- This summary draws on evaluations of Innovation Programme projects published in 2017 by the Department for Education; on programme learning events on looked-after children; and on the on-the-ground experiences of projects. The summary is published by the DfE and Spring Consortium, drawn from Rees Centre, which led the evaluation.
In 2016, almost two thirds of children in care in England were aged 10 and over. Adolescents coming into care often have different, more diverse and more complex needs than younger children. These complex and interlinked vulnerabilities require comprehensive, whole-person approaches. This is challenging in systems that have traditionally provided discrete services: a YOT worker for antisocial behaviour; a social worker to support relationships with family; a child and adolescent mental health services referral for mental health problems.
Teenagers in and on the edge of care often have multiple vulnerabilities and develop high-risk behaviours, including involvement in gangs, substance misuse and disengaging from education. In addition, around 16,500 young people in England are estimated to be at risk of child sexual exploitation (CSE). These complex needs and their interdependencies require seeing the young person "as a whole" and understanding them in the context of their relationships with family, friends and surroundings, both past and future.
It requires planning with a focus on adolescents' long-term ambitions and outcomes into adulthood, as well as short-term risks. Effective support is comprehensive, personal and supports young people to build the relationships, skills and emotional readiness needed for adulthood.
What works well
Learning from across Innovation Programme projects working with complex adolescents supports the wider evidence base in suggesting that there are a number of common aspects to approaches that successfully promote placement stability and reduce risk.
Recruiting for culture in addition to competencies
Successful recruitment to key roles focuses on the critical beliefs and values of candidates as well as skills and qualifications, including:
- A combination of high expectations with empathy for adolescents
- A refusal to believe that any child is "unlovable" or "unfosterable" - that all adolescents can be successfully placed with a loving family, with the right support
- A commitment to "doing the right thing" and a "whatever it takes" attitude - having the confidence to challenge assumptions and habits when these are not in the interests of the young person
- Resilience and experience of working with adolescents - work with adolescents can be emotionally and physically exhausting, most acutely for foster carers and residential workers. Local authorities are increasingly looking to practitioners with backgrounds in health, education or youth work for these roles.
Building strong and skilled multi-disciplinary teams
Multidisciplinary, co-located teams are paying for themselves by reducing and avoiding costs associated with adolescents going missing, being taken into custody for protection or because of youth offending or being admitted to hospital emergency departments. By having access to and implementing the right therapeutic approaches, practitioners can treat the underlying causes of risk taking, enabling adolescents to learn to change their behaviour and keep themselves safe.
The role of police officers, embedded in support teams, is emerging as having a positive impact. Police can be advocates for adolescents in the community and with their colleagues; manage interactions with the justice system; de-escalate situations; keep young people out of custody; and negotiate bail conditions to keep adolescents at home.
Preparing young people for adulthood
Supporting birth families to provide a safe, warm and respectful environment with opportunities to learn and build consistent relationships is as important as direct work with young people. Outcomes can improve when birth families are an asset in adolescents' lives, and families' strengths are acknowledged and supported to grow.
For young women affected by CSE, for example, interacting with men in positive nurturing roles in their home setting can be helpful. Whether in birth families, foster families or residential homes, young people do best when there is a family feel to their home, with shared mealtimes, warm and consistent relationships, and opportunities to learn.
Five key considerations
- Support should balance short- and long-term risks, needs and goals, and focus on helping adolescents to become confident and independent adults.
- Adolescents in care often display risky behaviour because they are attempting to process trauma. Therapeutic approaches that address the causes of trauma, not behaviour management, have the greatest effect on outcomes.
- All young people can be placed successfully in a family setting with careful planning and the right support for carers. This should be the default goal, while recognising that there may be isolated exceptions. Residential care should be used to support this ambition, rather than as a long-term solution.
- Multi-disciplinary, co-located teams are necessary to provide the holistic care that adolescents need; coupled with one access point and consistent relationships for the young person.
- New approaches to, and understanding of, risk are essential to empower staff to make decisions and for practitioners and systems to see families as part of the solution.
OTHER PROJECTS STUDIED FOR THE LEARNING SUMMARY
- The House Project A housing co-operative for care leavers, piloted by Stoke-on-Trent Council and being implemented by Warwickshire, Solihull, Staffordshire, Islington and Cheshire East.
- London Borough of Enfield's Family Support Hub Setting up three multidisciplinary teams focused on re-unification, edge of care and CSE.
- Gloucestershire County Council Developing a multi-agency, council-wide service for the most vulnerable young people aged 10 to 25.
- St. Christopher Fellowship's Safe Steps Programme Developing a flexible, high-supervision model of accommodation for looked-after girls at risk of sexual exploitation in London.
- Sefton Council's Community Adolescent Service Creating a multi-agency/disciplinary service for vulnerable 12- to 25-year-olds.
- Tri-borough Alternative Provision Residential education provision for adolescents on the edge of care.
- Durham County Council's Aycliffe Secure Children's Home Testing a new model of support for young people who have experienced sexual exploitation.
- Mopac's adaptation of the Scandinavian Child House model A child-centred, multi-agency response to sexual abuse.
- Wigan's Achieving Change Together Co-designing social-care responses to CSE with young people.
- London Borough of Ealing A bespoke practice model that devolves decision making closer to young people.
- North Yorkshire's No Wrong Door Flexible residential support for those on the edge of care.
- London Borough of Havering Developing a multi-agency systemic service for 11- to 24-year-olds.
- Adolescent Service Change and the Edge of Care: Innovation Programme Thematic Evaluation Report, the Rees Centre, July 2017
- Adopting and Adapting Innovation to Improve Outcomes for Looked After Children, event hosted by Bradford and Spring Consortium, July 2017
- Residential Care and Staying Close, event hosted by Spring Consortium, November 2016
- Innovation Programme Interim Learning Report, January 2016
- Leeds ‘One Minute Guide' to the Mockingbird Family Model, September 2015
- Multidimensional Treatment Foster Care for Adolescents in English Care: Randomised Trial and Observational Cohort Evaluation, Green et al, British Journal of Psychiatry, 2014
- Edging Away From Care: How Services Successfully Prevent Young People Entering Care, Ofsted, 2011
- Reducing the Risk: Barnardo's Support for Sexually Exploited Young People - A Two Year Evaluation, Scott and Skidmore, Barnardo's, 2006
Evaluation reports for all projects, alongside thematic and overview evaluation reports are available from reescentre.education.ox.ac.uk
Further information on projects as well as learning summaries and materials on innovation in children's social care are available from www.springconsortium.com