Select Committee on Health First Special Report

Children Looked After by Local Authorities

SESSION 1997-98
Health Committee Recommendations: Progress - Children Looked After by Local Authorities

Second Report: Children Looked After by Local Authorities (HC 319) Published: 16/07/98
Government Reply: Cm 4175 Published: 12/98


Government Action

1. We were very disturbed to learn that the DoH has over a number of years simply disregarded the statutory requirement that it submit an annual report to Parliament on the working of the Children Act. It should not have been necessary for us to remind the DoH of its duty to obey the law. (paragraph 30)

The Department of Health published the Children Act Report in January 2000. A supplementary report was also published in July 2000. We (the Government) are committed to publishing annual reports in the future.

2. It seems to us that the average costs to the public purse of caring for looked after children are a matter of legitimate public interest. We recommend that this information be re-instated in future editions of the Annual Report. (paragraph 41)

The Children Act Report (January 2000) includes figures on the average costs of children looked after. This data will continue to be included in future annual reports.

5. We consider that children looked after by local authorities are victims of "social exclusion", as defined by the government, to a very high degree, and that they suffer from just the kind of failures of co-ordination of policies and communication between agencies which the Social Exclusion Unit was set up to tackle. We therefore recommend that issues relating to children looked after should be investigated by the Social Exclusion Unit as a priority in its second phase beginning in summer 1998. (paragraph 57)

Looked after children have figured strongly in the work of the social exclusion unit so far, particularly in the work on teenage pregnancy and on 16-18s not in education, employment or training. The Unit has made recommendations wherever necessary.
The Quality Protects Programme is a key part of the Government's wider strategy for tackling social exclusion. It focuses on working with some of the most disadvantaged and vulnerable children in our society: those children looked after by local authorities; in the child protection system and other children in need. It is the main vehicle for delivering the aims in Modernising Social Services of effective protection, better quality care and improved life chances for children and it involves agencies across Government in collaboration work.

9. The non-implementation of the preventative provisions in the Children Act provides an object lesson in how a rational and humane policy may be undermined by failure to provide adequate funding. We recommend that the Government should take the necessary steps to establish the extent of failure to provide a desirable level of family support services across the country, and to establish what funding is required to provide services to that level. This survey should identify the extent to which current standard spending assessments fall short of this. In order to enable local authorities to move from what, in some cases, may be minimal services through to an acceptable level of provision, we recommend that specific ring fenced grants should where necessary be made. (paragraph 68)

The Social Exclusion Unit's Policy Action Team (PAT 12) report on young people at risk argued for clearer Government structures for leading and delivering the Government's approach to the social inclusion of young people. In response, the Government established a new Cabinet Committee on Children and Young People's Services. The Government has also established a cross-cutting review of young people at risk and a newly created Prevention Grant of £380m over 3 years which, coupled with the new Local Network (£70m over 3 years), comprises the £450m Children's Fund. The Fund is to be administered by the new Children and Young People's Unit, based in DfEE, which will report to the Cabinet Committee. While the precise distribution mechanisms have yet to be determined, the Children's Fund will be used to intervene earlier and more effectively in response to early triggers of difficulties among children. While the Fund is targeted at 5-13 year olds (with Sure Start dealing with under 5's and Connexions providing a universal service to 13-19 year olds) it will work to the benefit of all children and young people.
In addition, improving life chances for children in need is one of the Department of Health's children's services objectives and this forms a key element of the Quality Protects Programme .

12. We support the NFCA's proposal that local authorities should be required as a matter of course to involve foster carers along with social workers in training in the use of LAC records; funding to enable authorities to do this should be available. We recommend that the DoH centrally should monitor the use of LAC records and their contribution to good outcomes. We recommend that use either of LAC records or of a similar active planning system should be mandatory for local authorities. (paragraph 78)

The Department of Health is currently funding a 3-year TSP sub-programme of £2 million per annum to provide training for foster carers. The money is available for induction training, training in child development and the Looking After Children system.
The Department of Health has also funded the research team at the University of Loughborough to audit the implementation of Looking After Children in each of the implementation cohorts. In addition a longitudinal audit has been undertaken with a sample of authorities that implemented in the first year to see if implementation improves overtime. The audit findings have shown that there has been a steady increase overall in the use of the forms. The forms are currently being used by 98% of authorities. Work is currently in progress to link the Looking After Children system with the new Assessment Framework into a single integrated children's system for assessing and recording work with children in need and their families.
This will enable social services departments to assess, plan and monitor outcomes for individual children. In addition, it will facilitate aggregation of the data for management planning purposes, contributing to the provision of resources which are appropriate to the identified needs of children.

13. We counsel against any automatic assumptions that foster care is preferable to residential care, although in many cases this may be so. A variety of options should be available to SSDs so that placements can be suited to the needs of the individual child. (paragraph 85)
14. One problem, which appears to be very widespread is that of instability in children's lives, caused by the sheer number of separate placements an individual may experience. (paragraph 86)
18. The problem of over frequent moves between placements must be tackled. Nothing contributes more to low self-esteem and under-achievement on the part of children than the sense that they are un-cared-for parcels to be passed from one social worker or foster carer to be passed from one social worker or foster carer to another. (paragraph 99)

As was said in the response, the Government agrees about the importance of placement stability and is taking action to ensure that local authorities improve both the number and quality of placement options. At March 31 2000, the percentage of children looked after with three or more placements during the year was 14%. This is below the Performance Assessment Framework target of 16% and an improvement of 2% on the previous year. The figures for March 2000 continue a downward trend that began in 1995-96.
The Department of Health is closely monitoring progress towards meeting the placement stability target. The Management Action Plans for Year 2 of Quality Protects, i.e. 2000/01, showed no significant change in the average position over the previous year, but local authorities expected the proportion of children with three or more placements a year to have dropped this year, and to continue to fall. Almost three quarters of councils predicted that they will meet the national target of 16% by 31 March 2000; and all but two predicted that they will have reached it by 2002. The Department is looking at progress again as part of the Autumn performance assessment monitoring round.
The Management Action Plans for 2000/01 also provide considerable information about what local authorities have been doing to improve placement choice. Detailed information is contained in the overview of the evaluation of the QP Management Action Plans. About £30 m of last year's £75 m QP grant was spent on improving placement choice, and over £40 m of this year's grant of £120m is due to be spent in this area.
As part of the Quality Protects programme, a placement choice project group has been set up, to help local authorities achieve the placement stability target. The group considers that there is generally much research and good practice material available to help local authorities with planning, commissioning and providing placements, and that its main task is to promulgate and disseminate all the information available. It is currently working on guidance booklets for authorities, to help them assess their need for different types of placements, and then to help them with commissioning and providing those placements. It is also considering what more should be done to promote family and friends as foster carers.
The Government response in December 1998 mentioned a national foster care recruitment campaign. This was launched in July 2000, and the advertising phase began in September. This campaign is funded through £2 m of Government money. This is the first ever national recruitment campaign and we will be evaluating its effectiveness.

