Children, Schools and Families Committee

Inquiry into Looked-after Children

NCH Submission on Care Matters: Time for Change white paper 15th Feb

 

1. Executive summary

 

NCH[1] is pleased that the Children, Schools and Families Select Committee is conducting an inquiry into looked-after children. We see this as a timely inquiry and one that can assist in the development and implementation of Care Matters and ultimately improve the outcomes for children who enter the care system.

 

NCH would like to see:

 

o a greater emphasis on preventative services, with the recognition that there may also be a need for long-term ongoing support for some families with complex needs;

o the Government addressing the needs of vulnerable groups of young people in the care system, specifically young offenders and unaccompanied asylum seeking children;

o work to promote emotional health and wellbeing for young people in the care system;

o work to ensure that children and young people in the care system are not confronted with a 'cliff-face' at key transition stages whereby services end entirely or change considerably. Also given the vulnerability of those leaving care there should be a specific emphasis on supporting young people to learn skills and to find employment or training - for example apprenticeships.

 

2. NCH

 

2.1 NCH believes raising the life chances and improving the experiences of children in care is an urgent need. We work to promote the best interests of children and young people in care through providing a range of residential services for children, young people and families, including residential services for disabled children and those who are leaving care or homeless.

 

2.2 NCH also has a long tradition of adoption work, as well as a variety of foster care placements, ranging from emergency and short term through to specialist long term, remand and shared care placements.

 

2.3 The outcomes children in care - be they educational attainment, physical health or emotional well-being, lag a long way behind that of the general population and certainly fall below what we would aspire to for our own children.

 

2.4 NCH supports Care Matters ambition and objectives, and we will make every effort to support measures to build services that place the child at the centre and deliver better outcomes for all vulnerable children.

2.5 Care Matters is a unique opportunity to unite support and action in ways that will demonstrate society's commitment to our most vulnerable children and to develop services that help them to realise their potential.

 

3.0 Family and parenting support

 

3.1 Care Matters offers a package of measures to address the shortfalls of provision for children in the care system. It also has a strong focus on prevention, looking at policies to ensure earlier intervention and support for families with children on the edge of care. The paragraphs below highlight the impact and benefits of intensive family support to families with children on the edge of care.

 

3.2 NCH Intensive Family Support Services

Intensive family support, where appropriate, is an effective intervention that supports and challenges families with children who are on the edge of entering the care system;

its aim is to avoid children and young people unnecessarily entering the care system;

on average, four out of five referrals to NCH's intensive family support services are deemed successful and cost-effective.

NCH intensive family support services can also help meet the needs of children and their families after being in care and can prevent repeated re-entries into the care system.

3.3 NCH runs a number of intensive family support services that support families where children are at risk of entering the care system, perhaps as a result of family breakdown or severe difficulties. This service can also be used to support children leaving care and returning home to live with their families, or to prevent the breakdown of a foster placement.

 

3.4 Intensive family support builds on the family's strengths and coping strategies, and incorporates a strong degree of challenge. The service usually involves a time-limited but intensive (24-hour/seven-day-a-week availability) intervention for families in crisis. At the end of the period, the family is linked into existing local services. The intervention involves defusing the immediate and precipitating crisis that led to the service referral, with support workers engaging the family, children and/or young people, liaising with other agencies, assessing the problems, developing specific, measurable goals, and helping everyone in the family to acquire the skills to achieve them.

 

3.5 NCH Phoenix Service - Merton

In Merton, NCH works with the local authority to prevent children coming into care. The service works with families in crisis using a solution-focused brief therapy model of work. Intensive support is offered for a period of three months, with all interventions regularly reviewed. When the work is completed, families are tracked after six months to see if the progress they made has been maintained and, in some cases, to offer a 'one-off' review session if this is considered useful.

The project consists of a rapid response team, adolescent resource team and family group meetings. The rapid response team offers crisis intervention by responding with 24 hours and providing intensive intervention with the family during their crisis.

CONT

 

The adolescent resource team offers direct work with children and young people. aged 9-19, using different methods to engage young people. Family group meetings are used to ensure that children remain within extended families wherever possible.

