House of Lords - Adoption: Post-Legislative Scrutiny - Select Committee on Adoption Legislation

Adoption: Post-Legislative Scrutiny - Select Committee on Adoption Legislation Contents

Chapter 7: Post-Adoption Support

The case for post-adoption support

207. The Adoption and Children Act 2002 introduced an entitlement for adoptive parents and their children to request and receive an assessment of their adoption support needs.[227] However, there is no requirement for those needs, once assessed, to be met. Provision of support is at the discretion of local authorities and thus varies considerably. The evidence we have received almost universally calls for an entitlement to support to be introduced.[228]

208. As outlined in paragraphs 16 and 20, the nature of adoption has changed over recent decades. Most children are now adopted from care and often have complex needs due to their early life experiences. The impact of such experiences will vary depending upon the age of the child, the length of exposure to maltreatment and the severity of abuse. The effects may be compounded by experiences in the care system, where delay and frequent placement moves can leave children bewildered and mistrusting of adults.

209. The formation of consistent relationships with their new adoptive parents, allowing them to form new attachments, was described by mental health practitioners as "the ultimate aim" of adoption for these children."[229] Adoption alone, however, did not address these problems. Lynn Charlton, Chief Executive of After Adoption explained that children's complex histories and associated needs did not "get wiped out with the making of an adoption order."[230]

210. Adoptive parents could struggle to deal with challenging behaviour, which might not become apparent until some time after the adoption had taken place. Difficulties often emerged at times of transition in a child's life, such as moving from one school to another or entering adolescence. There is evidence that some adoptive parents were reluctant to seek help when problems first emerged because they were afraid of being judged or perceived as failing. [231]

211. The availability of support was considered critical for sustaining adoption placements and this was especially the case for disabled children, older children and children with complex behavioural needs.[232] Failing to provide the necessary post-adoption support services risked a family breakdown and the possible return to care of an already damaged child.

212. Concerns over the cost of providing post-adoption support needed to be balanced against the wider cost of a failed adoption, including the cost of accommodating a child into adulthood.[233] The Department for Education indicated that a child who had experienced a breakdown may have additional support needs and the cost of accommodating a child post-breakdown might therefore be far greater than for a child with no experience of breakdown.[234]

213. There is evidence that children who grow up in care are more likely to join the population that is not in education, employment or training, therefore presenting an additional future burden to the state in terms of benefits, and possibly health and criminal justice services.[235] Adoption provides lifetime gains in enhanced employability and a reduced burden of state support in both childhood and adulthood.[236]

214. A good case can, therefore, be made for investing to save with post-adoption support. We agree with Tim Loughton MP, that "adoption support services are greatly underestimated and it is a false economy not properly to invest in them."[237] The "ultimate cost" is when an adoption fails.[238]

215. Children adopted from care have a range of needs due to their early life experiences which are not resolved simply by being adopted. As a result adoptive parents face challenges that many other families do not. Adoptive parents perform a vital social function in caring for very vulnerable and often damaged children, and thereby save the state money.

216. The failure of adoptive placements can be extremely expensive for local authorities in the short and long term, as well as causing significant harm to the children concerned. Well-targeted support services have the potential to ensure placement stability and to avoid these costs.

217. We believe that adoptive parents should receive greater and more consistent and continuing support. Calculations of cost need to take into account the contribution which support services make to preventing adoption breakdown and the associated costs. To support this, we recommend the Government commission an independent cost-benefit analysis setting out the cost of breakdown against the cost of providing support.

218. Post-adoption support was also considered critical to attracting more adopters to come forward: "where there is a guarantee of adoption support available this significantly increases the enquiries from prospective adoptive parents."[239] Many witnesses cited the lack of support as a reason for prospective adopters dropping out during the process.[240] We welcome the Government's proposal to make information about post-adoption support available through the National Gateway, which may help to address this issue.

219. In addition to enhancing placement security the provision of post-adoption support has been shown to increase the number of adopters coming forward. We believe that the availability of such support would greatly assist with meeting the Government's objective of increasing significantly the number of prospective adopters.

The needs of adopted children

220. It is difficult to establish with any certainty the level of support generally required by adopted children: there is no central data collection of the levels of need assessed by local authorities, or indeed of the services offered. We asked the Department for Education for assistance but no such figures were available.

