Keep Fostering - National Implementation Service

• It is available for three different age groups and there are 20 programmes running in 12 different local authority areas
• An independent evaluation of the Keep Standard programme found it helps improve parenting skills and reduces children's stress and behaviour problems

ACTION

Keep, which stands for Keeping Foster and Kinship Carers Supported, was brought to England in 2009 via the National Implementation Service (NIS) as part of the drive to improve outcomes for looked-after children.

Improving the professional development of foster carers was a key priority, explains NIS Keep lead Jo Warburton. "We were thinking about programmes that could be delivered to foster carers to support recruitment, retention and the stability of foster placements," she says.

The approach, developed by the Oregon Social Learning Centre in the US, is based on the same principles. There are three different strands according to the age of the child in placement. Keep Standard is for those aged five to 12, Keep Prevention is for three- to six-year-olds and Keep Safe is for adolescents.

The training is delivered to groups of eight to 10 carers over 16 weeks - or 20 weeks for those caring for teenagers. Carers can self-refer or be recommended by their supervising social worker or the child's social worker. The programme is open to carers with children already in placement and those about to welcome a child with both experienced and newly-approved carers learning alongside each other.

Weekly sessions last about 90 minutes and are delivered by two facilitators who have been trained in the Keep programme - most are supervising social workers but child and adolescent mental health practitioners and some foster carers who have been through the programme have also done the training.

Carers get a home visit before embarking on the scheme, which can be particularly important for kinship carers, who are less used to doing training and may be more nervous about attending, says Warburton. The sessions themselves are all about giving carers practical skills and strategies to deal with different aspects of their multi-faceted role, including managing difficult and challenging behaviour.

"This is less about why a child is behaving like they are and more about what to do about it," Warburton says. "Carers often know the theory but want to know what to do if their child is screaming in the supermarket and they can't get them out or getting them to school every day is a complete battle."

The focus is on reinforcing positive behaviour and replacing challenging behaviour and includes learning how to use incentives, setting limits and boundaries, managing "power struggles" in a safe way for both child and carer and using discipline effectively.

Techniques include "pre-teaching" where a carer talks a child through every step of an activity such as a supermarket trip before they go so they know what to expect.

"We also look at how foster carers manage their own emotions while caring for children," says Warburton. "Part of it is about giving permission to take time out for themselves and also knowing when to step away because their behaviour may not be helpful to the child."

She says the strength of Keep lies in the fact it provides both training and support - from facilitators and mutual support from fellow carers - and is delivered consistently across the 16 or 20 weeks.

The course comes with a manual that carers can continue to refer to with exercises such as simple steps to staying calm or tips on talking to teachers at a parents' evening.

In addition to the sessions, carers get a weekly phone call from facilitators called a Parent Daily Report to assess children's behaviour and carers' stress levels over the past 24 hours.

"This is a great way of not only monitoring the stress of carers but also catching behaviours early and looking at patterns over time," says Warburton. "If a carer has had a difficult week and is feeling low or exhausted, facilitators can support and encourage them."

IMPACT

An independent evaluation of the standard Keep programme in England, funded by the Department for Education's Children's Social Care Innovation Programme, was published in October 2016. The evaluation included data from 12 Keep groups delivered by 10 local authorities and involved comparing before and after results for 59 carers who took part in Keep with results from a control group of 26 carers who did not do the training.

Carers completed Strengths and Difficulties Questionnaires (SDQs) for children. When the Keep group was compared with the control group, there were no statistically significant differences in overall SDQ scores. However, researchers identified significant improvements for the Keep children when it came to sub-scores for emotional distress and positive behaviour, compared with the control group.

Meanwhile, Keep carers showed significantly greater improvements in parenting skills and style of parenting - as measured on the Parenting Scale. Carers felt it had improved how they responded to challenging behaviour and equipped them with new strategies. Most said their child's behaviour had changed as a result.

An analysis of the cost-effectiveness of the scheme suggests it has the potential to save money by preventing placement breakdowns and reducing the need for additional support.

A recent internal analysis of Keep programmes for all three age groups also found improvements in children's behaviour and emotional difficulties, reductions in stress for carers and a lasting impact on parenting style.

This article is part of CYP Now's special report on foster care. Click here for more