Other services include group work for parents with teenagers and for young people. These help young people to gain confidence and raise their self-esteem in order to develop healthier peer relationships.

The NCH Phoenix service operates in a multi-agency context, working in partnership with CAMHS, YOT, education and other voluntary agencies.

 

3.6 Benefiting families - At our intensive family support service in Plymouth, results after two years showed that 94 per cent of young people referred did not enter the care system. A survey in similar service that was run by NCH in Tower Hamlets, based on a sample of 33 families followed up one year after receiving a service, showed that 88 per cent of the young people remained within the family.

3.7 New research - Researchers from Sheffield Hallam University have recently completed a three year study[2] into the longer term outcomes of families who had worked with intensive family support projects. The families were at risk of eviction because of anti social behaviour and had worked with IFSP to address their often multiple and complex needs. This kind of support has the potential to reduce the need of children entering the care system.

 

3.8 28 families who had significant needs were referred to the service and their progress was evaluated. The researchers judged that for 20 families the project was a success. The other 8 families were considered to have continuing difficulties. Interestingly, the researchers highlighted the fact that the families who were referred to these services often had deep-rooted problems, suffered from multiple deprivations and were likely to continue to be vulnerable.

 

3.9 Cost-effective approach - In Glamorgan, NCH worked in partnership with the local authority and recorded 15 successful interventions over a period of nine months. It is estimated that had these 15 interventions not been undertaken, the average weekly cost of each placement would have been 815 per week. Given the average placement time is three years, this offers a significant potential cost saving.

3.10 The annual cost of a mid-range NCH intensive family support service working to prevent admission to care is just over 300,000 per annum. This provides an intensive service to approximately 60 young people and their families a year, available 24-hours a day over 52 weeks. An 80 per cent average success rate means that accommodation is avoided for 48 of these 60 young people.

 

3.11 Based on the above costs, there are also potential cost savings on intensive family support services to prevent the need for entering the care system. Below are the figures that highlight the average gross weekly expenditure per looked after child in foster care or in a children's home in England.

 

 

3.12 Weekly cost of looked after children in foster care or in a children's home.

 

2005-06

 

Average gross weekly expenditure per looked after child in foster care or in a children's home (CF/B8.1)

Gross total cost for children looked after in foster care and children's homes during the year (CF/B8)

England

716

1,972,814

Shire

709

661,875

Metropolitan

700

566,421

Unitary

683

358,855

Inner London

835

180,890

Outer London

759

204,772

Source CSCI performance assessment framework report 2005-06

 

 

3.13 While there are financial savings to the exchequer and to local authorities, arguably the greatest savings may be seen in the value of services to people - enabling a child to remain safely within their own family and community has immeasurable benefits in terms of their long-term development and wellbeing, including increasing the likelihood of avoiding custody, mental illness or reliance on harmful substances.

 

3.14 NCH would like to see a greater emphasis on preventative, intensive family support services. These services prevent family break up, deal with each families' complex needs with the aim that they will not reach a crisis point in the future. Based on research findings this can also provide a cost-effective intervention. In addition, given the vulnerability of these children and their families there may also be a need for long-term ongoing support to help them address their deep-rooted needs.

4.0 Care placements - vulnerable groups

4.1 The government must do better in addressing the needs of particularly

vulnerable groups, even where that may not be popular.

 

4.2 NCH is disappointed with the lack of acknowledgement given to the needs of asylum seeking children or young offenders, or discussion as to how these

needs should be addressed within the care system.

 

4.3 Young offenders - The disproportionate number of children in care who offend is

well known, running at almost three times the national average. We are disappointed

that the opportunity for making the links and addressing this issue explicitly in the

white paper has not been seized.

 

4.4 We welcome the recent developments to join up work across government on youth justice. NCH believes that this progress at national level now needs to be cemented on the ground, in particular to ensure that targets and incentives work across organisational boundaries to keep young people from offending and out of custody wherever possible.

