Self-audit tool for parent-infant teams
Background
As part of our mission to support the growth and quality of specialised parent-infant relationship teams across the UK, we created the UK’s first definition of a specialised parent-infant relationship team in the Rare Jewels research and report.
This work forms the basis of this self-audit tool which outlines a number of descriptors of a team, against which you are asked to assess yourself. You can download a PDF of the key characteristics of a parent-infant team here. Or you can read them below.
Purpose of the tool
The purpose of this process for you as a team is to:
- Assess your own development and maturity as a team against a set of commonly agreed descriptors
- Work towards creating a service development action plan.
You can also use it as a leverage for funding, or in whole system wide discussions.
The definition used helps to ensure a clear distinction between a parent-infant team and other services within early years, who may offer parent-infant relationship work as a secondary function.
It also enables us to speak to national decision makers using clear facts and descriptions of services across the UK.
Key characteristics of a specialised parent-infant relationship team
Team composition and clinical governance
Clinical supervision is offered to all practitioners at the recommended level and frequency - and is separate from line management.
Recommended minimum supervision frequency:
- Practitioners with less than three years’ experience of working with children under two should have one-hour reflective clinical supervision a week
- Practitioners with over three years’ experience should have one hour per fortnight.
These amounts can be adjusted on a pro-rata basis for part-time staff.
A multi-disciplinary team which includes highly skilled mental health professionals with therapeutic expertise in strengthening the relationship between babies and their parents.
The team should be able to deliver interventions at different levels of need. This package of interventions should be pitched at the different levels of care outlined in the THRIVE model and include evidence-based interventions.
The team/service is led by (or has clinical oversight from) a consultant psychotherapist or psychologist who has additional training equivalent to AIMH Level 3 competency. They are able to understand, articulate and screen adult mental health risk.
NB: According to all professional bodies and the NHS Pay scales, this means paid at equivalent of 8C or above for clinical/counselling psychologists and psychotherapists. In practice however, during austerity, many 8C jobs were removed and replaced with 8B pay but with the same responsibility as the previous 8C job descriptions. In educational psychology, this means Soulbury scales Senior and Principal (SCP1-18).
All staff have infant mental health expertise, knowledge and skills and have demonstrated competencies to AIMH Level 2 or 3.
See AIMH competencies for further information.
Some may have additional modality training in parent infant intervention or assessment. Variations may include: PPIP, VIG, VIPP, CPP etc.
Referrals and accessibility
There is a clearly outlined referral pathway to enable families who need parent-infant relationship support to access the service.
The team accepts referrals for children aged two years and under. If referrals are only accepted up to a year, then this would be a targeted team.
Concerns about the parent-infant relationship is an accepted reason for referral in its own right. Criteria is not limited to those with a defined characteristic (e.g. the ability to pay privately, parental mental health difficulties, children in or on the edge of care).
If the answer to this question alone is ‘No’, then your service may qualify as a targeted parent-infant team.
Clinical work
The team offers individual assessments and a variety of parent-infant interventions, so that a package of developmentally-appropriate therapeutic work can be tailored to meet the families’ needs. This package of interventions should be pitched at the different levels of care outlined in the THRIVE model and include evidence-based interventions. See toolkit for more information.
Dyadic (and ideally triadic) interventions are offered with a primary therapeutic focus on the quality of the parent-infant relationship, not just on infant behavioural indicators or parental mental health status.
Wider systems work
The team are experts and champions in their local system. They use their infant mental health expertise to help the local workforce and others to understand and support parent-infant relationships. This is recommended to comprise 50% of the work of a parent-infant team. This work can happen through the following mechanisms:
- Training in assessment and observation
- Training in parent-infant interventions
- Consultation and advice
- Supervision or reflective practice
- Advice to systems leaders and commissioners
Outcomes and sustainability
Output and outcomes data is routinely collected and and collated. It speaks clearly about the impact of the work, ideally using both qualitative as well as quantitative data drawn from recognised outcomes tools. This impact is written up and communicated to both the funders and to the public. See Toolkit entry for further information.
NB. This domain is not part of a team definition but used for the self-audit.
Funding is sufficient and commissioning arrangements ongoing. This descriptor is clearly aspirational! Ideally, specialised parent-infant relationship teams should be commissioned as part of a wider strategy that secures a pathway of support for babies and their families in the local area.
Parent-infant teams ideally are funded via different budgets and address commissioning outcomes in both health, social care and public health.
See Toolkit entry for further information.