how other services are delivered, it could be reasonably assumed similar outcomes could result from Magu in RCT. In the next section, we explore what we do know about the impact Magu is having.
Key Points
The Magu service aligns with the core principles embodied by similar services at all stages of service delivery.
There is clear emphasis on referral to the service as early as possible, and on ensuring support after birth ends at a time the parent is comfortable with, with referral onto other specialist services and community groups where appropriate.
Due to funding constraints Magu does not provide group sessions delivered by comparative services. Instead, they utilise available resources and build on good relationships with voluntary sector and community networks.
Read the next section: What, so far, has been the impact of Magu in terms of outcomes for the investment?
Cliciwch yma am y Gymraeg
As set out above, our report does not directly seek to evaluate the success of services in Rhondda Cynon Taf at preventing parent-baby separation. Instead, we seek to highlight the potential benefits which could occur as a result of providing such preventative service. Magu is the only service whose primary focus is preventing parent-baby separation specifically, thus our focus is on potential outcomes of this service.
In sections 5 and 6, we reviewed outcomes of services similar to Magu and how their delivery models and core principles contributed to four categories of outcomes. We now aim to determine the extent to which Magu aligns with these core principles and models of delivery. To do this, we ran a workshop with practitioners from Magu, Children’s Services colleagues, an NHS midwife, and a service user to map the journey through the service from a service provider and user perspective. Participants were asked to describe each stage of the journey through the Magu process, from referral to closure. Findings from this workshop were then combined with internal documents outlining how the service intends to work, and testimonials from other service users. In this section, we discuss how these activities align with the key principles and models of delivery used in the provision of services elsewhere.
Service summary
For both the service and user perspectives, we identified five stages of the process: referral, contact, pre-birth, post-birth, and closure. The summary below provides a written narrative as to how the service works: a visual summary of the user journey can be found in Annex 1. This highlights user involvement, key touchpoints, and feelings at each stage.
Referral
Referrals to Magu can be made for care-experienced parents, those who have been separated permanently from children in the past, or young, vulnerable or inexperienced parents where reaching the threshold for statutory intervention is likely. Referrals are typically initiated by the submission of a C1 referral form to the Information, Advice and Assistance (IAA) team as part of statutory safeguarding procedures (Cwm Taf Morgannwg University Health Board, 2024). Usually, this is done by a community midwife, at the point where they believe Children’s Services may require involvement; however, the form can also be submitted by other professionals such as probation officers, housing workers, or 16+ services for those leaving care. At the point of referral, the professional should discuss this with the user and obtain their consent. A Magu leaflet is always provided and posters are displayed in health settings to raise awareness of what the service offers.
Once received, referrals are reviewed during an unborn interface meeting, where it is decided if the unborn child will be placed on the child protection register. C1 forms are screened to identify parents’ motivational factors and support networks, and an initial assessment is made to align a practitioner whose skillset fits with the outlined family need. Contact is made to other services to ensure the family can access support, if required. If held, information within Children’s Services is collated to develop an understanding of the family’s previous experience.
Contact
If referred to Magu, initial contact is made through a phone call followed by a face-to-face appointment. This is arranged in conjunction with the family, at a time and place suitable for them. Support networks are identified and encouraged to attend. Depending on the nature of the referral, contact may involve joint visits with other services such as 16+, mental health, or substance misuse teams.
The service works to offer early reassurance and support to parents, separate from statutory services. Focus is placed on providing a support pathway that encourages voluntary engagement with services, shifting from the power imbalance that is typical of a family’s relationship with statutory services. Appointments have no time restriction to allow careful, trauma-informed management of highly emotional situations, with parents provided opportunities to be heard and understood.
During the contact stage, an “All About Me” form is introduced which is a strengths-based tool completed over a period of sessions. The outputs from this help to identify needs and determine personal outcomes and goals. This informs the personalised intervention plan which can involve delivery of a wide range of parenting programmes to build on skills and knowledge. The emphasis is on creating a self-focused plan and Magu works collaboratively with other service providers. Support is tailored to the family’s preferences, ranging from daily to minimal contact, aiming to reduce pressure. Magu’s provision of support is available to both parents even if they have separated.