4.5 NCH has been able to demonstrate success in using various models of care in working with young offenders while also keeping them out of custody. The white paper does makes reference to the Intensive Fostering programme being developed by the Youth Justice Board, but only in passing as a model for the development of Multi-dimensional Treatment Foster Care Pilots for adolescents with complex needs and challenging behaviour. We believe the links between the Youth Justice Board pilots and DCSF initiative needs to be expanded to provide a continuum of services that encompass real alternatives to custody through the greater use of specialist and remand fostering.

4.6 Some young offenders will still end up in the secure estate. These young people should be treated as 'looked after' children so that they are eligible for all the same support and access to services as other children in need.

4.7 Below is an example of a project that is currently provides remand and intensive fostering services.

 

4.8 Case Study: Foster Care NCH Wessex Community Project

Foster Care NCH Wessex Community Projects has lengthy experience in providing remand and post custody fostering. A recently published evaluation of the project indicated that 75% of young people in remand foster care did not offend while in placement (BAAF 2006).

In addition considerable success has been achieved in reducing substance misuse, re-establishing positive links with family and community and with access to education, training and employment. This is achieved by working closely with Youth Offending Teams, Children's and ETE Services and other involved agencies.

NCH has undertaken to run two of the three pilots for Intensive Fostering with funding through the Youth Justice Board. Before sentence young people are offered a fostering placement, as an alternative to a custodial sentence. The young people are then involved in an intense behaviour modification programme which ensures that they have structure and boundaries, sanction and rewards to shape their behaviour.

Given the opportunity to become actively engaged in education, training or employment, separate from their peer group and broaden their social opportunities, the changes seen in young people can be profound. The programme includes work with their families to support the changes they are making by improved relationship management so their return home can be successfully achieved.

 

4.9 The YJB needs to look urgently at future funding options for these models that can make the link between youth justice and social welfare - thereby enabling local areas to design a service that is centred on the needs of the young person. This work will need to address the current financial disincentives for Children's Services Departments to providing accommodation for children within the youth justice system.

 

4.10 Unaccompanied Asylum Seeking Children - The white paper talks about the particular needs of Unaccompanied Asylum Seeking Children (UASC). We believe that unaccompanied asylum seeking children are children first and foremost and have the same universal needs as any other child. While the common factors for asylum seeking children will be needs and issues relating to immigration matters, NCH believes the response to each child has to be tailored to take into consideration their unique needs and circumstances. We are concerned that asylum seeking children over 16 will generally be placed in accommodation that is shared with other young people, while the majority of under-16s are placed with foster carers.

5.0 Health and wellbeing

5.1 NCH is pleased with the importance given to emotional and physical health which ran throughout the White Paper; from the promotion of resilience factors for carers, to elements of the care pledge. We also welcome the fact that the emotional and behavioural health of children in care will now be measured by local authorities through the 'Strengths and Difficulties' questionnaire.

5.2 Emotional wellbeing is seen increasingly as key to successful adaptation to adult life, achievement of educational success, positive relationships and mental health. NCH's Growing Strong campaign has identified a number of specific actions which the government should employ to make this happen to improve the emotional wellbeing of vulnerable children. These include:

all public services giving priority to the promotion of emotional wellbeing and support the development and creation of educational, social, health and other services that have been proven to encourage this

setting specific targets and indicators based on positive measures of emotional health rather than a reduction in harmful behaviours

local authority drawing up an action plan for developing and supporting young people's emotional health, with particular reference to removing the barriers that make it difficult for the most vulnerable children in care to use services.

 

5.3 Since launching Growing Strong we have been approached by a number of local authorities requesting our assistance in helping their children and young people improve their emotional resilience.

 

5.4 Below is an example of one of our services to improve emotional wellbeing.

 

5.5 Coventry After Care Service, England

 

This service helps young people leaving care, and almost all the young people have emotional wellbeing needs following years of care placements and separation from their birth family. Many had endured abusive experiences while with their birth families and also had needs arising from these experiences.

