Document 10
REPORT TO THE BOARDS FOR CORPORATE PARENTING,
THE CHILDREN’S TRUST AND SAFEGUARDING CHILDREN
A report on the measures being taken to improve the provision of
stable care placements for children and young people looked after.
Background
1. Placement stability is a fundamental building block for helping looked
after children achieve better outcomes. The Board will be aware that
performance in providing short-term placement stability (the number of
placement moves for looked after children) has been weak for a number
of years. Despite making this aspect of provision a priority area for
development, with closer monitoring, analysis and targeted actions that
have resulted in temporary improvements, the trajectory of performance
over a three-year period shows a flat-line. It is the one area of local
performance in supporting looked after children, which is consistently
under average both nationally and for statistical neighbours.
2. The actions taken so far to improve performance in this area have
centred largely on raising the expertise of foster carers and residential
care workers to stick with children and young people who exhibit posttraumatic syndrome as a result of their experiences of maltreatment,
compounded by separation and loss. This capability requires an empathic
understanding of why these children have difficulties in forming
attachments and why they often present challenging behaviours.
What we know
3. The senior management team for social care has brought together
data, experience, audit, independent review and feedback from children in
care, parents, foster carers and care workers to undertake a more
systemic analysis of the causes why some children have a high number of
placement moves. The analysis shows the following causal factors:
i) Data shows that the demand for the help and protection of
adolescents 11 years plus has increased significantly over the
last 3 years. The largest proportion of requests for care
placements are in respect of adolescents, many of which are
unplanned as a result of a growing family crisis and often at the
request of their parents/carers. A precipitating factor can often
be school exclusions (formal and informal) and an inability to
sustain the young person in full-time school timetable. This
places additional strain on families already at breaking point.
The largest proportion of looked after children is young people
11 years plus and a significant proportion of them are in care
under a voluntary agreement with their parents. This profile is
indicative of the impact of the ongoing recession on fragile
families, particularly step-parent families, which is likely to get
worse as the welfare reforms are implemented. The data shows
that it is these young people who are over-represented in three
or more placement moves.
1
Document 10
ii) Case reviews show that many of these young people have
behavioural, emotional and social difficulties, which have
developed over a long period due in large part to intergenerational family poverty and an associated gap in parenting
capacity. Most have experienced a family life that is
characterised by a constellation of inter-connected factors,
including parental unemployment, alcohol and substance
misuse, anti-social behaviour or offending, mental health
problems and domestic abuse. These problems have already
impacted negatively on the life chances of these young people
and their inclusion in society. This often includes poor school
attendance, educational progress and attainment. Many have
experienced low levels of stability and security in their lives
already, in family relationships, accommodation and school
placement. Parents, carers and teachers struggle to cope with
the consequences of these childhood experiences. Often, the
young people have lost confidence and trust in adults.
iii) Young people have told us consistently that they want us to do
more to prevent them from having to come into care. They
want more effective help for themselves and their parents or
carers at an earlier stage. Whilst they understand that in some
circumstances things have become so bad they need to come
into care, when that is the case they want us to do everything
we can to see if a connected person in their wider network of
family and friends could help so that they can stay with people
who are familiar, ideally in their community with their peer
group and at their school. If they have to come into care they
want to have more say about whom they live with and where
they live. Birth parents have mixed views about what should
happen. Some seek to blame the young person’s behaviour and
find the idea of a relative or family friend caring for them very
difficult to accept. Some young people have been threatened
with care as a punishment for their behaviour.
iv) Government funding available to spend on early help services that
support these young people and their families has been reduced
significantly over the past three years. The services that remain
to support these vulnerable young and their families are
insufficiently co-ordinated, the use of evidence-based
approaches has been patchy, front-line workers in preventative
services report that they feel they lack the practice skills to
respond to their needs and make a lasting difference. The
specialist Child and Adolescent Mental Health Service (CAMHS)
has limited and reducing capacity to meet the rising demand
and lacks the expertise to provide appropriate interventions to
modify the behavioural difficulties of young people living in
unstable families or the emerging emotional and mental health
problems they are experiencing as a result of maltreatment.
