House of Commons - Health

Select Committee on Health Second Report

CHILDREN LOOKED AFTER BY LOCAL AUTHORITIES

Foster Care

101. As at 31 March 1996, about 33,000 children and young people in England, amounting to 65% of the looked-after population, were in foster care. Although the total number of children fostered has not varied greatly over the past quarter century (ranging between a minimum of 28,400 in 1973 and a maximum of 36,900 in 1982), the proportion of looked-after children who are fostered has risen dramatically, from 32% in 1973 to 65% in 1996.[108] There has been a corresponding fall in both the numbers and proportion of children looked after in residential accommodation. At 31 March 1996, about 6,000 children and young people in England, amounting to some 12% of the looked-after population, were living in residential accommodation; the comparable figures for 1973 were 28,300 and 32% (and the figures in 1976 were higher still: 38,000 and 40%).[109]

102. The figures given in the previous paragraph relate to looked-after children who are fostered, that is, children whose foster care is arranged by the local authority, either with its own carers or with carers supplied by independent fostering agencies. In addition to these children, there is an unknown number of children who are privately fostered, in other words whose parents or guardians make private arrangements with other individuals for them to be fostered. Under the Children Act, any person proposing privately to foster a child under the age of 16 for a period of 28 days or more is required to notify the local authority. There is no requirement for the authority to approve or register private foster carers, and it appears that many such carers are either ignorant of or disregard the requirement to inform the authority. In paragraph 144 below we express our concern about this situation.

103. The decline in numbers of looked-after children in residential accommodation reflects an increasing recognition in the 1970s and 1980s of the drawbacks and risks, as well as the comparative expense, of such accommodation. The Social Services Committee, in its 1984 report, commented that

"Residential care has both inherent and practical disadvantages. ... A children's home is an undesirably artificial environment for a child to grow up in ... it does not and cannot provide the family experience which all children need, and which those in care are likely to benefit from in particular. In practical terms, it may be both too protective and too exposed. Children growing up in residential care may never have been shopping or travelled on public transport or controlled their own pocket money by the time they come to prepare for an independent life."[110]

104. The Committee added that "the long-term emotional and developmental effects of growing up in residential care are perhaps even more serious. The absence of parent figures, the shifting population of many homes and the likelihood of children themselves spending periods in different homes has led to many children who have spent years in residential care having difficulty in forming relationships either with contemporaries or adults".[111]

105. The shift in placements towards foster care over recent decades has been largely prompted by such concerns. It has been argued that fostering offers a more 'normal' and caring family environment. The comparative cheapness of fostering has also undoubtedly been an incentive. As long ago as 1952 the Select Committee on Estimates noted "the striking and most unusual fact that what is generally agreed to be the best method of providing for children in the care of local authorities [i.e. 'boarding out' or fostering] is also the cheapest".[112] As we have seen, there is a dramatic difference between the average cost to the public purse of keeping a child in residential care, at over £57,000 a year, and that of providing for a child in foster care, at over £8,000 a year. (It is worth noting, however, that the differential in costs has probably been exaggerated by the trend towards fostering, in that children now in residential care include a higher proportion of those with severe behavioural problems than was the case 20 years ago[113]—whilst the figure given for the costs of foster care is almost certainly an underestimate, because it does not include the associated costs of recruitment and support of foster carers.)

106. It is generally accepted that a continuum of types of care for looked-after children is desirable. At one end of the spectrum are adoption and "residence orders" (which strengthen the legal relationship between carer and child but fall short of full adoption). In the middle of the spectrum are various forms of fostering. At the other end of the spectrum is residential care.[114] Each of these types of care may be best suited to the circumstances and needs of a particular child. The consensus in recent years has been that the needs of most children are most likely to be met by one of the fostering options in the middle of the spectrum than by either adoption or residential care. Most children in foster care eventually return to their own families, and almost half of all children looked after return home within three months.[115]

107. Foster carers do a wide range of jobs, including short-term care of younger children, the care of adolescents for specified work over a fixed period, remand fostering, and the care of teenage mothers and their babies. They often work closely with the families of the children and young people they foster. The vast majority of foster carers are volunteers who do not receive a salary but do receive some reimbursement for the expenses they incur.[116]

108. A review of recent research by the National Children's Bureau points out that although about half of all children being looked after are placed first in foster care, this is very much age-related and foster placements for adolescents are often scarce. The NCB comment that surprisingly few children have been fostered with their own relatives, despite the fact that research has, they claim, shown this to be a successful method.[117] (About 12% of foster carers are relatives or friends of the child, although practice varies considerably between local authorities: an NFCA study found that one authority reported have no carers who were friends or relatives of the child, whilst four others listed more than 30% of carers coming into this category.[118])

