Foster care: stability is the key

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Foster care: stability is the key

Despite there being obvious agreement between care professionals, commissioners and families that placement stability is key, there remains a single depressing fact about foster care

CAHMS needed to support fostering stability

Foster care depends upon stability

: the proportion of children moving placements three or more times in the last year, has not moved from around 11% since 2010. And for children’s social services, this is a key performance indicator.

When a placement works out for all concerned, the results – short, medium and long term can be positively life changing for all. Foster care families are at present providing care for some of the most neglected and vulnerable children in the country. This amounts to three-quarters of the 69,000 children in England who are looked after by social services. What is so frustrating is that the best of outcomes will always represent a sharp distinction between what is happening for children and young people who simply do not know what it is like to experience stability. Failed  placements can cause deep psychological wounds and emotional problems that become near impossible to reverse. This is especially the case when set against the well publicised shortfalls of CAHMS (Child and Adolescent Mental Health Services) to provide adequate support for children who are not in stable placements: the very group presenting with the greatest need.

The priority for social services across the UK is to make sure placements are stable: simplistic, yes, but the point has to be made that at least this key driver for success is clear and unambiguous. There have been many studies highlighting the negative psychological, social and academic ramifications of placement breakdown for children in foster care. Less investigation has been done in the past into how the care services can work, in a planned and consistent fashion to make a significant impact on the aforementioned stubborn 11% figure. Past studies that have been both quantitative and quantitative in approach, have shed light into the the key factors that affect stability. Placements that tend toward instability: these include children who are older, youngsters with a longer time spent in care, residential care as the first placement experience, experience of many different social workers and separation from siblings. Placements tending toward long term stability: a placement setting where the providers of foster care are older and more experienced, foster carers who already have strong parenting skills and placements where the children have the opportunities and support to achieve their educational potential.

A great deal of investigation and research continues into this area: another recent review; conducted by King’s College London, and South London and Maudsley NHS Foundation Trust – with financial support from Lambeth’s child and adolescent looked after service – analysed the international research on foster placement instability. The value of this exercise was  that it collated evidence from 58 separate studies – with 22 being from the UK – in order to define a set of factors that affect stability.

What emerged, unsurprisingly, was the crucial importance for a child, of a good long-term relationship with a social worker. This is vital for the management of the transition phase where the child/young person is placed in a new foster care setting. And predictably, where a child was exposed to a number of multiple relationships with different social workers the likelihood of negative outcomes significantly increased. Where the relationship with a social worker was enduring, far more scope existed for defining and achieving educational goals – as well as actively involving children in making decisions that affected them. It is also true to say, that the foster carers themselves benefit from a relationship with a social worker who they know is going to be a settled part of the foster care experience for them.

The review found what makes for good foster care outcomes

Effective preparation is crucial: foster carers – as well as any children they might already have -need to be well informed about the child/young person they are taking.

Education plays a huge role in determining the success of a placement. Where foster care parents, together with the social worker, can actively support a child, this can make a profound difference. Demonstrating engagement and working to raise a child’s expectations, can give them a sense they have; perhaps for the first time, a future.

It also indicated that avoiding residential care as a first placement increases the chances of a placement being successful. Looking across the studies that the review drew upon, it became apparent there was no link between stability and the frequency of contact with the child/young person’s birth parents.

Age is also a key determinant: adolescent children are more likely to have experienced placement breakdowns and they often present with behavioural difficulties and complex needs. What is important is the early recognition of mental health difficulties and referral to CAHMS for early intervention. The review commented:

‘One of the encouraging findings of our review is that much can be done to promote stability through careful selection, training and support of foster carers. The Personal attributes of carers like tolerance, persistence, flexibility and kindness are linked with more stable placements. Older and more experienced foster carers also tend to provide more stability.’

Conclusion

There have been many reports, reviews and investigations. What is apparent is that the factors  that are conducive to placement stability are not complex. What is complex are the accompanying considerations – funding, training and support. But perhaps the most far reaching issue to address is the entire service delivery model. We have at least the two most fundamental givens: the need for foster carers with very particular sets of attributes, alongside social workers available in sufficient numbers so a child or young person can rely upon one, at least, being a consistent and enduring presence in their lives.

And the good news at the end of this rainbow…we are moving on apace with our project to create a musical digital editing suite. This will enable our foster children to explore their musical talents, as well as support their interests in acquiring computing skills: there is much potential to relate skills gained back to core curriculum subjects.

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