Ripe for reform


With government pledging to undertake a 'national stocktake' of foster care and MPs conducting their own inquiry, Joe Lepper asks what measures would improve quality of care and outcomes for children.

Even though the vast majority of looked-after children live in foster placements, government attention has homed in on adoption and residential care in recent months and years, leaving fostering remarkably overlooked.

Until now. The Department for Education's Putting Children First social care policy paper in July promised to conduct a "national stocktake", while the education select committee has since announced it is holding an inquiry into the state of fostering in England.

According to commissioners, providers, regulators and academics alike, fostering is an area of the care sector crying out for reform, with too many children going missing, too many placements breaking down and not enough carers available to support the rise in referrals.

According to Ofsted, missing incidents increased by 19 per cent in 2014/15, while there were 7,245 placement breakdowns in the year, affecting eight per cent of fostered children. In half of all cases the carer ended the placement and in a fifth of cases the placement did not even last a full day, Ofsted found.  

As well as an ongoing shortage of foster carers across the country, concerns are increasing about ensuring there are enough specialist carers to meet the needs of the most challenging children.

Since announcing plans for a "stocktake" no detail has emerged from the government on how this will proceed, with the DfE's attention seemingly occupied by other matters such as proposals to extend grammar school provision.

A DfE spokesman says it will aim to "build a rich evidence base about how the foster care system works", with a focus on spreading best practice and highlighting areas of improvement.

Concerns over independence

But fostering experts are concerned it will be lightweight compared with the residential care review and the government's focus on adoption, which has included an independent review of post-adoption support and the release in March 2016 of the government's Adoption: A vision for Change strategy.
 
The Fostering Network chief executive Kevin Williams says he is concerned about the proposed stocktake's lack of independence, since it will be carried out directly by the DfE, and questions why "the government has undertaken reviews into other areas of care but did not start with the area with the largest group of young people".

On launching the MPs' own inquiry in October, education committee chair, Conservative MP Neil Carmichael, said: "We do not have any details as to what [the stocktake] will look at, how long it will take or what the outcomes will be."

Andy Elvin, chief executive of adoption and fostering charity The Adolescent and Children's Trust (TACT), believes the government should draft in independent academics and financial consultants to offer a critical analysis of the foster care market.

Harvey Gallagher, chief executive of the Nationwide Association of Fostering Providers, says a "stocktake" itself suggests it will merely collect data but not "propose any solutions".

He fears it may fall short on the task of bringing meaningful improvement to a "poorly co-ordinated" foster care system blighted by a lack of cooperation between different councils as well as with independent fostering providers (IFPs). "No one has a sense of where the carers are and who is best to take a child."

A national register would go some way to address this, says Williams. He wants any review to examine the feasibility of such a register to produce a national picture of "what the foster care workforce is" for thefirst time.

Foster care training also urgently needs national co-ordination, says Williams.

At present, local authorities and IFPs have their own training schemes, so "when a carer moves to a different part of the country they almost have to start the process of being approved again". Instead, he wants to see national, standardised training "that gives carers portability when they move".

Such calls are part of an increasing desire among foster carers to be seen as professionals within the wider children's services workforce, with payment and support to match that status.

Last month, a group of foster carers voted to set up their own union as a dedicated branch of the Independent Workers Union to focus on professional status, pay and conditions.

But Williams does not want greater gravitas for foster care to mean Ofsted moves beyond agency and service inspections to start inspecting individual carers (as it does individual childminders). "Ofsted already looks at the systems that support foster carers and care for individual children within that," he says.

Charlotte Ramsden, chair of the Association of Directors of Children's Services' health, care and additional needs committee and director of children's services at Salford City Council, says any review must prioritise the emotional support carers receive.

She points to the Salford Therapeutic Advisory and Referral Service, which "works closely with looked-after children but also provides therapeutic support to the carers and their family".

Professor Judy Sebba, director of the Rees Centre for Research in Fostering and Education based at the University of Oxford, also wants to see carer support take precedence.

The Mockingbird Family Model is a prime example of the type of innovative support for carers that should be emulated, says Sebba. The model originated in the US and has been used by nine fostering services across England over the past year. It organises "constellations" of carers around a "hub" home that can offer respite care, peer support and social activities to prevent placements breaking down and improve relationships between carer and child.
 
Among the 160 children and 155 families involved in Mockingbird in the UK over the past year there have been no placement breakdowns and no carers have left.

Social work communication

Another area in major need of improvement, says Williams, is communication between social workers and carers. Ofsted's 2016 social care report found 40 per cent of carers did not get a chance to find out important aspects of a child's life before they arrived in their home.

Williams says: "Being honest and open with carers will help get the right placements, but what we hear on occasions is that social workers do not always tell the full story to the children."

One west of England-based foster carer, who specialises in short breaks for younger children (and declines to be named), describes how she felt like she had been "deliberately hoodwinked" by one social worker over one recent placement.

"I asked how old the child was and was told, very flippantly, ‘oh she's definitely over three years old',"she recalls. "Various meetings ensued over the next couple of months and the age was never clarified," until eventually the carer was told the child was 16.

"I felt like we'd wasted two months of our time and was pretty cross." When she made her "frustrations known" to the social work team she was then told to "let it go and get over it".

"All it needed was an apology," the carer adds.

Such anecdotes do little to help attract more foster carers to a sector struggling to meet rising demand and the increasing range of specialist roles needed, including parent and child foster carers (see box).

New carers are also needed for long-term placements, says Gallagher, especially as Staying Put arrangements, whereby children can stay with their foster carer until they are 21, are now in place.  

Gallager says: "What we have at the moment is a cohort of carers who never expected to be providing Staying Put support and find that a difficult prospect. But if you recruit new carers, that long-term commitment can be made clear to them at the start."

The national examinations of the fostering system are long overdue. They have plenty to get stuck into as a result.


Parent and child fostering

An increasing appetite has emerged among councils to use specialist parent and child foster placements.

According to Nikki Luke, research officer at the Rees Centre for Research in Fostering and Education, such placements were set up for teenage girls in care who became pregnant. "Now it is being used more for mothers in their 20s and 30s where there are concerns around their parenting," she says.

Luke says placements usually last for around three to four months, over which time the carer will assess the parent and child's needs and relationship, help them to develop their parenting skills and then work closely with the responsible council to assess whether there has been an improvement. If the change is positive the mother may be able to return home with her child.

Christine Henry, East London deputy area manager for the charity The Adolescent and Children's Trust (TACT), which provides such placements, has also seen increasing demand for parent and child fostering.

The closure of some specialist residential mother and baby units, which would have normally offered this form of intense support, is a factor, she says, with long-term savings on the public purse another.

Due to the intense nature of such placements, TACT usually only uses experienced carers and those with no other foster children in their homes, "as this placement is enough of a focus on their time".

A five-day course covering attachment theory, child development, report writing, giving positive feedback and working with another adult in their home, is also given by TACT to its parent and child carers.  

Carol Sloan, a TACT parent and child carer in Yorkshire, says a major part of the job is to "watch, monitor and suggest" rather than "take over or look after the baby". The intense nature of the support can be challenging, but Sloan says talking through any issues, and "not to make the young mum feel a failure", are important.

Henry adds that having robust and tailored planning agreements, which can cover minor issues such as routines for sterilising bottles, can also help avoid conflict.

The Rees Centre is calling for further research into parent and child fostering to assess its impact in keeping families together and whether its use could be expanded further.

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