109. Foster care is regulated by the Foster Placement (Children) Regulations 1991, made under the Children Act. The Act provides that a carer may not foster more than three children at a time (except when all the children concerned are siblings, and in certain other exceptional circumstances).[119] The Regulations provide for approval of foster carers and annual reviews of that approval, and specify the circumstances in which placements are made, how they should be supervised and how often they should be reviewed. The Regulations support good practice by insisting on a foster placement agreement for each placement, setting out the objective of the placement, information about the child, and the agreed arrangements for health care and contact.[120]

110. Although the great majority of looked-after children who are fostered are placed directly with foster carers by the local authority, this duty can be delegated by the authority to an independent fostering agency. The number of such agencies has recently grown and now stands at about 40. There is currently no requirement that the agencies are registered or inspected, although the general requirement that foster carers be approved before a child can be placed with them remains. A 1995 SSI study of a small sample of independent agencies found examples of both very good and very bad practice. The concerns were that young children were placed at some distance from their home area; lack of separation of social work and financial management led to commercial pressures for the retention of children in placements; it was difficult to get adequate information about quality assurance issues; and placements were costly by comparison with local authorities' own provision. The DoH comments that given the significantly higher costs attached to these placements, it is in general only the most troubled children who are placed through independent agencies.[121]

111. Despite the value of the work they do, and the fact that a majority of children in care are looked after by them, foster carers have traditionally been neglected by Government, local authorities and academic researchers. Professor David Berridge of the University of Luton told us that "in the reviews of research I have done, we found very little work and interest in foster care, and indeed the Department of Health did not inspect foster care services for about a decade", and he warned about the dangers of being "mesmerised by residential care".[122] Two recent SSI Inspections of Local Authority Fostering Services found that 50% of foster carers surveyed said they did not always feel they were well supported, 30% recorded having problems with their local authority, and 65% felt social workers did not listen to their views.[123]

112. Recruiting foster carers and keeping them is increasingly difficult. Demographic changes have resulted in a reduction in the number of women (traditionally the main carers) available for this work, and the task itself is an increasingly challenging one, as older and more problematic children are placed with families, and as foster carers are required to have a wider range of skills and knowledge.[124] Lack of status and recognition for foster carers' efforts may be dissuading potential carers from coming forward. The increased prominence being given to allegations of abuse on the part of foster carers, and the allegedly insensitive way in which some such allegations are handled, may also play a part in discouraging people.[125]

113. Being a foster carer can also involve making a significant financial sacrifice. Research published in 1997 concludes that to meet the direct costs alone of caring for foster children, allowances for four, 10 and 16 year olds need to be raised by 71%, 56% and 19% respectively. In a comparison with the other EU countries plus the United States, Australia and Norway, the UK came 10^th out of 15 in the generosity of fostering allowances.[126] Most local authorities pay carers below the NFCA recommended rates required for clothing and feeding children and catering for their basic needs. Commenting on these findings, Professor Berridge stated "it is no wonder that there are supply problems".[127]

114. The Birmingham Foster Care Association told us that some potential carers cannot afford to offer their services to local authorities; they cited single carers on Job-Seekers' Allowance and carers whose partners earned low wages. The BFCA commented that "outside agencies offer far more realistic financial arrangements: e.g., Midland Area [a private agency] pay £301 per child in placement while the most Birmingham SSD pay for a pre-teenage child is approximately £54 fee and £68 maintenance". They attributed this to a "chronic lack of funds in the care services" rather than to any failure on the part of the SSD to recognise the problem. They alleged that carers were switching to the private agencies, that as a result the SSD was regularly making placements with those agencies because of a lack of specialised carers on their own books, and therefore "funds needed to improve the level of payments, training and support to SSD carers are haemorrhaging out of the department". The BFCA also claimed that shortage of carers meant that existing carers were being asked to cope with too many children too often, and as a result "the children are failed and the carers who are doing their best are put under intolerable strains".[128]

115. During our visits to Wigan, Birmingham, Shropshire and within London we met individual foster carers. They told us of problems affecting the recruitment of carers. These included: (1) the offering of much higher reimbursement by independent fostering agencies; (2) no retainers being paid to foster carers who are on standby to receive emergency cases; and (3) special payments being made to foster carers for dealing with children with particular problems, which cease when the problem is solved, thus creating no incentive for the carer to solve the problem.

