Letters to 6 November 2008 Community Care

Fostering figures tell part of story

The question was asked: “Why are so many councils still putting children through multiple placements?” (“Moving stories”.

Perhaps the Independent Children’s Home Association should have had heeded the maxim: “Do not put your faith in what statistics say until you have carefully considered what they do not say.”

In 103 local authorities, at least one child has experienced more than 10 moves. A shocking statistic but what does it not say? It doesn’t tell us that most children are successfully attached to their foster carers. It doesn’t break down the proportion of placement breakdowns between fostering and residential care.

It doesn’t tell us the age or gender of the children the age at which they were accommodated the reason for this nor, indeed, does it tell us the type of first placement or later placements.

A council that considers its primary focus of care to be the residential home is a rare one. The success of foster care has risen in direct relation to that of stability in placement, better experiences in care and better long term outcomes. Local authorities want to provide children with a positive experience of family life that they can take with them into adulthood.

Increasingly, residential care is sought only for those children who have either come into the care system late and reject an alternative family, or those children whose needs are too great to expect to be met in any family. Placements tend to fall into one of two categories: the first is the crisis model, where everything else has been tried and failed the second meets those high-level, complex needs.

Given this, it is not surprising that the independent residential providers experience high levels of instability among the children they care for. The providers need to decide which sector of the market they will concentrate and organise their service to meet the needs of the commissioner.

Ruth Love, Ossett, West Yorkshire

Means-testing the German way

“Do we have the means?” cites Germany as having non-means tested adult services. This sounds good but, as often, the devil is in the detail.

In Germany, the working population and also pensioners pay a percentage of their income, in addition to other contributions, into the care insurance system to finance it. You have to be a member of the health insurance to receive funds from care insurance.

To be assessed as having the basic level one need, you need to have help with basic functions (hygiene, eating, mobility) of at least one-and-a-half hours a day at least 45 minutes of that have to be for at least two of the basic functions. The time corridors that assessors have to apply in their assessments are strict (for example, 25 minutes for a full body wash is the maximum that is applied).

The sum that is currently paid to an informal carer for level one is £170 a month (£3.77 an hour) and £333 for a care agency (which would be £7.40 an hour). Care insurance pays a maximum of 75% of your costs when you have to move to residential care (which would be £1,167 a month when you are assessed as having level three needs and in special cases it might go up to £1,389 a month). The rest must be paid from your income and/or from the income of your relatives, who by law have to support you financially if they can.

Only if all these sources fail would the state top up the rest of the costs.

I am sure Germany’s system has its pluses but I thought these details might shed a different light on what appears to be a “non means-tested” service in Germany.

I wonder how people in England would respond if the government charged older people 1.9% of their pension and the working population another 1% of their income to fund social care? Not to mention the legislative jungle that seems to have entangled itself to the care insurance in Germany.

Christine Strohmeier, London

Registration key to cutting abuse

Jeff Jerome says “many incidents of abuse involve care staff who are registered with the GSCC” (“Nearly all adult social workers want personal assistants to be regulated”. )

This view is probably influenced by the fact that, through regulation, we have been able to highlight misconduct and the action we have taken against those who commit it.

However, at the moment we only register social workers so incidents of abuse involving other social care workers are unreported.

Concern about abuse against people who use social care services was a factor in the government’s decision to register the entire workforce over time. Through registration we can take action against anyone found to have committed misconduct, and remove an individual from the workforce in the most serious cases. Without this, perpetrators of abuse can work elsewhere, putting others at risk.

The next group to join the register will be those working in home care and we look forward to the government’s final decisions about how and when we will open the register to these workers.

Sir Rodney Brooke, chair, General Social Care Council