Memorandum submitted by Action for Children
(formerly NCH)
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.
— 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;
— the Government addressing the needs
of vulnerable groups of young people in the care system, specifically
young offenders and unaccompanied asylum seeking children;
— work to promote emotional health
and wellbeing for young people in the care system; and
— 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. 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; and
— 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.
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% 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% 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% 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. 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 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. 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; and
— 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;
— 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; and
— 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.
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; and
— 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. 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; and
— 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; and
— 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.
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 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.
February 2008
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. Back
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: January
2008. Back
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