116. Other witnesses pointed out that carers are tempted to 'defect' to independent fostering agencies not just because they offer higher fees but because they offer, or are believed to offer, a higher quality of support for carers.[129] Ms Carmen Peets, a foster carer from east London, told us that "a lot of my friends who have been fostering for 15, 20 years have opted out from the local authority and gone into private fostering [i.e. independent fostering agencies] ... they tell me there is more money in it, there is more support, ... they feel safe within that environment".[130]

117. Another foster carer, Ms Debra Gibbs from Surrey, said that the best method of recruitment was by word of mouth, as friends of foster carers learnt from them that fostering could be a fulfilling activity. However, Ms Gibbs added that lack of support for carers inhibited this kind of recruitment:

"if you have carers who do not feel well-supported and well-rewarded and well-trained and all the rest of it, none of those will recommend fostering. I know this is true because a lot of my friends have said they would not recommend fostering to their friends. I would not ask them to do it. I do not know why I am doing it. ... I would never recommend my friends to do it."[131]

118. Although it is difficult to quantify the extent of the difficulties local authorities are facing in recruiting foster carers, there is no doubt that these difficulties are real. Several of our witnesses spoke of a "crisis in foster care". The SSI inspection of fostering services in 1994-95 found that 80% of authorities reported having insufficient placements to meet their needs, and the 1995-96 inspection found that for 75% of children there was no choice of placement.[132] The ADSS noted that "across the country local authorities find it more difficult to recruit and sustain sufficient numbers of suitable foster carers".[133] They also commented on lack of choice in placement, particularly for black and mixed-race children, children with disabilities and special needs, siblings and adolescents; and on the fact that almost half of the authorities they surveyed had no positive recruitment policies aimed at groups under-represented among carers, such as older people, single people, and gay men and lesbians.[134]

119. BASW stated that social workers "typically now have to place a child in whatever foster home happens to be available, with little scope for selecting the placement most likely to meet the child's needs; it is not, therefore, surprising that there is growing concern about the incidence of placement breakdowns in foster care".[135] Professor Berridge said that this view was substantiated by academic studies:

"research has shown that when children require foster placements the choice is usually extremely limited—frequently there is only one family in the locality with a vacancy and there is no alternative option for the child other than to go there. With the exception of taking into account ethnic background, 'matching' is often largely non-existent."[136]

120. BAAF claimed that the increasing use of independent fostering agencies had led to placements that were undesirably distant from children's own homes, reducing the likelihood of effective rehabilitation.[137] A small-scale study by the SSI in 1995 confirmed that this was a problem.[138]

121. The only witness to challenge the general consensus that there is a developing crisis of foster care was the former Parliamentary Under-Secretary, Mr Burns, giving evidence to our predecessors before the General Election. Mr Burns said that "we do not have evidence to suggest ... that there is a special problem in getting foster parents to come forward to look after children; ... there are certainly problems that we hear about with regard to adoption, but in fostering there is not, that we are aware of, a significant problem in attracting people".[139]

122. Mr Burns's was, however, very much a lone voice amongst our witnesses. His successor as Parliamentary Under-Secretary under the new Administration, Mr Boateng, said that

"My view is different from that of Simon Burns. There are undoubtedly shortages of carers for particular groups of children and shortages that make the appropriate choice that we ought to have in place for the children that much more difficult. That is the reality. The evidence you have received in my view respectfully represents the truth."[140]

123. Criticism of the state of local authority fostering services receives support from a national assessment of such services carried out by the SSI in 1995-96. This identified some impressive work, but also highlighted significant concerns in areas where minimum statutory requirements were not being met. In particular, the study found that a significant proportion of children had not been assessed comprehensively and did not have individual care plans; standards of recording were poor and there was little information about children's health histories; and the range of placements was often insufficient to meet children's needs.[141]

124. Our witnesses called for a variety of measures to improve the quantity and quality of foster care. BASW urged that

"It is important that fostering schemes in which carers receive fees or a salary are further developed. The task is increasingly a professional one; foster carers are or should be treated as colleagues by social workers. ... The number of carers able and willing to provide such a service on an 'expenses only' basis (i.e. a fostering allowance) is likely to continue to decline."[142]

The NFCA urged that foster carers be paid fees "to recognise their skills, labour and time commitment, in addition to an allowance to cover the full costs of looking after a child".[143] Mrs Moira Gibb, Director of Social Services at Kensington and Chelsea, called for a salaried foster service as a means of recruiting beyond the present "limited pool" of volunteers.[144] Mr Richard Evans, Director of Social Services at Birmingham, suggested that a national pay structure for carers might be needed to enable local authorities to compete with the "hugely inflated rates" paid by private agencies.[145] Professor Berridge said that "there is a general consensus that foster care should become more professional in the future and those involved better trained. It seems inevitable that fees paid to carers should be increased significantly, although this could have considerable financial implications for local authorities."[146]