15. We welcome the evidence showing that, overall, there have been improvements in planning, assessment and review for children looked after in recent years. However, there remain grounds for real concern. We are particularly worried by the SSI findings that a significant proportion of children still are not being assessed comprehensively and do not have individual care plans, despite local authorities' statutory responsibilities in this regard.
We believe that this is an area where the DoH centrally has a positive duty not only to monitor but, where necessary, to intervene, to ensure that local authorities are not in breach of the law by neglecting their responsibilities. We look forward to receiving the DoH's proposals as to the action it intends to take with regard to such authorities. (paragraph 96)
16. We support the recommendations made by Dr. Sinclair and the NCB research team as to ways of improving the current process of assessment and review (these are briefly summarised in paragraph 81 above, and set out in full in an Annex to this report). Sensitive, objective assessment of a child's needs and wishes is essential. Wrong decisions at this initial stage may have particularly serious consequences. (paragraph 97)
19. The conduct of reviews ought to be re-examined in the light of the strong dissatisfaction with them expressed by young people, both those whom we met during our inquiry and those whom the NCB research team interviewed. Reviews should be seen as part of a process rather than as one off events imposed by bureaucracy¼.We recommend that the DoH should consult with the local authorities and the NCB, as well as with other well-informed bodies such as the Who Cares? Trust, and should then issue guidance to local authorities on the conduct of reviews. A sustained effort is needed by local authorities to improve monitoring of the quality and regularity of the decision making process in reviews, which should then be reported to the DoH and subject to inspection by the SSI. (paragraph 100)

The Government has now issued a new framework for the assessment of children in need and their families. This intention was first signalled in December 1998. It was issued in draft and the final version was produced following extensive consultation. Further work is underway to ensure full implementation of the framework by 31 March 2001. Progress on implementation is being monitored thought the Quality Protects Programme.
Improving assessment and care management is a priority area for expenditure of the Quality Protects special grant and is a central theme of the Quality Protects programme. Work is underway to develop an integrated system for assessment, planning and review across children's services. The specification for the integrated children's systems will be developed by 31 March 2002.

17. It is important that specialist mental health services are not only provided during the course of children's placements but that, where appropriate, there should be psychiatric or psychological input at the crucial initial stage of assessment. (paragraph 98)
72. We believe that the current arrangements for providing psychiatric and other specialist services to children in care are grossly inadequate. It is a disgrace that children should have to wait as long as two years before even being assessed for treatment. We recommend that the DoH should investigate how more effective links can be created between SSDs and local health services, to ensure that the former can speedily access expert medical attention, including psychiatric care and guidance on sexual health, for the children in their care. (paragraph 269)

By April 2001 all children who start to be looked after will have been assessed within the new framework for the Assessment of Children in Needs and their Families. This will include an assessment of the child's health needs including mental well being, which will inform the placement and ensure appropriate services can be provided as quickly as possible where necessary.
The Government has recently consulted on new guidance on the health of looked after children. When published this will include advice on assessing and meeting their health needs including mental & physical health and health promotion. It is clear that looked after children have a higher risk of mental health problems than their peers. Local Child and Adolescent Mental Health Service (CAMHS) Development Strategies (which are drawn up jointly by health and social services) should take full account of this in planning services. No child or young person should have to wait for long periods for treatment or for assessment, and local CAMHS strategies should seek to ensure that all children and young people, whether they are looked after or not, have timely access to appropriate services. The National Priority Guidance for Health & Social Services has a CAMHS objective which states that service users should be able to expect:

*a comprehensive assessment and, where indicated, a plan for treatment without a prolonged wait;
*a range of advice, consultation and care within primary care and local authority settings;
*a range of treatments within specialist settings based on the best evidence of effectiveness, and
*in-patient care in a specialist setting, appropriate to their age and clinical need.

23. We believe it right that all foster carers should be adequately reimbursed for actual expenses incurred¼.The Government should require local authorities to reimburse carers at a realistic rate for actual expenses incurred. (paragraph 134)
24. We do not accept the Parliamentary Under-Secretary's argument that fostering would be in danger of ceasing to be a vocation if there were to be an element of reward in payments to foster carers. We believe that there should be a stepped scale of payments to carers, with the level of payment being linked to the level of their skills and experience in dealing with difficult or demanding children. We also believe that in cases where lack of appropriate accommodation or means of transport prevents suitable individuals from becoming foster carers, special payments or other appropriate assistance should be available. We recommend that the Government, in consultation with local government, the NFCA and other interested bodies, should as a matter of urgency draw up proposals for establishing a national framework of payments along these lines. (paragraph 135)
29. We recommend that the Government should ensure that local authorities are properly resourced to make these investments. It is essential that there should be sufficient capacity in the system for children to be offered an appropriate choice of placements. It is clear from the evidence we have taken that this capacity does not currently exist; remedying this situation will undoubtedly require the injection of additional resources. Each local authority needs to have surplus capacity at all times in order for real choice to be exercised; this may require more stand-by payments to be made to foster carers. (paragraph 139)

The Government does not believe that national levels of fostering allowance are appropriate. The level of allowance paid by councils to foster carers is generally determined by the age and personal circumstances of the child(ren). This reflects an assumption that older children, and those with disabilities or special needs, cost more to look after than other children. There are many contributing factors, which might affect the rates of allowance payable. For instance, the number of looked after children the local council is caring for, the available pool of foster carers and whether special skills are needed by the foster carer to look after a particular child. It is therefore right that each local council determines and pays its own rate of allowance, taking into account the circumstances that exist locally. Many councils are introducing innovative schemes to pay high allowances to those caring for the most demanding children.
The Quality Protects programme is ensuring that children's services are now properly resourced - £375m is being pumped into children's services over the three years of the programme, and the Government's plans to extend Quality Protects into years 4 and 5 (i.e. 2002/03 & 2003/04) have recently been announced. It has also launched the £2m National Foster Carer Recruitment Campaign. If this campaign is successful, there should be a situation where local councils have a much wider choice of placements for the children in their care.

