Select Committee on Children, Schools and Families Written Evidence

Memorandum submitted by Professor June Thoburn CBE, University of East Anglia


  In order to provide the best possible service to these most vulnerable children who need the state to become involved in providing out-of-home care, it is essential to learn what we can from best practice in other countries. But in the past in the UK we have been overly narrow in limiting our gaze to the USA and other English speaking countries and have missed out on learning from the more positive approaches to out-of home care in other European countries, for example, the way in which France and Scandinavian countries seek to retain challenging adolescents (including those who commit offences) within their child welfare and out-of-home care systems. It is also important not to undervalue the progress that has been made in the UK—the policies that we can recommend to other countries. In particular, we have reason to be proud of the progress we have made in placing children for adoption and the steps we are taking towards finding a range of alternative routes to permanence and family membership without requiring children to give up links with their birth families.

  In looking across national boundaries, it is essential to understand the context in which apparently successful policies and practices in other countries have been developed. Taking policies and interventions "off the peg" from other countries may result in costly mistakes, especially for the children involved.

  Research from the UK and abroad supports the general direction in the Children and Young Persons Bill— to improve services for children on the thresholds of care, and at the same time to improve the service provided to children who are looked-after by the local authority.

  "Success" should be measured not only in terms of numbers in or out of care, but in terms of ensuring that those children who can remain with their families are enabled to do so, and those who need out-of home care come into care in a planned and timely way and remain for as long as is needed.

  An approach to the place of the care system within child welfare services and to the evaluation of outcomes needs to be differentiated in terms of age, type of difficulty and type of care service.

  Specific areas for further research and development are:

    —  support foster care for families under stress;

    —  more appropriate arrangements for the support of kinship carers;

    —  reducing the number of "predictable emergency" admissions to care;

    —  appropriate out-of-home care services for teenagers;

    —  reunification practice; and

    —  ensuring that more long term foster families become "families for life" for the children in their care.


  1.  I am an Emeritus Professor of Social Work at the University of East Anglia. This memorandum is based on over 40 years of experience as a child and family social worker and team leader in England and Canada, and as a social work academic. Since 1980 I have researched and published on most aspects of the social work service to vulnerable children and their families and carers, but have focused especially on children who may need out-of-home care, and on placements and outcomes for looked-after children. This memorandum particularly draws on a recent Leverhulme Foundation funded study of children in out-of-home care in 14 "first world" countries in Asia, Australasia, North America and Europe (including the four UK nations). I have continuing links with policy makers, researchers, data analysts and practitioners in these countries. My comments are of relevance to some of the clauses of the Children and Young Persons Bill and to the broader issues listed especially: corporate parenting, family and parenting support, care placements, transition to adulthood, the role of the practitioner. (I shall use the term "in care" alongside "looked-after" as this is the term in general use in the other countries to which my memorandum relates.)


  2.  The research on outcomes for young people in care is often over-simplified and gives a misleading impression of care outcomes. (See summary of international evidence on outcomes by Bullock et al which presents a more realistic overview of outcomes—this article has subsequently been published in refereed USA and UK journals.) Global statements about outcomes of care are unhelpful since they lump together different ages of children, entering care for different reasons, who stay for different lengths of time and exit care in different ways.

  3.  A valid authoritative research study on outcomes would need to have a longitudinal design, include all children entering care during a given period, and retain within the study those who return successfully home, those who are successfully placed for adoption and those who are successfully placed with long term foster families or relatives and are provided with stability and loving care well into adulthood. Such a study does not exist anywhere in the world, although there are some longitudinal studies of smaller samples in France, the UK, the USA and major population-based studies in Sweden. The UK birth cohort studies have some data but were not set up to provide large enough numbers or collect sufficiently robust data on the care experience. The England Children Looked- After (903) data set is the envy of many countries, and is beginning to provide robust data on those who stay long in the system, or re-enter (although it does not provide comprehensive data on children adopted from care who re-enter the care system since these have a different name and identifier).

  4.  Too much of the "evidence" of poor outcomes is based on what have come to be known as "care leavers"—young people moving into some form of hostel accommodation or "independent living" environment sometime between the ages of 15 and 18. Many of these entered care because they were already showing troublesome or troubling behaviour (including poor school performance) when over the age of 10. Many, as demonstrated by their evidence to the Care Matters consultation, the Children's Rights Officer and our survey of the views of over 700 looked-after young people (Timms and Thoburn, Your Shout published by the NSPCC—available if it would be helpful), make progress in care and value the experience, even though on the outcome measures used such as GCSE results, they do not measure up well to the "average" child. For children who enter care with serious difficulties a "value added" measure of outcome is needed, alongside the standard measures, if we are to know whether being in care has resulted in gains to or deterioration in their wellbeing.