125. The ADSS called for local authorities to improve levels of support for foster carers to match those offered by independent agencies. They commented that "if local authorities worked more collaboratively with foster carers in meeting their needs, this would in the longer term enable them to recruit and retain carers far more effectively".[147] The NFCA argued that foster carers should be "accorded full status as professional colleagues, with clear terms, conditions and tasks", that training should be compulsory for foster cares, and that social workers and foster carers should be required to train together as often as possible. They also called for the foster care service to be fully integrated within Children's Service Plans, and stated that preparation of a detailed care plan should be an absolute priority for every fostered child.[148]

126. The foster carers whom we met expressed support for an increase in opportunities for training. Approval was expressed for the NFCA's six-week training package for new foster carers, called Challenge: Foster Care.[149] The practical difficulties which carers could face in attending training courses were stressed, as was the need for SSDs to seek feedback from carers as to the kinds of training they would find useful.[150] The NFCA argued that training should be ongoing rather than just provided at the start of carers' careers.[151] BAAF claimed that although the importance of foster carer training is recognised in official guidance, "provision is sometimes minimal". They told us of an innovative training programme they have organised jointly with Wakefield SSD. The programme, which links training to the new NVQ for foster carers, consisted of training courses run in community education centres on different days of the week and at weekends. The aim was to offer maximum accessibility and to encourage male carers ("traditionally a reluctant group") to participate. BAAF told us they were now seeking to promote awareness of the NVQ for foster carers on a national basis.[152]

127. In their joint submission, the ACC and AMA called for stricter regulation of independent fostering agencies. They argued that such agencies should be legally defined, and that they should be registered and subject to regular inspection, as recommended in the recent Burgner Report on the regulation of social services.[153] They also recommended that private foster parents be registered, as children were currently less well protected while living with private foster carers than in day care with childminders, and SSDs were frequently not informed about families and organisations arranging private childcare agreements. ACC/AMA commented that the placement of foreign students gave cause for particular concern.[154] The NFCA urged that all agencies which provide foster care services should be subject to a mandatory, comprehensive system of regulation and inspection.[155]

128. In his report, People Like Us, Sir William Utting considered measures to reduce the risks of sexual and physical abuse of children in foster care. He concluded that the nature of foster care meant that children were isolated and vulnerable, and therefore at risk. They had fewer people to turn than their counterparts in residential care. There appeared to be more risk attached to long-term foster care. There were also risks from the children in the foster family (although this worked both ways as in some cases foster children were themselves perpetrators of abuse). Sir William made a number of recommendations, including that arrangements for the checking and assessment of foster carers should be strengthened, and a Code of Practice promulgated; that policies on family placements should be reviewed to take account of the dangers of peer abuse; and that social workers should be required to see the child alone during their inspection visits.[156]

129. Sir William also considered the question of abuse in private foster care. He observed that such children are "extremely vulnerable and at very considerable risk of abuse". He called for it to be made mandatory for private foster carers to seek approval and registration, and for the law to be changed to make caring for children without registration a criminal offence.[157]

130. Commenting on the evidence we received in respect of foster care, the Parliamentary Under-Secretary, Mr Boateng, acknowledged the difficulties faced by carers and local authorities. He argued that they could best be tackled through local initiatives, with encouragement from central government. He expressed some scepticism about the view that the way forward was to turn fostering into a profession, pointing out that fostering was as much a vocation as it was a career.[158] He said that the question of benefit and pension entitlements of volunteer carers was currently the subject of a wide-ranging review being conducted within the Department of Social Security.[159]

131. A further initiative to which the Government has contributed was announced in autumn 1997. A UK Joint Working Party on Foster Care has been set up. This "will identify examples of best practice and produce published standards of care by March 1999, which every foster care agency will be expected to meet".[160]

108 See Table 1 above. Back

109 Ibid. Back

110 HC (83-84) 360-I, para 203. Back

111 Ibid., para 204. Back

112 Report on Children in Care, HC (1951-52) 235. Back

113 See para 40 above. Back

114 Q265. Back

115 Ev p 352. Back

116 CLA 49, Annex B, p 1. See National Children's Bureau, Highlight: No.142 (not printed). Back

117 CLA 40, Annex A, p 1. See National Children's Bureau, Highlight: No. 141 (not printed). Back

118 Ev p 352. Back

119 Children Act 1989, Schedule 7. Back