 

The service has clear and consistent methods to improve young people's emotional wellbeing. These include:

focus on practical skills in order to cope with the demands of living alone at the age of 18 or younger - success in managing money, equipping a household or in simple activities such as changing a lightbulb were instrumental in improving young people's self-confidence;

staff persistence in the face of common initial reluctance by care leavers to engage;

use of consistent relationship - low staff turnover compared to services in the local authority was identified as a particular strength and was responsible for enabling young people to reflect and grow emotionally;

CONT

 

use of positive reinforcement of young people's achievements, however small they might be, particularly within the context of a sound professional relationship or in public, such as the awards ceremonies at Coventry Cathedral;

opportunities to contribute to the running of the service and to individual pathway plans.

 

The service works with young people from diverse ethnic backgrounds and this had in some instances complicated the understanding of young people's mental and emotional wellbeing, for example avoiding eye contact but out of respect and not as a sign of an emotional or relational difficulty. Other service users believed in possession by spirits while some young people, from Eastern Europe in particular, had trust issues because of historic, if not personal, experiences in their home countries.

 

Staff have also identified that boys find a talking approach more difficult than girls. The service has therefore set up a series of activities for service users of both genders so that 'talk' can happen while engaging in an activity with a staff member, and this is less threatening for many young people.

 

The service has also developed a specific suicide risk chart for use with young people in view of the service user group's high risk of self-harm and suicide. This chart enables the worker to map changes to a young person's emotional and mental health.

 

5.6 Below is an example of a service that builds a responsive approach that is based around the needs of the young person, and aims to provide them with stability. We know that continuity in a young person's life is the key to promoting their emotional well being and to enable them to form positive relationships with their carers and thus leading to more positive outcomes in their lives.

 

5.7 Case study: Multi-disciplinary Intervention Service Torfaen (MIST), Wales

MIST is a service based, network-managed CAMHS project led by NCH Cymru. This radically innovative service model has been further refined in the light of several years of operational experience. The young people MIST works with have had multiple placements leading to out of county or secure unit placements due to their needs in terms of emotional wellbeing, behavioural control and relationships.

 

The operational elements of the MIST service are the multi disciplinary members of the MIST team, highly committed foster carers and the wider network of professionals involved with the young people.

 

The MIST service forms a team around the child and provides support and advice 24 hours a day; by delivering this service NCH has reduced the out-of-county residential population from Torfaen from 13 in 2003 to three in April 2007.

 

Given the complex and widely variable situation of the young people MIST works with, it is difficult to categorise outcomes, but in its first three years the project has achieved significant changes for the children, young people and their families they have worked with.

CONT

 

 

These include:

 

the reduction of risk taking behaviour and episodes of self harm by one young user, who now no longer runs away from her carers;

the reduction in the number of young people involved in the youth justice system;

preventing young people from entering youth custody;

maintaining young people in their educational placements;

ensuring placement and stability for the children and young people in the project, which had a positive impact on placement and stability generally in the looked-after-children population;

a reduction in the need for children and young people to be placed outside their communities, which has led to improved family relationships and parental emotional health and wellbeing.

 

6.0 Transition to adulthood - leaving care

6.1 The issue of leaving care is very important and it is pleasing to see the high level of attention it is given in Care Matters. These children and young people should not be confronted with a 'cliff-face' at key transition stages whereby services end entirely or change considerably. Such a disruption is particularly significant for those young people who enter the care system later on in their childhood and for who continuity and consistency is particularly important.

6.2 We very much welcome the proposals around lengthening young peoples' contact with mentors or foster carers.

 

6.3 Nationally young people leave home on average at the age of 24 and most people experience two or three attempts at leaving home before finally leaving. If the government is serious in raising the standard of corporate parenting and fostering so that it is genuinely a positive experience we need to design a system that reflects the needs of young people to move gradually towards independence over a longer period of time - just like their peers who are not in care. We know that these arrangements will take time to bed in and we would be keen to see how these proposals work out in practice.

 

6.4 We support the way in which the government is addressing issues around leaving care through providing longer term access to mentors and foster care, and the needs of older children on the edge of care through Multi-Systemic Therapy.