221. The evidence we have received from specialist post-adoption support agencies demonstrated that not all children will have the same needs, and that their needs will change over time.[241] There was widespread support for the notion that adopted children should have priority access to Children and Adolescent Mental Health Services (CAMHS). It is, however, worth noting that both After Adoption and PAC reported incidents of adoptive parents experiencing attitudes from CAMHS practitioners which were not considered "adoption-sensitive."[242]

222. The Government promised, in January 2013, to improve access to services by commissioning new NICE guidelines on attachment, raising awareness amongst health professionals of the behavioural issues that some adopted children face, and encouraging commissioners of services, including CAMHS, to recognise and address the needs of adopted children. We welcome these proposed measures.

223. Education was a key area for support identified by the adoptive parents that we spoke to.[243] In many cases parents had battled for school places for their children, becoming frustrated with bureaucracy and a general failure to understand the special needs of adopted children. In one case a child had been out of school for a significant period of time due to being adopted from a different local authority area. We understand that under the new School Admissions Code adopted children now have priority access to schools, just as children in care do.[244] This is to be welcomed.

224. The adopted children whom we met also referred to a need for more support with regard to their schooling. Many had been subjected to bullying on the grounds of being adopted: "People say 'your parents didn't want you and that's why you're adopted'."[245] Many felt that teachers did not take this seriously, or understand the issues likely to be faced by an adopted child. There were disturbing anecdotes of adopted children being criticised by their teacher for being unable to complete the task that had been set for them: creating a family tree. Many of the children felt that teachers and pupils needed to be educated about adoption and its effects.[246]

225. We welcome the new School Admissions Code which gives adopted children, along with children in care, priority access to school places from September 2013. In order to safeguard further the wellbeing of adopted children we recommend that the Government extends the current duty on schools under the Children and Young Persons Act 2008, to appoint a designated teacher to promote the educational achievement of looked-after children, to include adopted children, with a specific remit to educate teachers and children about adoption and its effects.

THE GOVERNMENT PROPOSALS

226. We noted the Government's proposal for post-adoption support, published on 24 December 2012, as part of which an Adoption Passport will be made available. This will outline current legal entitlements, such as the right to have needs assessed; priority access to schools from 2013; and free early years education for two year olds from 2014.

227. We welcome the promised introduction of professional learning material on issues faced by adopted children, and we urge the Government to extend this to all staff working in schools in order to raise awareness amongst teachers and children.

228. There is also a commitment to provide prospective adopters with new learning materials on therapeutic parenting skills and the common issues faced by adopted children. In light of the particular needs of children adopted from care, highlighted in paragraphs 208-210, this may not be adequate for some families who may require more focused and specialised support.

229. The Children and Families Bill, published on 5 February 2013, includes a clause giving adoptive parents (and those who have been adopted) the opportunity to receive a personal budget to meet their support needs. The clause does not create a duty on local authorities to provide post-adoption support; the section applies only where "a local authority in England decide to provide any adoption support services to a person."[247] We welcome any opportunity for adopters to play a greater role in selecting and securing the services that they believe are required for their child. We do not, however, believe that this measure alone will meet the support needs that we consistently heard about in evidence.

230. As detailed in paragraph 207, the Adoption and Children Act 2002 introduced a duty upon local authorities to assess the need for post-adoption support, but did not introduce a duty to provide services to meet those needs once assessed. This was consistently identified as a shortcoming of the Act; many witnesses suggested that a statutory duty to provide post-adoption support services was also required.[248]

231. We were told that such a duty could not apply solely to local authorities; the LGA argued that "the question of post-adoption support should not be restricted to only local government, but [should] also give consideration to the role of other public services such as Child and Adolescent Mental Health Services and schools."[249] We agree that the provision and financing of post-adoption support should not be seen as a matter solely for local authorities.