26. All foster agencies should be subject to a mandatory requirement that they be approved, registered and inspected. The Government should bring forward legislation as soon as possible to achieve this. (paragraph 136)

The Government recognises that the independent sector has a role to play in the provision of foster care services. With the passing of the Care Standards Act 2000, independent fostering agencies will be brought into the regulatory framework and will be subject to regular inspection by the National Care Standards Commission. Commercial operators may also enter the market and register with the NCSC on the same terms as not-for-profit ones.

27. The relevant legislation should be amended to protect young people who are placed in short-term accommodation with another family by a third party through the registration and inspection of language schools and host families, and to prohibit language students from being accommodated in the home of a person convicted of an offence against children. (paragraph 137)
34. Local authorities lack of information about children who are being privately fostered is a matter of great concern. Lack of information entails lack of protection. We strongly support Sir William Utting and those other of our witnesses who called for registration and inspection of private foster carers to be made mandatory, and for failure to register to be made a criminal offence. (paragraph 144)

The Government believes that the existing legislative framework is sufficient, if properly enforced. The primary responsibility for ensuring the welfare of young people who come to this country to learn English must rest with the parents who send them. At the same time, however, it wants to safeguard these children and promote high standards. It is therefore working with a range of agencies to introduce a national code of practice for foreign language schools. The Government hopes to encourage parents only to use those schools that had been so accredited. It is also looking to tighten up the private fostering regulations by ensuring that the current regulatory framework is properly enforced.

. We believe that local authorities should invest more resources in the training of foster carers, in link and support workers to liaise with carers, and in practicalities like help with transport and insurance. We recommend that the government should investigate the possibility of setting up a pension scheme for foster carers. We recommend that local authorities should be required to ensure that foster carers receive appropriate training, and to make training opportunities available throughout foster carers' careers, not just when they first become carers. (paragraph 138)

The Government readily accepts the points about training opportunities for foster carers and the strengthening of selection procedures. It has introduced, for the first time, National Standards for Foster Care and a Code of Practice on the recruitment, assessment, approval, training, management and support of foster carers. Foster care can be a very challenging and demanding task and it is clear that too many foster carers give up because of a lack of support. The Government recognises that there must be an investment in ensuring that foster carers receive all the training and support they need in order to develop and gain the appropriate skills and significant, ongoing improvements are being made in this area. We will be enforcing appropriate levels of training through the new regulatory arrangements to be introduced through the National Care Standards Commission.

33. We support the recommendations made by Sir William Utting in regard to the prevention of abuse in foster care: in particular, his call for selection procedures for foster carers to be promulgated. (paragraph 143)

Agreed. The Department of Health funded the development of a Code of Practice on the recruitment, assessment, approval, training, management and support of foster carers. This was published in June 1999 by the National Foster Care Association on behalf of the UK Joint Working Party on Foster Care. All councils were asked to audit their fostering services against this Code, and its standards will be enforced in due course through the National Care Standards Commission.

35. The Government, in addition to accepting the specific proposals we have set out above, should develop and publish a coherent and costed national strategy for the future development of foster care. (paragraph 145)

The initiatives listed in the Government response have all continued and some have been completed. When the Department of Health published the Code of Practice and National Standards for foster care, all authorities were asked to audit their fostering services against those standards. Progress with this auditing is being monitored through this year's autumn performance assessment round. Depending upon the results of that assessment, the Government will take decisions about next steps. The foster care recruitment campaign was launched in July 2000, and is due to run until the end of November. Other strands of work are also being taken forward in relation to developing foster care. For example, the Department of Health is currently working on national minimum standards for foster care for use by the new National Care Standards Commission, when it is introduced in April 2002 (following the Care Standards Act 2000). The new initiative on adoption has implications for fostering services, and a White Paper is planned for later this year.
Foster care remains, and will continue to remain, the main placement for children looked after by local authorities. As part of the Quality Protects programme, to improve services and outcomes for looked after children, we will continue to develop a coherent policy to ensure that we have good quality fostering services.

38. It is not realistic to suppose that the trend towards foster care can be continued to the point at which residential care becomes unnecessary. (paragraph 169)
39. The reduction in residential home capacity has gone too far. There is a clear need for an increase in the number of children's homes countrywide, to enable local authorities to make appropriate placements, to reduce problems arising within homes from an inappropriate 'mix' of children, and to relieve pressure on the fostering service. In order for the desirable choice of placements to be available, it will be necessary to plan on the assumption that each home will normally contain some spare capacity. We support Sir William Utting's recommendation that the DoH should "establish and resource a dedicated group to develop and implement a national strategy for residential childcare", which should "extend to the volume and nature of service needed , with plans for securing provision to the standards required". (paragraph 170)

The work of the QP placement choice group (see above) intends to include advice to local authorities about how to assess likely demand for residential care placements and about how to set about commissioning and providing good quality appropriate placements. In assessing the QP Management Action Plans for 2000/01, the evaluators considered how far they set out appropriate plans for residential care provision. The overview of the evaluations found a mixed response, but most authorities were developing systems to ensure high quality residential care was provided, whether in-house or by external contractors. More work will be needed on this, in the context of Year 3 Management Action Plans.

