Working with families

Working with families, friends and carers is an important part of delivering person-centred care. Our framework sets out some practical guidelines about how adult social care employers and staff can work well with families. 

Families, friends and carers are often a vital part of the life of someone who needs care and support. When services know how to work well with families, the outcomes for individuals can be improved. 

Whilst this sounds like a common sense approach, some employers have a culture that sees families as a problem and difficult to work with.

Our framework sets out some good practice guidelines about what adult social care employers and their staff need to know and do to work effectively with people’s families, friends and carers.

A framework for adult social care employers

Click on the headings below to read the framework. You can also download a PDF of the full framework here, or email us for a printed copy. 

This framework sets out some good practice guidelines about what adult social care employers and their staff need to know and do to work effectively with people’s families, friends and carers.

Who is the framework for and how can you use it? 

It’s useful for adult social care managers or those in learning and development roles, such as human resources, trainers and learning providers, in any type of social care setting, including residential care, supported living, domiciliary care and/or voluntary organisations.

You can use the guidelines in the framework as a measure of good practice. For example, you can use the framework as a checklist to help you to review and assess how your service and staff work with families, friends and carers now, and identify what you can improve.

The framework can also give you an idea about what learning and development around ‘working with families’ might look like, to help you to design or commission training.

It might also be useful for adult social care staff, to show them some of the  ways that they can work well with families, and people who need care and support and families, to help them to understand what they can expect from the services and staff that support them. 

Please note that not all the points in the framework will be relevant for all settings. You can adapt and build on the framework, and tailor it to your service, the people you support and their families, friends and carers.

Note about terminology

For ease, we’ve used the terms ‘families’ and ‘family members’ throughout the framework. This includes reference to people’s partners and wider connections, including friends, distant relatives and carers, and shouldn’t be read as people who are only formally related by birth or marriage.

Note about legislation

The framework adopts a person-centred approach. The Mental Capacity Act 2005 states that we should assume that people have the mental capacity to make their own decisions.

If someone has the mental capacity to make a decision, when it needs to be made, their choice should take precedence over anyone else’s. This means that sometimes, in practice, you might need to help people to explain the decision that they’ve made to family members who disagree with it or do things that family members disagree with.

This framework explains some of the ways that you can manage these situations, to ensure that the individual is always at the heart of any decisions around working with families, friends and carers.

Where a person lacks the mental capacity to make a decision, you need to work in line with relevant legislation and guidance, including the Mental Capacity Act (2005) Deprivation of Liberty Safeguards (currently under review) and the Human Rights Act.

Things to know

Things to do

What you need to do when your service first starts working with an individual and their family

Get off to a good start by making early contact with family members, where appropriate.

Check if individuals and family members have previously said how and when they’d like to be involved, for example, in conversations with a social worker or care manager. Respect that decision and use it to start conversations, rather than repeating information.

Offer to visit or meet with family members to understand their needs, worries and issues.

Involve family members throughout the process when their relative starts to use your service. Be mindful that there may be occasions when this isn’t possible, or you’re asked not to.

Respect family member’s knowledge of their relative, and their history. Use this information to plan effective care and support.

Agree how and when family members would prefer you to communicate with them, for example email, phone, face to face or text messaging.

Agree the frequency for communicating with family members, and under what circumstances you would otherwise contact them.

Help family members to understand the role of your service by sharing information about your service and staff with them. 

Your organisational values, policies and procedures, and how they support you to work with families

Ensure that your workplace values, policies and procedures enable staff to work well with families.

Role model dignity, respect, empathy and compassion in all interactions with families.

If policies and procedures don’t support a partnership approach with families, ensure staff know who to talk to about changing this.

How to respectfully work in someone else’s home (if applicable)

Talk to individuals and their family about how they want you to work in their home and the things that are important to them about their family life. Identify and agree what you can do to best support this.

Treat people’s homes and possessions with respect. Don’t impose your own standards and way of living onto them, for example cleanliness. Consider things that you might otherwise take for granted like playing music, opening windows and spraying air freshener.

Avoid saying or doing anything that could feel like criticism or judgement of the way people live and maintain their home and possessions.

When you’re not able to maintain the agreed way of working, apologise quickly and ask family members to help you plan to avoid this mistake again in future.

 


Things to know

Things to do

The unique dynamics of different families and family relationships

Identify the significant people in an individual’s life, and what skills and experience they can bring. Don’t make assumptions about this.

Communicate with the individual and their family to find out about them.

Find out if, and how, an individual’s family is involved in their care and support.

Understand and respect that individuals have different perceptions of the role of family members.

Recognise that individuals within a family will have different levels of involvement and different preferences for how this happens, and that there may be smaller family groups within a wider family.

Understand how people who need care and support want to engage with their family, and the support they need to do this

Where possible, ask the individual if, and how, they would like their family to be involved in their care and support.

Establish what areas of their life the individual would like their family to be involved in, for example:

  • updates about their health and wellbeing
  • updates about social and everyday activities
  • communication and decision making
  • healthcare appointments
  • planning care and support
  • regular visits.

Establish if there are any times or situations that the individual does not want shared with their family or particular family members.

Prepare for the individual to want different family members involved in different ways, and discuss with them how this will work in practice.

Consider how these decisions can be made if the individual doesn’t have the capacity to consent.

Document this in their care plan and review it regularly.

Ensure that all staff are aware of this information.