232. Mark Rogers, Chief Executive of Solihull Metropolitan Borough Council, highlighted the partnership work of Children's Trust Boards[250], underpinned by a statutory 'duty to cooperate' contained in section 10 of the Children Act 2004. Mr Rogers suggested that local authorities and clinical commissioning groups should be subject to a similar 'duty to cooperate' in the provision of post-adoption support.[251]

233. We welcome the Government's proposals for post-adoption support, but we regret that they fall short of a statutory duty to provide the support needs as assessed. There should be a statutory duty on local authorities and other service commissioning bodies to cooperate to ensure the provision of post-adoption support; this should include appropriate access to health, education, and Children and Adolescent Mental Health Services, and other services as necessary. These entitlements should form part of the Adoption Passport.

Support for children subject to Special Guardianship Orders and kinship care placements

234. Adoption is not right for all children in the care system; we have already discussed the variety of permanence options available and the importance of choosing the right route to permanence for individual children. Children in Special Guardianships and kinship care are also likely to have complex needs due to their early life experiences.

235. Special guardians and kinship carers receive little of the training and preparation that is given to prospective adopters; they also receive few of the benefits and financial support arrangements that foster carers receive. Several of our witnesses expressed concern that such carers were struggling to meet the needs of the children in their care.[252] Many kinship carers have to give up work in order to care for children because, unlike adopters, they are not entitled to paid leave when a child comes to live with them.[253] The profile of kinship carers and special guardians is older (they are often grandparents[254]) and poorer than the average adopter.[255] In addition, they often have to manage complex contact arrangements, where the birth parent seeking contact may be their own child; a study of special guardians found that 60% were seeking assistance with contact arrangements.[256] A survey by the Kinship Care Alliance found that 68% of respondents who sought help from their local authority did not receive the services they required.[257] The Family Rights Group summed it up as follows:

258

236. Children being cared for by special guardians and kinship carers are as vulnerable as those who are adopted from care. Special guardians and kinship carers are performing a valuable social service, just as adopters do, but often with fewer resources at their disposal, and less preparation and support. The service which they provide saves the state money. The failure of such placements would be extremely expensive in the short and long term.

237. Children in special guardianship and kinship placements deserve the same support which we recommend for adopted children. We therefore recommend that our proposed statutory duty on local authorities and other service commissioning bodies to cooperate to ensure the provision of post-adoption support should be extended to include formerly looked-after children in other permanent placements, such as special guardianship or kinship care.

Post-adoption support for birth families

238. Under the Adoption and Children Act 2002 the categories of persons entitled to an assessment of their support needs includes the birth parents of any adopted child. As with adopted children and their adoptive families there is no need to provide the services once the needs have been assessed, and provision is therefore patchy.

239. We were told that many birth parents will experience the removal of a child as bereavement. Most birth families needed emotional support to enable them to process what had happened to them.[259] The absence of such support could have a "profound impact on how they might seek to mitigate that pain...so that it is very difficult for them to then function as citizens in our society."[260]

240. Without the possibility of dealing with feelings of anger and loss, and a proper understanding of how their lives needed to change to be able safely to parent subsequent children, there was a dangerous pattern that emerged:

261

241. The importance of independent provision of support to birth parents was stressed in the evidence. Some local authorities contracted the work out to an adoption services agency, and this was considered beneficial: many birth parents found it traumatic to visit the social services department of their local authority—it may be where they last had contact with their child prior to the adoption.[262] And no matter how good the provision of support, when it was delivered in the context of the local authority, parents continued to feel that it was part of the process that had led to their child's removal and they continued to feel judged.[263]

242. There is evidence of the positive impact which counselling can have on the future behaviour of parents who have had children removed. PAC reported on a project working with birth mothers in prison; all of the women on leaving prison had either decided not to have another child, and 12 months later had not, or they had had subsequent children but had been able to change their lives sufficiently to be able to keep them.[264]

243. The role of early intervention to address parental problems, which we considered in paragraphs 61-71, is relevant here. Early intervention programmes aim to prevent the removal of children, where it is safe so to do. Support for birth families after removal is at the other end of the spectrum, where such efforts have failed. But the purpose is the same—to break the cycle which leads to more children being born into families that are not able safely to parent them.[265] Where early intervention has not been effective and the removal of a child has been in that child's best interests, there is very good reason to engage with the birth family to prevent subsequent children from suffering the same fate.

244. Many parents who have had children removed go on to have subsequent children, who then also become involved with the care system. This adds to the burden placed upon social services and the state. Providing support services to birth families whose children have been removed should be seen as an essential step in breaking the cycle which leads to more children being born into families that are not able safely to parent them.

