Scotland’s care system in need of 'radical overhaul', warns independent review

The Independent Care Review, launched by Scotland's First Minister Nicola Sturgeon in 2016, took into account the experiences of 5,500 care experienced adults and children and paid and unpaid staff working across the sector.

“Unprecedented” in its scope, the review examined all aspects of care in Scotland and reveals a system that is “fractured, bureaucratic and unfeeling for far too many children and families”.

“At its worst, it can perpetuate and worsen the trauma that many children have already experienced,” the "root and branch" review states.

• Clash over prioritising adoption

• Children’s services inspection

Review chair Fiona Duncan reveals the “eye-watering” £875m cost of the services to support care-experienced adults who were failed by the care system as children.

This is money spent on mental health, homelessness and addiction services, which a high proportion of care leavers require as adults, the review states.

The review also found:

• Brothers and sisters have been regularly separated and “have no say about their future contact”.
• Families living in poverty have been “stigmatised” and are more likely to have their children taken into care.
• Care-experienced children and young adults are unable to access mental health support at the point it is needed.
• Girls who have been sexually abused have been held in secure care.
• Children who have gone through secure care feel that restraint was used as punishment.
• Care has become "monetised" with competition rather than collaboration.
• Care-experienced children are too often excluded from school.

The review recommends more than 80 changes needed to reform the system including an overhaul of the inspectorate, an end to the use of secure settings and more support for carers of trauma-experienced young people.

Key recommendations include:

• Keeping families together “where children feel safe”.
• Keeping siblings, half-siblings and step-siblings together in care.
• More support for kinship carers, not limited to financial support.
• Not ending support for children at the point of a successful adoption.
• More support for care leavers up to the age of 25.
• Training for all carers to recognise and support children who are dealing with trauma.
• A limit to the number of placements for looked-after children.
• An end to school exclusions for children in care.
• No longer sending 16- and 17-year-olds to prison or detention.
• Better mental health support for care-experienced children and those supporting them.
• Changes to the way children’s hearing panels are run, including comprehensive training for those who sit on them.
• A new inspection process focused on children’s experiences and a new inspection framework that must prioritise the quality of relationships experienced by children, not the process surrounding their care.

The Independent Care Review has also published a 10-year plan for the implementation of key recommendations centred around giving a voice to children in care. It will be overseen by an independent panel, of which 50 per cent will be care experienced.

The care experienced community are at the heart of the #CareReview and have shaped and guided the review's conclusions.

Thank you to everyone who has shared views, ideas and hopes. pic.twitter.com/RxFxoShO96

— The Care Review (@TheCareReview) February 2, 2020

Duncan said: “The Care Review has listened to what care-experienced people have said needs to change and those voices have driven its work and underpins its conclusions. 

“It has sought to understand how the system feels to those who live and work in and around it. And it has produced the what, how, why and when of what needs to happen next. 

“This is a radical blueprint for a country that loves, nurtures and cherishes its children. This is Scotland's chance to care for its children, the way all good parents should.”

First Minister @NicolaSturgeon receives a copy of the Independent Care Review report from Laura Beveridge and also met other members of the Care Review. #CareReview pic.twitter.com/QpsjwtoSRR

— First Minister (@ScotGovFM) February 5, 2020

Sturgeon added: “So for the first time ever the voices of people with experience of the care sector have been, and will continue to be, at the heart of shaping care policy. Over 5,500 people, including care-experienced individuals and their families, as well as paid and unpaid care workers, took the time to discuss their thoughts, feelings and experiences to highlight where things are going well and where we need to improve.

“It is clear that despite the efforts of those within the system, the actual experience of too many people in care is not what we want it to be.

“We will keep listening to and working with care-experienced people because the case for transformational change is now unarguable and their voice must shape that change. We will work with them and with local authorities, care providers and others to deliver that change as quickly and as safely as possible.”

Today I receive the final report of @TheCareReview. Transforming the experience of young people who need our care is, for me, a political and a personal commitment. I’ll set out @scotgov initial response to @ScotParl in a statement this afternoon. We will #KeepThePromise ❤️

— Nicola Sturgeon (@NicolaSturgeon) February 5, 2020

The review has drawn praise from adoption, fostering and children’s services leaders with many calling for a similar review to be carried out in England.

Andrew Elvin, chief executive of Tact Fostering and Adoption said the organisation was "encouraged by the review".

"The report makes clear that the care community will continue to be placed at the heart of the process, ensuring that care experienced people are taking a leading role in future decision-making.  This is of course a must, as those who have experience with the care system are in the best place to know how to make the system better. They must take a leading role for any effective change to take place and succeed," he said.

Kathy Evans, chief executive of Children England, called the review “inspiring” and the Fostering Network said on social media: "The review rightly concludes that children must not wait, and there must be a concerted effort over the next year to develop a detailed, funded plan to ensure that the current generation of children in care can benefit from its ambition."

To say that the #CareReview is an inspiring read already (and I'm only half way through!) would be an understatement, but here's one glimpse of how it acknowledges some of today's problems and makes clear promises to resolve / prevent them:https://t.co/Mby7lwt14N pic.twitter.com/OeXo3cHWs5

— Kathy Evans 🕷 (@Kathy_CEO_CE) February 5, 2020

John Radoux, a children’s counsellor who grew up in care, recently penned a letter signed by hundreds of children's services professionals calling for a review of the system in England and Wales.

He said of the Scottish review: "Dear Scotland, I have just read The Promise [the review]. It is a work breathtaking in both it's scope and intent. I can only offer my awe-inspired respect to [Fiona Duncan], her team and all who contributed. You have led the way.

"The review, of course, is just the start - you have imagined what children's social care should look like, you must now build it. I have complete faith that you can. If you manage it, you will show the world what can be achieved."

Katherine Sacks-Jones, chief executive of national charity for children in care and young care leavers Become, said the review has "got straight to the heart of some of the challenges and set out a clear vision for what good care should look like."

“The voices of care experienced people can be heard throughout. It is so much more than a document; it is a promise. A promise to every child in Scotland that they will get the care and support they need in a system that truly has their best interests at its core.   

“Here in England, we need to make the same promise. We continue to call for urgent reform of the care system. I now hope that the government will see the great progress made in Scotland and commit to taking a similar approach. 

“Time is of the essence. This review has never been more crucial than it is now,” she added.