Understand how families want to be involved in their relative’s care and support, and the support they need to do this

Ask family members about what aspects of their relative’s life they are already involved in, and what they’d like to be involved in.

If family members are involved in an individual’s care and support, plan ways to manage any risks associated with sharing it.

Offer support to families to identify any support they need, and signpost them to accessible information and independent advice.

Identify if family members need any learning and development, to enable them to support their relative in the agreed ways (for example, new ways of understanding and communicating with their relative).

Explore if and how family members can get involved in wider aspects of your service, such as activity planning.

Review this information regularly.

The boundaries associated with working in partnership with families 

If needed, encourage and support individuals and their family members to have a conversation together about their level of involvement and how your role fits with this.

Clarify the individual’s, the organisation’s and the family members role in providing care and support.

Avoid, where possible, getting involved in family conflicts or disputes. Ensure that staff can identify and manage situations where they might be involved in family conflicts.  

Put policies in place that set clear boundaries about the relationship between staff and family members, and ensure that all staff know and understand them. It might include, for example, social media contact, sharing personal phone numbers, socialising outside of the workplace and/or receiving gifts.

 


Things to know

Things to do

How to build rapport and communicate well with families

If an individual is being visited by family members, offer support to make them feel welcome.

Respond to requests and messages from family members promptly and in a way that works for them.

Take family member’s concerns seriously and be mindful not to take them personally.

Do what you say you will do, in the agreed timescales, or keep people updated and informed if this isn’t possible.

When and how to provide information to families

Find an appropriate and agreed balance between the individual’s right to privacy, and their choice to share information with family members.

Agree with the individual what information you will share with their family members and help them to communicate this to those family members.

Respect the rights of the individual in regards to information that they do not want to share with family members

Fully understand the Mental Capacity Act 2005 and best interests decisions as they relate to individuals and their family members.

Discuss with the individual about occasions when you might have to share personal information with a family member.

Interact with family members in a way that respects their individual experience, culture and expertise.

Explore and address your own unconscious bias when work with and support families.

Adapt your attitude and behaviours, as needed, to support families.

How to address concerns, dilemmas and conflicts that may arise when working with families

Ensure that everyone puts the individual at the focus of any conversation.

Listen carefully to individuals and family member’s concerns, grievances and complaints. Ensure that they feel heard and decide, together, what actions will be taken.

Understand that what one family member sees and identifies as ‘normal’ may not be the same for others.

Be open to explaining how and why you’re providing care and support in the way that you are, and invite family members to suggest ways that they do it.

If needed, explain the importance of choice, involvement and mental capacity assessment of the individual, to their families - they might need learning and development to aid this understanding. 

Be confident in your own skills and knowledge about how and when to challenge decisions.

How to involve families when planning for the future

Understand the wishes of individuals and their family members, to plan for the future, including their needs and aspirations.

Follow your organisations policies and procedures for documenting future planning.

The organisational and legal requirements for recording information

Understand and comply with your organisation’s policies and procedures around recording and sharing information, including General Data Protection Regulations (GDPR) and confidentiality policy.

Discuss confidentiality and privacy with individuals and their family members from the start.

The agreed process for reviewing how you work with families 

Get feedback from families about how staff work with them and express your workplace values. Use this to shape, change and improve the quality of support.

Offer family members suggestions or comments in a way that preserves your relationship with the family.

 


Things to know

Things to do

How people who need care and support want to maintain family relationships, and how staff can support this 

Review if and how people who need care and support want to maintain their family relationship(s).

Support the individual to be engaged with family members to the level and in the way that they wish to do so. If needed, suggest a range of options for them to manage relationships with different family members and support and respect their decisions.

Offer the individual support to identify and develop opportunities to engage with their family members.

Support individuals to set goals around family involvement, and document these in their care plan.

Ensure that any decisions are made in the best interest of the individual, which may not necessarily be in the best interest of the family.

Ensure that families understand the Mental Capacity Act 2005 and best interests decisions. If needed, provide training, or there are lots of online videos that explain the Act.

Ensure that staff know how to guide families with the Mental Capacity Act 2005, and provide training if needed.

Support the individual and their family members to spend time together in a way that benefits them and be aware of activities that an individual enjoys doing with their family members. Create and maintain opportunities for them to continue, and make sure that your support doesn’t get in the way of these activities.

The ongoing support that family members might need

Reflect on how you work with families on a regular basis and make the required changes to improve this.

Offer support to family members to review the ongoing support that they need, which might change over time, and signpost them to accessible information and independent advice.

Offer support to family members to review their skills and knowledge. Identify if they need any learning and development and find ways of meeting those needs.

As family member’s circumstances change, explore how individual family member’s involvement may need to change, and find ways to support these changes.

 

 

Sample training session

The Avenues Group, funded by Skills for Care, developed this sample training session. It’s based on training for adult social care organisations that support people with a learning disability and/or autistic people. However, it might also be useful for other services. 

You can adapt and build on the content to tailor it to the size of the group, and the expectations of your organisation, the people you support and their families.

We recommend that family members are involved in planning the session and take part in it.

It’s important that the trainer or facilitator has a good understanding of person-centred approaches and can explain the Mental Capacity Act 2005 as and when it’s appropriate to the group discussions.

You can deliver it as a one day event, or break it down into bite-sized sessions. Each session has handouts and activities which you can download and print off below, or download a ZIP file of all of the documents here