40. We were disquieted to hear about the increasing trend towards placement outside the home authority. We share the concern expressed by the Minister and by the Chief Inspector of Social Services about this development. We recommend that the Government should take steps, through the Social Services Inspectorate, to establish the extent of the problem; it is unsatisfactory that the DoH does not collect statistics on this. The Government should issue instructions to local authorities that such placements should only be made when they are in the clear interests of the child's welfare. The Government must ensure that sufficient resources are available to enable local authorities to make appropriate placements within or very close to their own area, other than cases where children have exceptional needs (such as severe disability or behavioural difficulties) and specialist facilities are required, Local authorities should be required by regulations, when a child is placed out of their area, to communicate effectively with the authority in which he or she resides prior to placement or during placement, and to agree arrangements for the effective monitoring of his or her progress. The SSI should issue guidance on how this monitoring and communication should be carried out. (paragraph 171)
41. We recognise that in many cases cross-authority arrangements may be desirable. However, we are sceptical about the extent to which the current shortfall in residential capacity can be addressed by local authorities acting in consortia. (paragraph 172)
42. Local authorities should be resourced to provide or have access to all necessary non-specialist residential and foster care facilities within or very close to their own areas. (paragraph 172)

The Government recognises this problem which is being tackled through a Placement Choice project team as part of the Quality Protects programme. The Department of Health also collects data on the proportion of foster care placements inside and outside the home authority. This proportion rose from 16.4% at 31 March 1995 to 19.1% at 31 March 1999, although a large part of the rise is known to be the result of boundary changes following local government reorganisation over this period. The Department has introduced changes to its statistical collections to collect equivalent data for children placed in children's homes - the first figures will be available in October 2001.
The Government recognises the need to improve placement choice and reduce the number of children being placed outside their home authority. Increasing the number of foster carers is central to widening the choice of placements. The £2m National Foster Care Recruitment Campaign was launched in July 2000. Additionally, through its work on promoting the education of looked after children, the Government is currently looking at how to overcome the problems of out of authority placement.

43. We recommend that the Government make a public commitment to introducing legislation in the next session of Parliament (to) require small private children's homes to be registered and subject to supervision and inspection in exactly the same way as larger homes. (paragraph 174)

Section 40 of the Care Standards Act 2000 extends the existing regulatory framework under the Children Act 1989 to small private children's homes. The Department of Health wrote to all local authorities on 11 September 2000 informing them that they will be required to register small private children's homes from January 2001 and also that, in the future, they will not be able to place children in unregistered homes. Between January 2001 and July 2001, Registration & Inspection Units will be required to inspect and register small private children's homes in accordance with the Children Act 1989 and the Children's Homes Regulations 1991. The process of regulation and inspection will then pass to the new National Care Standards Commission when this is fully operational. The Department of Health has now issued LAC (2000)21, which sets out detailed implementation arrangements for this.

44. Fundamental problems persist with the training and career structure of residential social workers. ... As long as these problems remain unaddressed, residential care will continue to be a "Cinderella service". (paragraphs 192, 193)
45. There is scope for reconsideration of the task of residential social workers, as well as for a reform of the training opportunities open to them. (paragraph 194)
46. We believe that there should be a re-balancing of responsibilities. This should include a clearer definition of the roles and tasks of qualified residential social workers, and flexible allocation of roles and tasks between them and field workers in each case at the placement planning stage (paragraph 194)
47. It would be over-ambitious and unnecessary to train all residential social workers to the level of Diploma in Social Work. We consider that Sir William Utting's recommendations in his 1991 report are sound, that all heads of home and about a third of other staff should obtain this qualification, whilst other staff should follow a vocational training and qualification route. (paragraph 195)
48. We support the concept of a continuum of training¼. We also support the proposal that a three-year DipSW course should be introduced. (paragraph 195)
49. There needs to be continuing provision of funding to allow for the 1991 recommendations to be implemented. This will entail the revival of the Residential Child Care Training Initiative, or something similar to it on a permanent basis. Reform of training for residential social workers should be regarded as a priority by the new General Social Care Council. (paragraph 195)
50. We urge the Government to report back to us with proposals for a reconstruction of the tasks of residential and field social workers along the lines we have set out in paragraph 194 above, and for a fully funded expansion of training opportunities within that context. (paragraph 196)

The National Training Organisation for Social Care (TOPSS) has recently finalised their National Training Strategy for England "Modernising the Social Care Workforce". This strategy analyses the skill needs of people working in the social care sector throughout England (including those in residential child care) and proposes an action plan to improve both the qualification base and the quality of training over the coming five years. It also proposes a national qualifications framework matched to competences and job roles, which is underpinned by a comprehensive map of National Occupational Standards, plus career pathways promoting lifelong learning through flexible training opportunities and Accreditation of Prior Experience and Learning. The Department of Health is supporting the Training Strategy and the associated work that TOPSS is undertaking. The Training Support Programme for 2000/2001 is also linked to the training priorities highlighted in the Training Strategy.
A Post Qualifying Child Care Award was developed in 1999 and approximately 340 social workers started pilot courses for this new award in January 2000. Funds to support the candidates undertaking this award are available through the Training Support Programme for the 3 years 1999/2000 - 2001/2002. It is expected that further funding will be available after this period. A target has been set for 7000 social workers to be trained in the award by 2006, and an additional target states that 700 of these workers should be working in residential child care.
In 1998 a new National Vocational Qualification (NVQ) was released at Level 3 called Caring for Children and Young People. This NVQ has a particular focus for candidates who work in residential, day and domiciliary care settings. Later during 1998 a target was set for all staff in residential children's homes (other than social workers) to be trained in this NVQ Level 3 by March 2002. This target was linked to the acquisition of funds totalling £8.5 million from the 1998 Comprehensive Spending Review for a sub-programme within the Training Support Programme (TSP) for the period April 1999 to March 2002 specifically for training residential child care staff to NVQ Level 3.
At the present time, there is no intention to revive the Residential Child Care Training Initiative in the TSP. However, local authorities presently have the ability to use their TSP Main Programme to fund DipSW training for residential child care workers if they so wish. The question of the training required for residential social workers will be considered during the review of the DipSW.