  5.  More, of course, must and can be done to improve outcomes for this group of young people, but outcomes for late entrants to care (eg educational attainment) should be measured when they are in their early 20s and have had time to benefit from what a good experience of being in care can offer them. They need time to recover from whatever trauma led to them entering care before they can really start to make substantial gains.

  6.  In contrast to the mixed evidence coming from the research on long-stayers, research on children who enter care for a shorter period of time (usually accommodated for a specific purpose) or provided with a support foster care service (at times of family stress as well as for disabled children) reports high parent and child satisfaction rates, some evidence of improved wellbeing, and few negatives.

  7.  The generally negative view held of out-of-home care as a child welfare intervention is a characteristic of English speaking countries, as is the drive, coming from this view, to keep the numbers entering or remaining in care down. Although there is no actual target to reduce rates of looked-after children, there is generally perceived to be one (keeping children out of care is often used as an outcome measure for pilot interventions and CSCI reports have tended to report positively on those authorities which reduce the rates of children looked-after).

  8.  In contrast, in most European countries and in New Zealand, there is a much more balanced view of the benefits as well as the negative consequences of out-of-home care, and greater differentiation about the types of children who may benefit from different sorts of out-of-home care experience. The result is that rates of children in out-of-home care are generally higher in the non Anglo-phone countries. Whilst the rate for England and for the USA state of Illinois is 55 per 10,000 children under 18, those for Denmark, France, Germany, Norway and Sweden are respectively 104, 102, 74, 68 and 63 (there are particular issues for Alberta around the high proportion in the child population of very vulnerable native Canadian children). The explanations for these differences are complex but confidence in the ability of the care system to have a positive impact on children's lives is an important part of the explanation.

  9.  In summary, all countries seek to put in place a range of services to prevent the need for out-of-home care, but some would argue, and I consider that the UK and international research supports this, that a "keep them out at all costs" interpretation of legislation and guidance results in some children who should be provided with an accommodation service, or have their need for care considered by the family courts, being left to suffer at home for too long. When they do enter care, (especially those who enter beyond infancy) their problems are more severe. The "goal-keeping" approach also results in too many "predictable emergency" admissions, ie admissions which could have been planned for to minimise trauma and avoid a quick change of placement because the first one was unplanned. (I could cite evidence to support these points.)

  10.  The least safe and the least stable "permanence" outcome in the UK is return to the birth parents, indicating that the lack of confidence in what a good care system can provide results in some children being returned home too quickly or inappropriately.

  11.  Higher rates in care in some European countries are also explained by children staying longer in care. In part this is because only the USA, UK and Canada use adoption without parental consent as a route out of care (except in a very narrow range of cases). This results in some young children who in England would exit care through adoption remaining in the care statistics (often in the same foster family) until adulthood.

  12.  The major explanation for better outcomes in some EU countries is lower thresholds for entering care, and therefore those in care having fewer problems at the time of entry. Greater stability in care is achieved because there is not the same drive to get children out of care when it is sometimes inappropriate (leading to repeat admissions). Much higher use is made of long term residential care or boarding education, with good family contact, which, for these less troubled children, provides more placement stability than foster care or residential care in the UK.

  13.  The other important factual point emerging from my international study is around age at entry and exit from care. Other EU countries make more use of their care system as part of their child welfare service to children aged 14 or 15 and over. In most, a young person may remain "in care" until the age of 21 or 22 and in some, eg Sweden and Denmark, a young person can actually enter care at the age of 20. (The over 18s have been left out of the above "care rates", but is should be noted that 11% of the official "in care" population in France and 28% in Germany is 18 or over).

  14.  Only 4% of those starting to be looked-after in England in 2005 were aged 16 or over compared with almost 50% in Sweden and Denmark. This is largely explained by the fact that the child welfare systems in these countries (including the out-of-home care service) plays a larger part in their services for children who offend than is the case in the UK.

  15.  The large drop after the 1989 Act in entry into care for those aged 15 plus is explained by the removal of offending and non-school attendance as reasons for the making of a care order. However, there is some (mainly anecdotal) evidence that an unintended consequence of the otherwise very positive Children Leaving Care Act was that local authorities sought to save resources by being very reluctant to accommodate or apply for a care order for a young person aged 15 or over. This may have had an impact on the increase in the numbers of homeless teenagers and those entering youth custody, and (again anecdotal evidence) entering private psychiatric establishments under a mental health section.


  16.  The above facts support the general direction in the Children and Young Persons Bill—to improve services for children on the thresholds of care, and at the same time to improve the service provided to children who are looked-after by the local authority.