Pre-Birth
Supported offered in the pre-birth stage is flexible and can deviate from the original plan but is typically guided by the individual learning needs identified in the contact stage. Reflections are completed around every eight weeks to identify progress and ongoing support needs. Individuals are also given opportunities to explore triggers which may negatively impact them, including through listening visits.
The educative support delivered may include practical support including keeping the house clean, healthy relationships and how to make up bottles. Formal educational courses are also provided including the Grow Brain course which works to understand the importance of early brain development.
Where statutory services are involved, practitioners use their knowledge of statutory procedures and support the parents during an emotionally challenging time. Previous assessments are also revisited if there has been a history of child removal. Magu workers also consider all assessments made by statutory services, and the risks identified, to work with the individual on all their needs.
Magu workers can provide support and accompany parents to attend antenatal appointments, Children’s Services meetings, and community support. This can also include practical help, such as access to baby items. The team also provide photo frames for baby scans and a first picture. Magu also refer service users to a variety of services, to help meet the parent’s social, emotional and physical needs during pregnancy including the Resilient Families Service midwifery pathway offering specialist antenatal support and advice.
Post-Birth
The Magu worker assigned to an individual remains consistent from pre-birth to post-birth, which can mark a significant difference from statutory services. Workers are often present at maternity discharge meetings and can help with hospital visits to ensure consistent support between the hospital and home. If the baby is separated at birth, Magu can provide transport home and continue to support parents emotionally throughout this period.
Educative support continues building on the support needs identified pre-birth, with reflections still completed to look at progress and areas for future work. Listening visits focus on perinatal mental health and attachment.
Magu’s support continues for the parents, regardless of the status of the statutory intervention. This may include daily supervision or more flexible support depending on the family’s needs. The team works to keep parents engaged, making judgement on a continuous basis about the level of support needed, weighing observed changes against perceived risks. Magu helps navigate tensions that can arise between parents and statutory services, especially when there are differing views on the parents’ capabilities. If the legal threshold for separation is met, Magu remains involved, offering emotional and practical support to help parents cope with the trauma of separation, and offering family time, where appropriate.
Closure
Closure within Magu is a gradual, needs-based process. As statutory plans are shut down Magu continues to offer support, tapering this based on the family’s readiness and ongoing needs. Magu formally offers support until the child is one year old however many families feel confident and independent within a year, marking a natural point for Magu’s involvement to step back. Individuals are provided with safety plans and contact numbers for other professionals, with a planned exit that involves a phasing out of support, and ensures the user is aware.
Magu also makes referrals to community groups and other services to promote independence and resilience, along with a ‘goodbye’ pack of support. Individual evaluations are completed to consider achievements throughout the duration of support and to emphasise capabilities. If other services are involved, joint introductions are made to support ongoing relationships. Cefnogi Rhieni, a second stage of Magu, can provide support to parents whose child has not remained in their care: if this is provided, then the same Magu practitioner is assigned, to ensure further continuity in support.
Alignment with core principles and models of delivery
Table 6 below summarises the key activities and practice decisions which form part of how Magu operates at each stage. These are categorised across the four key principles of service delivery: relationship-focused, strengths-based, trauma-informed, and holistic. Magu clearly aligns well with all the core principles embodied by similar services, with focus on each of these principles across service delivery, from referral to closure.
In addition to these key principles in delivery, Magu also embodies the principles of early referral and ongoing support which are core to other similar services. There is a clear emphasis of intervening as early in the pregnancy as possible, with this mostly done through midwifery pathways. While service provision is offered for 12 months after birth, closure remains a gradual process, with Magu offering support based on family need, similar to other models, including those found in Wales (Research in Practice, 2022). Evidence of how these principles are applied can be found in multiple categories at the referral and closure stages respectively.
