Just over two weeks ago saw the beginning of the long awaited review of children’s social care and the chair of this review opened the discussion with the question ‘How do we ensure children grow up in loving, stable and safe families and, where that is not possible, care provides the same foundations?’ It is encouraging that the issue of stability is seen as central to this review as the evidence clearly indicates that care experienced people, their carers and those involved in decisions around where they should be cared for all agree that a lack of stability is a significant issue which all too often undermines children and young people’s lives.
The key question therefore must be, what are the causes of this instability and what needs to change to enable children and young people to benefit from a stable home life which could provide the foundations for a fulfilling life beyond care. I would argue that one significant factor is the limited range of possibilities when considering the most suitable home for a child entering care. Although there has arguably been a long-standing preference for foster care from as early as the mid-nineteenth century (Packman, 1975), the work of the Curtis Committee and the subsequent Children Act 1948 enshrined in law its privileged position which has since been reinforced by successive governments. This has seen a significant transformation moving almost exclusively towards foster care as the preferred mode of delivery. It was reported by the Department for Education that for the year ending 31st March 2018 that 73% of all Looked After Children (LAC) were placed in foster care with just 8% in residential placements (DfE, 2018). Compared to an almost even split of 45% of children in Foster Care (or ‘boarded out’) and 42% of children in residential care in 1966 (Bebbington & Miles, 1990), the scale of this shift becomes apparent.
Furthermore, in his review of residential care, Narey (2016) stated that ‘it is entirely proper for local authorities, at least initially, to pursue fostering as the first choice for children in care’ going on to argue ‘local authorities must treat it as the first option’ (p21). This review was clearly significant for the Conservative government which indicated in its ‘Putting children first’ programme for children’s social care (DfE, 2016) support for Narey’s recommendations which resulted in the recent ‘Foster Care in England’ review (Narey & Owers, 2018) which discusses at great length the actions needed to secure and cement the position of foster care. There is clear evidence here in support of foster care as the first choice for children requiring public care.
The impact of this privilege on practice is noted in a National Audit Office report which stated ‘Local authorities base decisions on children’s placements on short-term affordability rather than on places to best meet the children’s needs’ (NAO, 2014, p9). The NSPCC speculate that ‘There may be rules in place that affect placement decisions, such as a rule that the child’s first placement should be with an in-house foster carer, to reduce the use of higher cost placements’ (2015, p24). Hart et al (2015) state that children tend to experience a series of unsuccessful foster placements before residential care is discussed by social services. Research by Kerr (2016), reports that increasing numbers of children are experiencing foster care breakdowns as a result of a fostering first policy, even if the child’s needs might be better met by a residential placement. Furthermore, such children whose final placement (after multiple foster care placements) was in a residential care home have the worst outcomes.
The issue of a lack of placement options was reported by Norgate et al (2012) who found this to be one of the most significant factors impacting on placement instability according to social workers (n=71) in one local authority in England with higher than average rates of placement change. They found that when asked what factors were associated with placement instability, these social workers rated a ‘lack of choice of placements available’ the second most significant factor behind ‘lack of accessible mental health services’. Furthermore, they went on to more specifically locate the ‘limited choice of residential placements’, ‘limited choice of foster care placements’, ‘lack of a specific type of placement’ and the ‘number of different types of placement available’. When asked about factors which contributed to unplanned placement moves these social workers felt that the ‘mismatch between need and placement’ was the second most significant factor behind ‘behaviour of the child’. In terms of the factor which could have prevented unplanned placement moves, social workers felt that ‘better initial matching of child to placement’ was again the second most significant factor behind ‘support to foster carer’. When asked about the most important change required to reduce placement instability social workers clearly identified more placement options as fundamental. Norgate et al (2012) concluded that a key problem was ‘inadequacies in the placements available…this meant that matching needs to the skills of the available carers was an unattainable aspiration, with there being little real choice over the placement of the child, thus making it more likely to fail’ (p15).
There is also evidence from some children and young people that foster care does not meet their specific needs and may contribute to placement breakdown. Barry (2001) interviewed 34 young people aged 14 to 25 years who had experienced care in Scotland. Most of the young people had experienced residential care and foster care, whether as respite, short-term or long-term placements. The young people reported that ‘they could not relax in foster homes, partly because it was someone else’s house but mainly because they were wary of carers usurping the role their own parents should have been taking’ (Barry, 2001, p13). They felt that the foster carers own children were given preferential treatment, leaving them feeling alienated. The young people also reported that foster care seemed to have more rules and idiosyncrasies than residential care and felt that foster care was not an ‘appropriate alternative to their own families and they resented the often-poor replication of ‘family life’ (Barry, 2001, p30). The young people also clearly preferred residential care because it was less intense than foster care and they could blend into the background. They also felt that there were always other young people around and a wealth of different adult personalities and perspectives available. Some of these feelings were reported by Emond (2002) who engaged in a piece of ethnographic research in two children’s homes in the North East of Scotland. For these young people the preference for residential care over foster care ‘appeared to have much to do with their sense of family identity and the avoidance of confusion over loyalty’ (Emond, 2002, p35). The young people in Emond’s (2002) research felt the resident ‘group’ served several important purposes including, the opportunity to live alongside young people who had similar experiences and the value of being able to share and discuss these experiences and learn from one another. Carter’s (2011) work on a large-group therapeutic community for 15-25-year old’s, although based on the accounts of a very small group of ex and current residents offers further potential benefits for some children and young people. The young people interviewed in this research (n=8) commented on the larger community offering the opportunity to develop key social skills, the value of a larger staff team where ‘you can get little bits from each person’ (p156) and living alongside kids who have the same experiences as you and can understand you. These young people had lived in a range of previous placements including foster and adoptive families but the sense of ownership and fond familiarity they felt contrasted with other placements they described. Carter (2011) found that the outcomes for the residents in this residential community outperformed those of other looked after children. There is also evidence of support for the role of residential care in the systematic review of literature concerning children placed in residential care undertaken by Steels and Simpson (2017). They found clear evidence of the potential benefit of this form of care for some children and young people and conclude that ‘Whilst residential care is regularly used as a ‘last resort’, the findings in this systematic review suggest that residential care can be the most appropriate placement option for many children and that many children adapt, settle and achieve positive outcomes whilst in residential care’ (p1718).