6.5 NCH is of the view that, given the vulnerability of those leaving care, there should be a specific emphasis on supporting the need to learn skills and to find employment or training - for example apprenticeships.

6.6 Support services - We would like to see additional support for services that prepare young people for leaving care by training them in the life skills that they will need whichever route in life they take. NCH has developed several services that get young people ready for life after being in the care system.

6.7 For example, through partnership with Norwich Union we have produced a leaving care resource pack. We believe that resources should be made available to all young people preparing for adulthood. Over 12,000 copies of our leaving care resource pack have been distributed to-date. In addition our Youth Build programme provides a positive way of developing life skills and is an example of how the commercial and voluntary sectors can work together.

 

 

6.8 NCH Youth Build

 

NCH Youth Build is a pre-vocational programme of support for young people aged 16 - 24 for entry into the construction industry. The service can offer a programme of support and training targeted at young people leaving care and socially excluded young people who may face challenges in entering and competing in the labour market.

 

NCH has particular experience in bringing employers together with young people not in education, employment or training to offer supported apprenticeships and training:

the NCH Youth Build initiative offers a model of how to work with young people from a range of socially excluded backgrounds including young people leaving the care system

through the NCH Youth Build scheme we have helped employers meet the training requirements of young people whose complex needs would otherwise present a barrier to complying with a duty to participate in training, employment or education.

 

NCH believes that without the appropriate support to help young people participate, the educational under-attainment and inadequate life-skills of many socially excluded young people will deter employers, colleges and training schemes from offering them the places they need.

 

Successes on the NCH Youth Build programme include:

an average 80% success rate into employment for vulnerable and socially excluded young people

of 42 young people who entered one NCH Youth Build programme, 30 are due to complete and move on into construction or some other form of employment

considerable savings of working with this cohort, for example, the annual cost for a male in a young offenders institution is estimated at 47k

 

NCH understands the key support needs of these young people; including helping secure accommodation, developing basic life-skills such as managing a budget, and acquiring the discipline necessary to train in the workplace, such as time keeping.

 

6.9 Another project has involved NCH working with Barclays Bank to help care leavers improve their money management skills, make informed decisions about their finances, and reduce money worries.

6.10 Financial Futures

 

Barclays Bank and NCH have undertaken a joint national initiative to help vulnerable and excluded people improve their money management skills, make informed decisions about their finances, and reduce money worries. Barclays will invest up to 1.8 million over three years in the 'Financial Futures' initiative with NCH.

Financial Futures aims to help develop better budgeting skills, minimise debt and plan more effectively for their future. It will also help disadvantaged young people to manage their finances and live independently.

CONT

 

As part of the joint work NCH audited our own projects in order to understand what the major financial literacy needs are, and to identify examples of best practice in projects that already do some activities to promote better understanding of money matters. On their part Barclays Bank has enabled thousands of its employees to volunteer for Financial Futures.

 

Their work, for example, includes Barclays employees having the opportunity to provide practical financial workshops to NCH service users, offering expert advice on issues like setting up a bank account, managing debts, dealing with an income or debt crisis, and prioritising spending. The target is to reach 3,000 young people, parents and carers using NCH services over the three-year period.

 

6.11 These projects are all part of our commitment to ensuring that young people in care are equipped with the life skills they will need after leaving the system. The programmes noted above have been made possible through NCH working with private sector companies harnessing their Corporate Social Responsibility and skills for the benefit of or care leavers. However more support could be provided by central and local government to ensure that schemes such as these are available to all care leavers who need them.

For further information, please contact Samantha Windett, NCH Parliamentary and Public Affairs Officer on 020 7704 7155 or samantha.windett@nch.org.uk

 



[1] NCH is the UK's leading children's charity. We run nearly 500 services and work with more than 178,000 children, young people and their families across the UK (as at April 2007), some of the most vulnerable in our society.

[2] The Longer Term outcomes associated with families who had worked with Intensive Family Support Projects: Sheffield Hallam University on behalf of the Department for Communities and Local Government and the Department for children schools and families: Jan 2008