245. We believe that resources invested in birth family support in the short-term will produce savings for the state in the longer term. We therefore recommend that the Government should establish a pilot scheme to provide post-adoption support to birth families across a number of local authority areas to establish the benefits and costs of such provision.

Innovative funding mechanisms

246. In light of our recommendations concerning post-adoption support, we have considered innovative funding mechanisms, such as social impact bonds or community budgets, as possible vehicles to finance some of the necessary services.

247. A social impact bond is a type of contract in which public sector commissioners pay for an improvement in social outcomes (such as reducing the number of children taken into care, for example). Private investment is used to pay for an intervention, which is delivered by a practitioner with a proven track record. Financial returns are made by the public sector to the investor on the basis of improved social outcomes. Social impact bonds come in a variety of forms—they may be higher yielding to compensate for higher risks or tying up capital long-term, or they may be lower yielding to reflect lower risks; they may even have tax-relief built in for the investor.

248. A community budget, on the other hand, allows different local public service agencies—local authorities, police, health services, employment and benefit services and others—to work together in a local area, pooling funding and being released from some central government oversight. The intention is to address the needs of particular local service users—such as troubled families with a range of issues addressed by public services—in a more coordinated way. It is believed that such an approach could help to improve overall outcomes whilst also reducing the duplication of activity that currently takes place across different local services.

249. Central to both approaches is a solid evidence base to justify investment. It would be necessary to understand the support services required, the cost of providing those services and to balance those against the cost of adoption breakdown. A crucial figure would be the rate of adoption breakdown, since that would be the means for measuring improvements. As we have discussed in paragraph 201, these figures are not available.

250. While it is difficult to build a robust case for developing innovative financing for post-adoption support without such data, there is an easier case to be made for using service providers with a proven track record for finding adoptive placements. A new social impact bond, entitled 'It's all about me' has just been launched,[266] offering a service for finding adoptive families for children who are generally considered harder to place[267]. This work was acknowledged by the Government in Further Action on Adoption.[268]

251. Under the "It's all about me" scheme, local authorities can choose to approach a voluntary adoption agency from a provider list, including well known agencies with a track record of successfully meeting the needs of harder-to-place children. The service offered includes recruitment, training and support for the families and children involved. The support package is comprehensive, dealing with both practical aspects, such as advocacy on behalf of the families, as well as therapeutic interventions for the child and on-going training and support for the parents in dealing with the issues that arise with harder-to-place children.

252. Local authorities pay a premium for the service compared to the inter-agency fee, but not when compared to the costs of continued foster care, especially as the cost of care for those children who would be considered for the scheme is likely to be at the higher end of the spectrum. The social impact bond is a debt instrument offering a 4% fixed yield, paid quarterly, with capital repaid by year ten.

253. We believe the recently launched social impact bond for enhanced family finding is an innovative approach to finding homes for the most difficult to place children. It correctly balances the additional cost of the scheme against the cost of keeping children in local authority care until they are 18. We invite the Government to follow the progress of this social impact bond with a view to establishing what lessons can be learnt and applied more widely.

227 Adoption and Children Act 2002, section 4 Back

228 Oral evidence from Adoption Matters Northwest, After Adoption, BAAF, Intercountry Adoption Centre, Tim Loughton MP, PAC; written evidence from BASW, Nagalro Back

229 National Adoption and Fostering Service, South London and Maudsley Hospital Back

230 Q 451 Back

231 Q 129 Back

232 Barnardo's, written evidence. Parenting courses, which were recommended by both After Adoption and PAC, were also shown to have a positive impact on stability of placement. Back

233 Q 587 Back

234 The Department cited research which estimated the annual cost of a stable foster placement as £23k; whereas an unstable year in care, with various placements and periods in residential care, would cost £56k per annum; see Appendix 5. Back

235 Jim Clifford, written evidence Back

236 A 2011 study estimated the socio-economic gain secured by permanence in adoption at £800,000 per child adopted (Clifford, J., PACT Domestic Adoption and Fostering: SROI Evaluation, PACT and Baker Tilly, 2011). Back

237 Q 587 Back

238 ibid. Back