51. Failures of communication within the care system, particularly between junior staff and managers, may have contributed to persistent undetected abuse in some residential units, and prevented effective action being taken to tackle other problems. (paragraph 197)
52. Inadequate communications are a sure sign of a poorly performing organisation. Effective information flow, especially from residential staff to managers, is essential if abuse and other problems are to be tackled. It is important that not only the voice of the child but also the voice of the residential worker should be heard. Our recommendations calling for a redefinition of the roles of residential and field social workers will, if implemented, serve to improve communications. We support the recommendations by Professor Whitaker listed above. (paragraph 200)

On 29 August 2000, the Department of Health launched a Quality Strategy, which included two reports commissioned by the Department on the content and delivery of the Diploma in Social Work. These reports outline a need for significant upgrading of several aspects of the qualifying education for social workers, with a greater focus on field experience based on a single national curriculum. They also propose that Centres of Excellence should be developed and consideration given to ways of encouraging participation in training, and recommend a three year undergraduate social work qualification. The Strategy document invites comment on all of these important issues.
Decisions about the format and length of the professional entry training for social workers will be made after the consultation period has ended. In preparation for this revision, TOPSS has already begun work on reviewing the National Occupational Standards for Social Workers. These standards will be used when the curriculum for the revised/new award is developed and they will determine the tasks to be undertaken by social workers.
Work has already been undertaken to determine draft National Occupational Standards for Heads of Adult Homes and these are due to be finalised at the beginning of next year. A working group has now been set up to develop the National Occupational Standards for Heads of Children's Homes, and they will consider how the draft Heads of Adult Homes standards link into this work. Once standards have been developed, they will be linked to an appropriate qualification. In this way it is envisaged that the management of homes will be improved as staff in managerial positions obtain a greater understanding of the organisational tasks that are involved and the importance of good internal communications.

54. One way for children to be given a greater voice within the system would be if better trained and better resourced social workers were to rediscover their traditional role as confidants and champions of the interests of the children they look after. It is desirable that this be done, and we hope that our recommendations on redefining social workers' roles, if implemented, will contribute to this end. The role of the social worker should remain crucially important in relation to safeguarding children's rights. (paragraph 207)

The Government agrees that it is very important that councillors and senior managers understand the nature of their corporate responsibilities for looked after children. In short, they should always ask themselves whether the arrangements they make for a child or young person are the ones they would make for their own child.

It is clear from the Government's Quality Protects work that looked after children and young people themselves want to have access to someone who will 'champion' their cause.

55. We are convinced that children need to have the option of having an adult "friend" who will actively promote their best interests where appropriate, to assist a parent to play that part; if this is not possible, to identify, in partnership with the child, a suitable adult, known to them to be willing and able to take on the responsibility where there is no adult known to the child who is willing and able to do this, to make suitable volunteers available as "adult friends". (paragraph 220)
57. We recommend that every authority should be required to show that it is able to make "adult friends" available; that every statutory review of a looked after child should be required to consider whether an "adult friend" is needed and, where necessary ensure that the need is met; and that the Social Service Inspectorate should report on an authority's arrangements in this respect when they carry out inspections in connection with looked after children. (paragraph 221)
58. The role of an "adult friend", as we envisage it, should be seen as complementary to that of the child's field social worker. (paragraph 224)
59. The social worker who has healthy, direct, face-to-face contact with the child must also be planning and co-ordinating and accountable through reporting systems. The review of the responsibilities of field and social workers which we recommend in paragraph 194 above must take account of both of these imperatives. (paragraph 227)

The Government has invested £12m in the first two years of Quality Protects in listening to children and children's participation. The "Make it Happen" events, organised by the Government, took place in April 2000 - over 700 children, young people and their carers came to give their views on the changes that Quality Protects should be making. Under the Quality Protects initiative £7m is being spent from the special grant in promoting opportunities for listening to children, including the establishment of the Quality Protects Children's Reference Group. It was clear from these events that children and young people value a "champion" who can act on their behalf.

The Government continues to support the development of high quality advocacy services for looked after children through Quality Protects and it is known that enabling to children to speak up protects them from harm and low expectations. At its best, high quality advocacy allows the views of children to help shape service planning and delivery. Evaluation of local authorities' Year 2 Management Action Plans has shown that there is already very good work being undertaken across the country, often in partnership with the voluntary sector. The Government will continue to support development through QP.
In addition, in June 2000 the Government launched a consultation paper "Listening to People" on proposed reforms to social services complaints procedures. As part of the consultation process, views will sought on the specific question of whether a looked after child making a complaint would be better served by having a right to an advocate in formulating and pursuing a complaint.

62. We repeat our predecessors' recommendation that there should be a Cabinet Sub-Committee on Children and Young People, to ensure that the needs of children - including children looked after - are taken seriously at the heart of Government. We hope that the Government will look afresh at this proposal particularly in the context of the further proposal in relation to a Children's Rights Commissioner we set out in the following paragraphs (paragraph 230).

63. We recommend that there should be a Children's Rights Commissioner within the UK, with duties and powers along the lines we have set out in the previous paragraph. We urge the Government to introduce the necessary legislation to create the office of Commissioner as soon as possible, preferably in the next session of Parliament (paragraph 239).

The Government agrees that there needs to be better co-ordination of its policy and legislative programme for children which spans at least 8 Government departments. On 1 August 2000, the Prime Minister announced the creation of a new Cabinet Committee on Children & Young People's. The Committee will be chaired by the Chancellor and will be supported by a new cross-cutting Children & Young People's Unit based in DfEE. The Prime Minister has also appointed the Home Office Minister, Paul Boateng, as Minister for Young People. He will take responsibility for the Unit and co-ordination of the Government's strategy on vulnerable children and young people. The changes followed recommendations made by the Social Exclusion Unit's Policy Action Team on Young People.
On the issue of a Children's Rights Commissioner, the Government remains to be convinced that a Commissioner with a remit covering all children in England is needed in addition to the safeguards that already exist or are being put into place. The Government will keep this issue under careful review but its immediate priority is to target available resources at establishing better services for the most vulnerable children in society. Through the Care Standards Act, the Government has created the post of Children's Rights Director as a senior member of the new National Care Standards Commission. The Children's Rights Director will have a remit across all children all services regulated by the Commission and will go wider than simply children in care. The Government expects the role of the Children's Rights Director to evolve over time and will monitor this carefully.
The appointment of a Children's Rights Commissioners in Scotland, Wales & N Ireland are issues for the devolved administrations. In Wales, the National Assembly is committed to establishing a Children's Commissioner with a remit covering all children. The Government made amendments to the Care Standards Act to enable the creation of this post. The Government will monitor with interest the development of this role.