2
Document 10
v) Placement workers report difficulties in matching young people to a
suitable placement in these circumstances, often having to opt
for an emergency placement while they identify a more suitable
placement. This can take some time. Foster carers and care
workers have told us that they often struggle with the impact of
bringing a young person facing these difficulties into placement,
settling them and forming positive relationships. This is
compounded by the fact that admissions are often unplanned
due to a crisis. The young people are often in crisis themselves,
feeling blamed, rejected and confused. This can have the effect
of amplifying established behaviours of defying adult authority,
going missing from home and school, and risk taking. The
profile of the young person’s behaviour can become quite
negative, making the identification of a more suitable placement
even more difficult. Social workers report difficulties in
establishing a coherent care plan quickly in these circumstances,
as they need to seek the views of the young person and their
parents, establish whether a return home is possible, seek any
family members or other connected persons who could help or
provide care, and establish a balanced profile of the young
person as a basis for matching. In establishing a good
understanding of needs, risks and resources as the basis for a
way forward the young person is likely to experience a return
home, re-admission and/or trial placement with a connected
person, sometimes more than one.
vi) Despite attention and investment, successive self-assessments and
inspections have shown that three of the five directly managed
homes continued to struggle to provide good enough care
placements for young people in these circumstances. Young
people admitted to these homes were significantly more likely to
have three or more placement moves, in part due to established
behaviours (some had already had a placement breakdown) and
in part to shortfalls in the quality of provision. When admissions
to those homes have been suspended and/or the young people
in residence have been moved, in the main, more suitable
family placements have been identified and the young people
have settled better.
vii)
An independent review confirmed that the decision-making
process for accommodating young people was not sufficiently
robust. The decision making process was not always channelled
to a senior manger and when it was the senior manager was not
always in possession of the detail required to make a fully
informed decision. The placement team was often approached
directly by the child’s social worker to identify a placement at an
early stage, before approval by the relevant senior manager. A
significant proportion of these placement requests were not
required in the end. Placement workers, therefore, were not
always clear about which cases to prioritise for matching. In
some cases the information provided about the young person,
including their views, was insufficiently detailed for matching
3
Document 10
purposes. It was not always clear what alternatives had been
explored and tried out prior to requesting a care placement.
What we are doing
4. In a series of ‘Turning the Curve’ exercises undertaken by managers
and practitioners at the Quality Assurance and Performance Management
(QAPM) conferences, followed up in management discussions, the
following actions have been agreed to improve the quality of provision:
Strategy:
i) Completing the Self Assessment of provision and outcomes for
Looked After Children and Care Leavers (Lead: J Cordery –
October 2013)
ii) Refreshing the Corporate Parenting Strategy to reflect the needs
analysis and priority actions (Lead: D Roose – November 2013)
iii) Refreshing the Care Placement Strategy to reflect the needs
analysis and priority actions (Lead: D Roose – November 2013)
iv) Refocusing the Children and Young People’s Plan 2014/15 to raise
the profile of children in care and care leavers (Lead: A MankeeWilliams – November 2013)
v) Refocusing the Children’s Social Work & Psychology Service
Improvement Plan 2014/15, to reflect the measures being taken
to improve the quality of provision for looked after children and
care leavers (Lead: J Cordery – November 2013)
vi) Prioritising looked after children and care leavers within the schools
strategy for raising aspirations and attainment (Lead: D
Fishbourne – November 2013)
vii)
Refocusing the 11-19 Youth Strategy and prioritising young
people vulnerable to poor outcomes (Lead: P Barker –
December 2013)
Governance:
i) Strengthening the membership and functioning of the Corporate
Parenting Board, with a greater focus on the quality of provision
and outcomes (Lead: D Roose – October 2013)
ii) Raising the profile of looked after children and care leavers within
the Children’s Trust and scrutiny by the Board (Lead: A MankeeWilliams – October 2013)
iii) Raising the profile of looked after children and care leavers within
the safeguarding children partnership and scrutiny by the
Safeguarding Children Board (Lead: I Davidson – October 2013)
Practice development:
i) Continuing to invest in the expertise of foster carers and residential
care workers through continuing professional development that
includes higher skills training in evidence-based practice,
seminars and conferences, advice and consultation (Leads: D
Roose, R Sargent, T Phillips-Jones, L Rentoul)
ii) Reviewing the system for awarding skills level payments to foster
carers, to develop more explicit criteria for awarding Level 3
payments, establish a panel process and when considering
4
Document 10
continuation of skills level payments at the annual review to
consider the performance of Level 3 foster carers in sticking
with young people with complex needs and challenging
behaviours (Leads: D Roose, R Sargent – January 2014)
iii) Refocusing the foster carer recruitment strategy to match the
growing demand for adolescent care placements. Setting out
expectations for placement stability in the fostering handbook.
Reviewing fee levels for adolescent carers and/or reflecting the
skills required to care for adolescents in the skills level system.