Table 6: Alignment of Magu to core principles at each stage of service delivery
| Referral | Contact | Pre-Birth | Post-Birth | Closure |
| Relationship focused | - Initial assessment made to determine worker skill alignment with outlined family need
| - Phone call and face-to-face appointment – arranged with the family
- Emphasising difference from statutory – reducing power imbalance
- Exploring individual needs and learning style
| - Building trust through clear, consistent and honest communication – advocacy for the family and consistency in support
- Understanding, empathy and safety rather than judgement
| - Consistency in practitioner
- Navigating tensions between parents and statutory services
- Transport and emotional support if baby separated at birth
| - Continuous relationship after end of formal support
- Joint introductions to external services
- Ongoing work with continuity of worker if Cefnogi Rhieni support implemented
|
| Strengths based | - Screening of C1 form to identify motivational and protective factors and support networks
| - All About Me form to identify collective focuses – shared with family afterwards
- Family encouraged to identify their own goals
| - Tailored support – flexible but guided by the outcomes in All About Me – can deviate to meet individual need
- Reflections to identify progress and ongoing support needs
| - Support builds on the acquired skills in the pre-birth stage
- Identification of positive parenting and protective factors
- Reflections to determine progress – parents identify areas for future work
| - Parent typically identifies stepping back point
- Referral to community groups and services to promote independence and resilience
|
| Trauma informed | Collating information held in Children’s Services to explore negative/challenging experiences had by the family | Reassurance about the process – many apprehensive of Children’s Services
Time taken to explore parental thoughts and feelings
No time restrictions for appointments | Working to explore and address ACEs and barriers to parenting Individuals can explore triggers that may negatively impact them Listening visits | Listening visits offered to focus on perinatal mental health Support to reduce likelihood of meeting PLO threshold and break cycles of recurring proceedings | Ensuring individuals have safety plans and contact numbers of other professionals Planned exit utilising phasing out of contact |
| Holistic | - Range of routes into the service
- Contact and discussions with other services to ensure the family has the right support
| - May involve joint visits between services
- Support offered to both parents even if separated
- Exploring support networks- encouraged to attend initial meeting
| - Refer to RFS midwifery and other services to meet social, emotional and physical needs
- Work on identified risks highlighted in assessments
- Support to access baby items and photo frames for scans/first picture
| - Involved in discharge appointment
Help with practical tasks
Support continues if parents and babies placed in foster/residential placement
| - Feedback is obtained from individuals to help shape future service delivery
|
In terms of models of delivery, there is clear evidence that Magu provides support in a similar manner to other services. There is an emphasis on providing one-to-one sessions in a strengths-based, trauma-informed manner, with significant holistic and practical support, with multiple examples found across Table 6. There is emphasis on working with parents, although some other services do have a specific focus on working with fathers, enabled by male practitioners. The service area informed us that there was a desire to do this, but implementation is challenging.
Practitioners highlighted the flexibility in their job roles, with understanding from management that they best understand nuance in individual cases. Moreover, they highlighted significant work in developing a mutual understanding with statutory services about their role and support they can offer. This also extends to other agencies, with the relationship with midwifery also highlighted. While perinatal mental health support is available across the Cwm Taf Morgannwg region, accessing general mental health support for other family members remains challenging, but practitioners mentioned that this was not a challenge exclusive to Magu.
The key difference between Magu and the other services studied as part of this work, is that Magu does not utilise group sessions in its service delivery. Other services offer voluntary educative sessions on specific topics, which also aim to strengthen support networks. Practitioners stated that they would like to provide this type of support, but funding did not currently allow for this. Instead, they aim to utilise existing relationships with the voluntary sector and other community networks and refer service users to these to reduce self-isolation and increase individual resilience.
Given the strong alignment between Magu and how other services are delivered, it could be reasonably assumed similar outcomes could result from Magu in RCT. In the next section, we explore what we do know about the impact Magu is having.
Key Points
The Magu service aligns with the core principles embodied by similar services at all stages of service delivery.
There is clear emphasis on referral to the service as early as possible, and on ensuring support after birth ends at a time the parent is comfortable with, with referral onto other specialist services and community groups where appropriate.
Due to funding constraints Magu does not provide group sessions delivered by comparative services. Instead, they utilise available resources and build on good relationships with voluntary sector and community networks.
Read the next section: What, so far, has been the impact of Magu in terms of outcomes for the investment?