  17.  "Success" should be measured in terms of ensuring that those children who can be provided with loving, stable and safe care with family members should be enabled to remain with their families, and children who need out-of-home care should come into care in a planned and timely way and should remain for as long as is needed. Measuring whether these aims are achieved is difficult, but should be tried, eg through case audits, and should replace seeking to achieve an "optimum" rate in care, and keeping children out of care as a "stand alone" outcome measure.

  18.  An approach to the place of the care system in child welfare services needs to be differentiated in terms of age, type of difficulty and type of care service.

  19.  As part of the family support services, there should be an increase in support foster care (series of short term episodes) for children whose families are under stress, children who need therapeutic input because of their challenging behaviour as well as for disabled children. There is also still an important place for small specialist residential units to be available in such circumstances. For those emergency cases when the need for care can not be predicted and planned for, "crash pad"/emergency assessment facilities for the different age groups should be available to provide a "breathing/taking stock space"—sometimes for combinations of family members. This may involve a peripatetic team of foster carers, residential workers, social workers and a facility that can be brought into use when needed. There are examples in several countries (including the UK) of such services. If care then becomes necessary, there will have been time to plan the placement. Increased use of Family Group Conferences is also a positive step towards planning entry to care when this is needed as well as preventing it, so preventing entry to care should not be the major outcome measure used when FGC's are evaluated.

  20.  The research evidence that return home for those who have been in care for more than a few weeks is the most risky and unstable permanence option should lead, as the Care Matters working papers suggest, to a better resourced and differentiated set of reunification services and support for families when children return home (including children who have been accommodated as well as those returned following a care order).

  21.  For children and young people who do need a long term care service and for whom adoption is inappropriate either because they do not want it or because of their range of needs, this should include being encouraged to remain part of their foster family (even though they may be helped to set up home elsewhere when they are over the age of 18). This is an area where we can learn from Europe and some USA states, although there are many examples in England of foster families becoming "families for life". The term "leaving care" should be replaced by a different way of expressing the aim of providing continuity, family life and flexible continuing support to these vulnerable young people at this stage of transition into adulthood.

  22.  Similarly, if young people are well settled in a group care facility, they should not be moved on at the age of 16. There is (anecdotal but sound) evidence of this happening at the moment, demonstrating a need for better advocacy services to ensure that the young people can make strong representations if this is contrary to their own view of their best interests. For those who do not have "good enough" links with family members who can provide them with some emotional support (alongside that of their social worker and residential worker) as they move into adulthood, supported lodgings linked to the residential facility for them to move into around the age of 18 should be developed (eg "foyers" linked in with group care facilities).

  23.  The data on the comparatively small numbers of children aged 15 plus being provided with an out-of-home care service should be carefully looked at. There needs to be a consideration of why there are such big discrepancies between policy in England and in Europe. A rethink may be needed about the place of a child-welfare based out-of-home care service for some teenagers who are "unwelcome" in the family home, become homeless, or whose parents or schools are struggling to manage challenging behaviour, or who are starting to offend. It is possible that in such cases more use should be made of the provision of section 20 accommodation or consideration by the family courts as to whether a care order would be appropriate. At the time of the 1989 Children Act it was argued that a "cross-over" provision could be appropriate for a child or young person found guilty of an offence by the Youth Courts to be referred across to the family courts for consideration of whether a care order was needed. I understand that there is still support for such a move so that particularly vulnerable children could be considered in terms of whether a care order, or Section 20 accommodation might be more appropriate than a custodial sentence.

  24.  The education of children looked-after is not one where I claim detailed expertise, but, from my knowledge of the data on children entering care, the attention being given to ensuring that they have the highest quality education, specifically tailored to their needs, is greatly to be welcomed. However, there is an argument to be made for "measuring"; the educational outcomes of looked-after children in terms of the "value added" from when they entered care and to take the measure at around 20. Longitudinal research indicates that after a rocky period in their teens a proportion settle down to recoup lost time by taking GCSEs at FE colleges in their late teens or early 20s.

  25.  On workforce issues, the message from research in the UK and overseas is that successful child and family practice requires continuity of relationships with trustworthy, reliable, committed, skilled and knowledgeable social workers and carers, working in partnership with other professionals and the courts, as well as with the parents and children themselves. Exercising discretion and making or recommending decisions are central parts of the social work role, which require considerable knowledge about the context of a particular case and the likely outcomes of a range of placements.

  26.  Arrangements that maximise the availability of professionals with these characteristics are those which must be strenuously supported. I remain to be convinced that the proposed model of Social Work Practices is an answer to the need to increase the numbers of skilled social workers and increase continuity for young people in care. Certainly they will need to be very carefully evaluated.

  27.  Whilst it is important to learn from other countries (for example, about the role played by social pedagogues/educateurs specialisés) the different contexts in which they work and the different characteristics of the children in care should be carefully considered before interventions and practices from other countries are incorporated into UK workforce policy.

January 2008

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