Increasing the proportion of adolescents in long-term and
permanent foster care (Leads: D Roose, R Sargent, C Pearce –
January 2014)
iv) Developing a specific QAPM framework for children’s residential
homes. Setting out the expectations for sticking with young
people with complex needs and challenging behaviours.
Reflecting standards and targets for placement stability in Team
Improvement Plans and annual appraisal (PDS) objectives.
(Leads: D Roose, T Phillips-Jones – December 2013)
v) Investing in the professional capabilities of front-line practitioners
who work with troubled teenagers. Providing evidence-based
skills training that includes, the Family Partnership Model, Signs
of Safety, Motivational Interviewing, Restorative Justice, Family
Mediation, and Functional Family Therapy (Leads: B Doyle, Y
Yates, B Davies, S Wood, J Hampton, D Roose, K Dale, M
Russell)
Systems and processes:
i) Establishing service Resource and Care Panels as the pre-eminent
means for decision-making when considering care packages for
children and young people on the edge of care. Setting out
standards and expectations for bringing cases for consideration
at the Resource and Care Panels (Leads: Y Yates, B Davies, S
Wood, J Hampton, D Roose – October 2013)
ii) Establishing a dedicated Placement Hub as the single point of
contact for requesting, prioritising and matching children to
available placements, including independent agency placements
(Leads: D Roose, T Phillips-Jones – October 2013)
iii) Incorporating the placement request/decision-making process into
the workflow for Frameworki, the integrated children’s system
(Leads: G Goodier, T Flowers – October 2013)
iv) Providing monthly performance reports on the activity and
outcomes of the Resource and Care Panels/Placement Hub
(Leads: G Goodier, N Bryant, T Phillips-Jones – December 2013)
v) Appointing an Assistant Manager for the Safeguarding Children
Standards Unit to lead on looked after children and care leavers.
Introducing Signs of Safety/Wellbeing as the approach and tool
for reviewing the progress of children in care towards
permanence. Increasing the frequency of independent reviews
for children under 8 years. Extending independent reviews to
care leavers (Lead: K Dale – January 2014)
vi) Increasing opportunities for young peoples’ participation in decision
making and service planning by refreshing the implementation
5
Document 10
of Viewpoint and access to advocacy (Leads: K Dale, D Roose –
December 2013)
Service Developments:
i) Re-focusing the work of youth services on targeting information,
advice, guidance and support to vulnerable young people and
outreach. Exploring the capacity of local voluntary organisations
and community groups to undertake a larger proportion of this
work (Lead: B Doyle, P Barker – January 2014)
ii) Re-allocating revenue costs from the closure of failed residential
homes to create specialist, multi-disciplinary adolescent support
teams to work with young people at risk of family breakdown
and poor outcomes, using Motivational Interviewing, Restorative
Justice, Family Mediation, and Functional Family Therapy.
Developing a specialist adolescent resource centre that will
incorporate temporary, emergency accommodation (Leads: D
Roose, T Phillips-Jones, T Davey – January 2014)
iii) Re-investing revenue costs from the closure of failed residential
homes in specialist adolescent family placements (Leads: D
Roose, T Phillips-Jones, R Sargent – December 2013)
iv) Establishing a Family Plus Team to improve the quality of provision
for kinship carers (Leads: D Roose, A Waters – October 2013)
v) Establishing a dedicated foster carer and adopter recruitment team
to refocus the campaign and increase the number and range of
care placements for older children (Leads: D Roose, R Sargent,
A Waters – October 2013)
vi) Exploring the business case for a Social Impact Bond, together with
three partner local authorities, to develop additional capacity to
support vulnerable adolescents on the edge of care (Lead: J
Cordery – January 2014)
vii)
Reconfiguring Children in Need Teams to strengthen integration
through multi-disciplinary working (Leads: B Davies, M Owen –
October 2013)
viii) Reconfiguring Children in Care Teams to strengthen integration
through multi-disciplinary working (Leads: B Davies, S Wood, J
Hampton, M Owen, T Osborne – December 2013)
Summary
5. The Board is asked to:
a) Note, comment on and challenge the analysis and the actions
presented in this report.
b) Disseminate the report widely through their agencies or services
and commissioned services, asking for feedback and commitment
to improve the quality of provision and outcomes for looked after
children and care leavers.
c) Make suggestions about objectives and actions to be incorporated
into the Board’s strategy or business plan.
Report prepared by:
6
Document 10
Jack Cordery
Head of Service
Children’s Social Work and Psychology Services
September 2013
7