It is not therefore inconceivable that the absence of placement options may have contributed to the frequency of placement moves for some children and young people. According to Hannon, Wood and Cazalet (2009, p11) ‘the complex make-up of the care population reaffirms the range of purposes the system serves and the limitations inherent in pursuing a ‘one size fits all’ approach’. Therefore, it seems reasonable to hypothesise that limiting placement options in public care may be contributing to the poor experiences and outcomes for those children and young people requiring this provision.
It could be argued that inspiration for an alternative approach to meeting the care needs of these children and young people is needed. Some (Petrie et al, 2008) have taken influence from European models of care which have the concept of ‘social pedagogy’ at their heart where in the words of Smith ‘A pedagogue therefore is someone who is involved in the bringing up of children’ (2009, p151). The use of residential care as a positive choice in Western European countries has also received some attention. The aims in these countries were more likely to be around the care and upbringing of the child (whilst maintaining links with the birth family) as opposed to the predominant focus in residential care settings in England where the aims were more likely to be around the ‘assessment’ and ‘treatment’ of the child with care being seen as a bridge to their independence (Ainsworth and Thoburn, 2013). They also found evidence that this approach to residential care produced better outcomes (Petrie et al, 2008). Therefore, it seems that the potential capacity of residential care to meet the diverse needs of children requiring public care needs revisiting.
I explored one such example during a field trip to the town of Geel in the Flanders region of Belgium in March 2017. The setting in question had three units located around the town of Geel which offered residential care, day-care, independent living support and educational support for children aged 0-18 years old. Children and young people could be referred to the organisation via the integrated youth care system known as ‘the door’, through the juvenile court or directly by families themselves approaching the setting. The main purpose of the organisation was to offer support to children and families to create an environment where the child could safely return home. The focus was on a shared-care arrangement where the appropriate level of support depended on the individual circumstances of each child and family. Day-care provision was offered where there was a need to reduce tension at home and support was provided to both the child and their family. The child would attend the day-care centre after-school where they would have their dinner, do their homework and relax before returning home to their family at 7-7:30pm where they would sleep. In parallel with this the family would be offered support at home to enable them to provide an environment where the child could receive appropriate care.
If this level of support was not enough or it was not safe for the child at home, then they could live in the residential unit. Most of the children in the residential unit lived there for between 3-7 days a week, with all the children having some regular weekly time at home. Most of the children spent the weekends at home with their family and the aim was for them to have as much contact with their parents as possible. If the children did not want to attend school, then they were offered activities in the day-care centre. The children did not think of the residential unit as their home but somewhere they must stay for a while before they return home to their family. If it was impossible for them to return home, then they would move long-term into a foster placement but even in this instance the organisations aim was to try and get the child’s relationship with the parents to be as good as it could be. If children did return home, then support was on-going and support was also provided if the child moved into independent living. Support could be offered to the children who moved into independence up to the age of 21 years old. The average stay in the residential unit was six months but the children could stay up to two years.
Children who lived in the residential unit were those where it was felt there was a possibility of them returning home and the care was offered on a shared-care basis and as such there was a very close relationship between the setting staff and the family who are routinely invited to the setting. The staff talked about the importance of offering the children warmth, structure, empathy, honesty and security but they did not position themselves as replacement parents. They emphasised the close working relationships with the children’s parent who regularly undertook activities with the staff in the residential unit. When asked if they felt the children were happy at the setting the staff explained that children who have attended this setting reflected that they were happy there and that they felt the staff cared about them. When asked if this type of setting was typical of residential care in Belgium they reported that it was very typical. It is clear from this model of alternative care that the focus is very much on shared care with the family and for offering support based on the needs of each child and their family with the ultimate aim of returning the child to their home. The importance of working in partnership with the family was evident and the significance of flexibility in this seems to be key. The main aim appears to be to offer the family whatever support they need to enable the child’s safe return home with the availability of on-going support in the community. A key feature of this model of care appears to be the supportive nature of state intervention and the notion of shared care.
It seems to me that there are compelling reasons to revisit our over-reliance on foster care to meet the needs of a diverse group of children and young people and the potential for residential care to provide a warm, safe and stable home.
Senior Lecturer in ECEC