64. We wish to endorse Sir William Utting's main findings. In particular we wish to support the following proposals: The recommendations about recruiting and selecting staff in the Warner Report of 1992 should be fully implemented by all local authorities (most have already done so), and they should be applied in all settings in which children live away from home. Conformity should be a condition of registration and approval of children's homes. All organisations which care for children living away from home should provide parents with full information about their arrangements for keeping children safe. The Government should extend the legal protection of employers in respect of communicating information about people unfit to work with children, and the new system for criminal record checks should access other approved lists as part of its own checks. Staff should be required to communicate concerns about the conduct of other staff towards children and be afforded full legal and employment protection when acting in good faith. The Government should undertake a comprehensive review of the arrangements for prosecuting offences against children in order to make them more effective. (paragraph 239)

The response to People Like Us reiterates the Government's determination to ensure compliance with the Choosing With Care principles for successful recruitment and selection practices. Under Quality Protects, the Department of Health has asked local authorities to report on their progress in this area in their Management Action Plans. It has asked this in the context of this year's autumn performance assessment round. The Department has also produced a training and resource pack on recruitment and selection for local authorities entitled Towards Safer Care.

The Government has already introduced improvements to the procedures for vetting potential employees through the Protection of Children Act 1999. A new list of persons deemed unsuitable to work with children has been established under POCA and will be operational from October 2000. In addition, the new Criminal Records Bureau will provide much wider access to criminal record information than is currently available. The aim is that the CRB will provide employers with a central access point to criminal records information, DH Protection of Children Act List, DfEE's List 99 i.e. a one stop shop for checking staff who will work with children.

The Government's response to the Waterhouse Report entitled "Learning the Lessons" was published in June 2000. This set out what the Government is doing to ensure that effective whistleblowing arrangements are encouraged and facilitated wherever appropriate. The Local Government Act creates a statutory Code of Conduct for local Government employees. DETR is discussing the inclusion of a requirement to whistleblow in the Code of Conduct of Conduct. In relation to children living away from home, the new national minimum standards for children's homes will include a requirement for homes to have whistleblowing procedures in place, including systems to enable staff to contact the National Care Standards Commission if they have concerns about abuse or serious harm in the home. These measures build on those contained in the Public Interest Disclosure Act 1998.

65. We welcome these comments by the Government. We recommend that prostitution involving children under the age of 16 should be recognised as a child protection issue. Pimps and those who seek out children for paid or unpaid sexual gratification should be treated as child sex offenders. We call on the Government to being forward proposals for amending the law, if necessary, and issue guidelines for police and prosecutors accordingly.(paragraph 244)

In May 2000 the Government issued Safeguarding Children Involved in Prostitution. The Guidance sets out an inter-agency approach, based on local protocols developed within the framework of Working Together to Safeguard Children (Department of Health et al, 1999; National Assembly for Wales, 2000), to address this type of abuse. Its aim is to both safeguard and promote the welfare of children, and to encourage the investigation and prosecution of criminal activities by those who coerce children into and abuse them through prostitution.

66. We urge the Ministerial Task Force now considering the way forward to acknowledge that People Like Us is a report which should be implemented, notwithstanding the resource implications. (paragraph 246)

The Government's response to the Children's Safeguards Review was published in November 1998. The response makes plain that the Government accepts the general principles of Sir William Utting's report and almost all of its detailed recommendations. The Government's response sets out in detail its programme for change. The Ministerial Task Force on Children's Safeguards continues to monitor the implementation of this programme and the overall outcomes. Consideration is currently being given to the future of the Task Force in the light of the creation of the new Cabinet Committee on Children and Young People's Services.

67. Despite this array of statutory requirements, actual health outcomes for looked-after children are poor. (paragraph 252)
68. We recommend that the potential of the Looking After Children records should be exploited as a means of ensuring continuity and focus in children's medical treatment. (paragraph 266)

The Government has consulted on guidance for promoting the health of looked after children and hopes to publish new guidance later this year.

The Looking After Children materials are being redeveloped to link with the new Assessment Framework to form an Integrated Children's System for all children in need and their families. Within the redeveloped Modular Care Plan there will be a Health Care Plan which will e monitored through the reviewing process. The new Guidance on promoting health for looked after children will provide a stronger framework for monitoring children's health, ensuring appropriate treatment and improving health outcomes.

69. Greater sensitivity needs to be shown towards children by the healthcare professionals who treat them (paragraph 267)
74. We agree with the Social Service Committee's conclusion of 14 years ago that a named medical adviser should be responsible for the oversight of the physical and mental health of each child in care. We believe that the Government should accept this principle, and should consult widely on the best way of implementing it, considering options such as the RCN proposal that each residential home should have a named nurse wit responsibility for such oversight, or that each home should be required to have a formal link with the local primary care team.(paragraph 271)

The Government agrees that there have been some problems with respect to the sensitivity shown towards children by healthcare professionals. The new guidance on promoting the health of looked after children should help ensure that looked after children have a more positive healthcare experience in the future with greater sensitivity to their needs.
This new guidance will more clearly define the relationships between health commissioners and social care and the role of medical advisers. This formed part of the recent consultation process, the results of which will be reflected in the guidance.

70. Health education for looked­after children is at present regarded as a comparatively low priority. This is a very short­sighted attitude, given the problems caused for society as well as individuals by bad diet, obesity, drug abuse and under­age pregnancies. The statutory responsibility of local authorities to promote health education is clear, but as in so many other areas, there is currently no way of systematically monitoring the extent to which authorities carry out this duty, or of enforcing the duty on those authorities who neglect it. (paragraph 268)
71. We recommend that the DoH should report to us with proposals for ensuring that appropriate health education is provided to young people in the care system. (paragraph 268

The new health guidance will provide a more holistic, age appropriate approach to children's health within which health promotion will be very prominent. It will be structured into the health care plan, described at paragraph 68 and into the revised Assessment and Action record so that it can be monitored through the reviewing system.

73. A further area where greater liaison between health and social services is called for is in relation to looked-after children who are disabled. Their needs should be born in mind in Children's Service Plans. It is unsatisfactory that no reliable statistics on such children are available; the DoH should take steps to acquire such information when it gathers data on the care system from local authorities. (paragraph 270)

Data is not currently collected because there are difficulties surrounding definitions of disability e.g. 'learning disability'. Work currently underway through the Quality Protects Management Information Project, the Children in Need Census Data and the Integrated Children's System will lead to improvements in the collection of useful reliable data. This will enable statistics about the prevalence and needs of disabled children in the looked after system to be collected centrally.
Services for disabled children will be a new priority area for the Quality Protects Grant from 2001/2002.

75. We wish to endorse the call by the National Children's Bureau for NVQs DipSW and in-service training to include training in health care, child development and means of accessing health services. (paragraph 270)

The NVQ Level 3 Caring for Children and Young People was extended to include extra units in 1999. One of these was "Contribute to Promote Health and Social Well-being for Individual Children and Young People". This covers promoting and providing for healthy growth and development and responding appropriately to physical and mental health problems. Local authorities are being encouraged to link all their in-service training to the appropriate national occupational standards, or use units from the appropriate NVQs. The revised DipSW will also cover promoting and providing for healthy growth and development.

76. The current level of educational achievement by children looked after is appallingly low. Although such disadvantaged children are never likely, overall to match the educational standards of the population at large, we have no doubt that with proper support many individual children could achieve far more of their potential than they currently do. (paragraph 289)
77. We recommend that the Government draw up a strategy for tackling these problems. There should be a new emphasis on the duty of the whole local authority to ensure not only that children receive a full-time education suitable to their age, but also special help and attention to overcome their deficits. (paragraph 290)

Data published in the PSS PAF PIs collected at 31 March 2000, shows that 30% of the 6,800 people leaving care in 1999/2000 had obtained 1 or more GCSEs or GNVQ equivalent. The Government is taking positive steps to improve the educational attainment of looked after children. Through Quality Protects it has set specific educational attainment targets for local authorities. Targets to be achieved are:
*by 2001, 50% of all children leaving care at 16+ to have at least one GCSE or GNVQ equivalent; by 2003, 75% of all children to have achieved this.
*By 2004, 15% of all children leaving care at 16+ to have at least 5 GCSEs at grades A-C.
The Department of Health and Department for Employment and Education issued joint Guidance on the Education of Children and Young People in Public Care in May 2000 following consultation. This sets out clear steps for councils to take to help them improve young people's educational attainment The guidance aims to bring the educational attainment of these children closer in line to those of their peers, enabling them to achieve their full potential. The guidance is aimed at assisting local authorities in their role as corporate parents.
The guidance supports strategic change within local authorities to assist the effective education of young people in care and this is supported by statutory guidance in Circular LAC (2000) 13.
The Circular instructs authorities to:
*Secure education at the same time as identifying suitable care placements;
*Secure full-time, main stream education places for all young people in care within 20 days;
*Ensure every child has a Personal Education Plan within 20 days of entering care;
*Formulate a joint protocol for sharing relevant information about care placements and education.
Additionally the guidance states that all schools should designate a teacher with responsibility to provide a resource and advocate for young people in public care.
DfEE has appointed a team of Implementation Advisers to actively help local authorities implement the guidance.

79. We welcome the Social Exclusion Unit's announcement of a Government target that by the year 2002 all pupils excluded from school for more than three weeks should receive alternative full-time and appropriate education. The setting of targets is, of course, easily done; what matters is the measures taken to achieve them. We look forward to receiving specific and fully resourced proposals from the Government as to how this target will be achieved. (paragraph 290)

In 2000-01 the amount available to help schools and LEAs tackle poor behaviour and move toward the full timetable for excluded pupils has more than doubled to £131 million. In 2001-2 the money available increases to £174 million, a further rise of 33%. This includes between £3000 and £6000 to follow pupils who are excluded to pay for education outside school or to re-settle excluded pupils at a new school.
Local Education Authorities are asked to make annual returns on their
progress toward the full timetable for excluded pupils, which must be in place by September 2002. Preliminary analysis off the latest returns
indicates that nearly all authorities are making satisfactory progress and all are providing more than the three hours per week education that was common in the past. Some authorities will meet the full timetable well before 2002. Other data confirms that pupil contact time at Pupil Referral Units (where excluded pupils are often placed) is increasing. Analysis from OFSTED also indicates that the quality of education for excluded pupils has shown a significant improvement.

80. We also welcome, in principle, the Government's setting of a target for a significant increase in the proportion of looked after children attaining academic qualifications. However, we are worried by the details of the proposal. The Government suggests that the targets might be set at 50% of all looked after children achieving a qualification by 2001, and 75% by 2003. The best research data currently available indicates that between 50% and 75% of care leavers have no qualifications. If the lower of these figures is correct, then the Government's proposed initial target is in fact already being met. (paragraph 292)
81. Secondly, as the Government itself acknowledges, "there is a great shortage of data about the educational circumstances and achievements of children in care". There is little point in setting target at all until firm statistics are available, together with mechanisms for measuring progress beyond an initial baseline. We therefore recommend that the Government should ensure that reliable data is collected as quickly as possible on the extent of educational provision for children looked after, and on educational outcomes. The Government should then set genuinely challenging targets against which its measures for improving the education of looked after children can be judged. The Government should, of course, proceed with the implementation of those measures themselves without delay. We look forward to receiving specific and full y resourced details of these measures. (paragraph 294)

For the first time, the Government is collecting detailed data on the educational attainment of looked after children. This will be published on 26 October 2000 (See recommendation 76)
The progress of local authorities on the education of looked after children will also be scrutinised as part of the Autumn 2000 Performance Assessment round. In this context, they are also being asked to report on the progress made in implementing the DH/DfEE Guidance on the Education of Young People in the Public Care.

82. We recommend that every looked after child should have his or her educational progress assessed at each of the Key Stages. (paragraph 294)

DH collection of statistics includes Key Stage results for all young people in public care.
The Quality Protects Indicator 7 is to measure 'the proportion of looked-after children attaining the target levels or better in each of the tested subjects in the National Curriculum Assessments, expressed as a ratio or better in the authority.' Data will be received in December 2000 with results expected to be available in May 2001.

83. We recommend that the Government should investigate ways of developing more sophisticated performance indicators, to assess how far schools are assisting looked after children. (paragraph 295)

In January 2002 the Department for Employment and Education is introducing an annual schools census, which will collect data on individual pupils using a unique pupil identifier. Data will be input by schools electronically - some information will be retained locally and other data will be available centrally. Currently information in relation to children in public care will be included as an option for schools to hold locally. However, proposals are currently being considered to make that data available centrally.
Specifically, it is proposed to collect data centrally which identifies: whether the pupil is in public care on the census day; the local authority with responsibility for looking after the child; and whether the pupil has been in public care at any time since he/she became a registered pupil at the school.
This data will enable DfEE to monitor the educational achievement of children in care alongside a wide range of other educational indicators such as exclusion and SEN.
DfEE and DOH are reviewing ways of linking their two systems. Such cross-referencing would enhance the potential of both systems and provide a valuable research tool.

84. Schools should take active steps to minimise any sense of stigma, which attaches to children who are looked after. (paragraph 296)

The DH/DfEE joint Guidance on the Education of Children and Young People in Public Care, issued May 2000, addresses the barriers that young people in public care face including bullying and harassment. Schools are asked to designate teachers who will act as a resource and advocate for children in care and raise expectations of their abilities. It is recommended that this person have sufficient authority to be able to influence school policy.

85. We recommend that the Government should investigate ways in which local authorities who neglect the education of children in their care should be subject to appropriate invigilation and penalty. (paragraph 297)

Circular LAC (2000) 13 was issued with the joint DH/DfEE Guidance on the Education of Children and Young People in Public Care and provides statutory guidance. As figures on the educational performance of young people in or just leaving care are received, Government Departments will have a far better picture of local authorities which are failing in their duty under the Children Act 1989 which includes provision education within the welfare role. Under Quality Protects, the Government has set clear objectives for the educational attainment of looked after children. This area is being scrutinised as part of the Autumn Performance Assessment of Social Services. Quality Protects grant funding could be withheld from those local authorities who are not making satisfactory progress on the education of their looked after children.

86. We believe that for every looked-after child there should be a single individual who will have the responsibility of acting as an advocate for that child in respect of education, by monitoring their progress, keeping in regular contact with their school, and actively promoting their best educational interests. (paragraph 298)

The joint DH/DfEE guidance issued in May asks all schools to designate teachers who will act as advocates for young people in public care. It also highlights the need to train social services personnel to better understand education and procedures for choosing schools, admissions, exclusions and special educational needs. Section 15 on Advocacy asks local authorities to ensure primary carers, social workers and teachers have the necessary training to be effective advocates.

87. It is important that educational materials are available in the child's home. (paragraph 299)

The Department of Health is developing National Minimum Standards for Children's Homes (currently in draft form), which will form the basis of the regulation and inspection criteria of the National Care Standards Commission. One of the minimum standards requires that children's education is promoted in the home and that children are provided with facilities that are conducive to study. The standard includes a requirement that children have access to IT equipment, books and other educational aids to assist their education and development. This requirement is reiterated in the joint DH/DfEE Guidance on the Education of Children in Public Care (May 2000).

88. We were astonished to learn that secure units face difficulty in gaining funding for the education of 'statemented' children, because they are not designated schools, despite the range of educational facilities they provide. We were glad to hear that the SofS (for Education and Employment) proposes to take action to rectify this anomaly. We strongly support the taking of such action. (paragraph 303)

The DfEE had intended to include in the new Special Educational Needs Bill measures to ensure that local Education Authorities work with secure units to meet the terms of Statements of Special Educational Needs as far as it is possible. This involved amendment to Section 562 of the Education Act 1996, which states that no duty of the Act applies where the person is detained by a court order. However, legal advice suggested that the Human Rights Act may require a wider view of S562, which took this issue beyond the scope of the SEN Bill. DfEE continue to review ways of ensuring that - as far as possible - the Statemented needs of young people in secure units are met.

90. It is clear that in many cases undue pressure is put on young people to leave care as soon as they are 16, irrespective of how well or badly prepared they may be for independent living so early in their lives. This should be discouraged. (paragraph 314)

The Government agrees that the current trend is for young people to be discharged from local authority care as soon as they are 16, regardless of whether or not they are ready for this. Many of these young people receive little support from their 'parent' local authority and may be expected to rely instead upon the benefits system. The Children (Leaving Care) Bill will change this.
The Bill is based upon the proposals of the Department of Health consultation document Me, Survive, Out There? - New Arrangements for Young People Living in and Leaving Care' published in July 1999. The basis of the Bill is to impose new and stronger duties upon local authorities to support care leavers until they are at least 18, with additional duties until they are at least 21. The Bill removes any financial incentive for councils to encourage children to leave care at 16 whether they are ready or not. The Bill has completed its stages in the House of Lords and was introduced into the House of Commons on 23rd May. Implementation is planned from April 2001.
Recently released data (Children's PSS Statistics, to be published w/c 23rd October) already shows a notable increase in the number of young people remaining in care until their 18th birthday.

91. The social services must not turn their backs on young people when they have left care. (paragraph 314)
92. We support the proposal by Sir William Utting and others that the Children Act 1989 should be amended to convert the discretionary powers contained in Section 24 into duties imposed on local authorities to offer appropriate support to care leavers in the form of services, in-kind assistance and cash. We recommend that this duty should extend to young people up to and including the age of 21, an should exist as a discretionary power up to and including the age of 25, or beyond in exceptional circumstances. The Government should ensure that the resources necessary to achieve this end are provided. (paragraphs 315, 92)

The Government accepts that the support currently provided by local authorities for young people who are leaving or who have left care is entirely inadequate. The Children (Leaving Care) Bill ensures that councils must continue to provide for qualifying young people aged 16 and 17 whom they have looked after ("relevant children"). This covers assessing and meeting their needs, including accommodation and maintenance, providing them with a Young Person's Adviser. They will also have a Pathway Plan, looking ahead to at least the age of 21, which will be regularly revised and and updated and their responsible authority will be obliged to keep in touch with them.
The Children (Leaving Care) Bill imposes new duties on councils in respect of "former relevant children" - that is, those aged 18-21 who have left care, having qualified for the new arrangements under the Bill when they were 16 or 17. They will continue to have a Young Person's Adviser and a Pathway Plan. Their responsible authority must continue to keep in touch with them until they are at least 21, or later if they are being helped with education or training.
The Bill also creates new duties on councils to provide general assistance for these young people, in cash or in kind, until they are 21, and to assist with employment, education and training. The duty to assist with education and training will last for as long as the young person is pursuing their agreed programme, even if it takes them beyond the age of 21.

93. We recommend that the Government should take the necessary steps to improve the quality of statistical information available on service provision for, and outcomes of, care leavers. (paragraph 316)

The Government has established a target for achieving this objective and a new statistical collection has been introduced to monitor the education, employment and accommodation of young people after they have left care.

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