Thousands of children enter the care system every year in the UK. While generic fostering services aim to meet most individual needs, specialist foster services fill in the gaps. A child or young person may have to be fostered through a specialist agency because of their religious or cultural background, their health requirements or even their sexual identity. Ensuring carers have the necessary skills can prevent placement breakdowns. Barbara Hutchins, deputy chief executive of Baaf Adoption and Fostering, says specialist services developed because of the difficulty mainstream services had in recruiting foster carers from non-conventional backgrounds. "There is an absolute shortfall of foster carers for particular categories of children and young people."

Although the shortage of foster carers for children without additional needs is legendary, what can services do to recruit foster carers from specialist backgrounds? Hutchins says they must move away from being a service "that is largely based on the goodwill of the volunteers" by providing enough support - including financial help - 24 hours a day. The beauty of specialist foster care schemes, according to Ena Fry, young people project development worker at the Fostering Network, is that practitioners and foster carers working in them become experts with extra skills from which others can learn. Fry urges social care professionals to educate different communities about the workings of the UK care system and the role they can play.

She adds: "We need to look at what mainstream resources we have and how they can be improved to help children in specialist services."

Over the following pages we look at several specialist areas of foster care.   

Trafficked children  

The UK's only safe house for trafficked children has opened in southern England (news, page 10, 6 May). Operated by Integrated Care, the house has nine places for 16 to 18 year olds while under-16s go to specially trained foster carers.  

So far, the agency has one young person in its safe house. Integrated Care conducts a four-week assessment of each child's mental and sexual health and physical needs. 

The agency's UK trafficked children's resources manager, Lynne Chitty, says three potential foster carers in southern England and two in London have been identified.  

 A dedicated foster service is necessary for children trafficked into the UK, usually to work in the sex industry or as domestic slaves, because of their unique circumstances.  

Chitty says: "If we don't understand the dangers for trafficked children they are not going to be safe with an ordinary foster carer. The greatest risk for trafficked children is that they will go missing from their placement. Trafficked children are likely to contact their trafficker as soon as they can reach a phone because they fear for their and their families' lives if they don't." 

Chitty advocates closely supervising trafficked children, barring their phone use and not allowing them out on their own. She admits this degree of intensive work could discourage some foster carers but seasoned carers may be up to the task.

Treatment Foster Care   

Southampton Council is one of 10 English local authorities taking part in a pilot to move young people with challenging behaviour from residential care into intensive foster care.  

The scheme, funded by the Department for Education and Skills, is being operated by south London's Maudsley hospital over three years. Councils have to bid for funding. The first grants were awarded at the end of 2003 and Southampton Council was awarded £400,000 in the second round.  

Southampton's foster care team manager, Leigh Clark, says the local authority became involved because it is always looking for new ways to tackle problems. Due to be launched in October, the Treatment Foster Care Project aims to accommodate six children aged 12 to 15 in foster placements for 18 months. To be eligible the children must have had multiple placements or be in care outside Hampshire. The council is now recruiting and training foster carers willing to take on these challenging children and is offering a salary of up to £29,000 a year as an incentive.  

Southampton's fostering recruitment officer, Jeanie Lynch, says placing children in out-of-county residential care costs the council up to £5,000 a week. She believes the scheme will reduce these costs and return young people to their communities.  

Clark is confident the pilot will improve the authority's overall fostering services: "Any development work we do will have a knock-on effect on our mainstream fostering service. We can learn from it and so can other professionals and foster carers."

Islamic Fostering Service   

After nearly two years in development, the Islamic Fostering Service, part of the Foster Care Link agency, was launched at the end of April. The scheme was started because there are an estimated 2,000 Muslim children in the care system and not enough appropriate foster carers.  

Co-director Ismail Amaan says the Muslim community is in denial about their children going into care, which accounts for the low number of foster carers, even though the prophet Muhammad was an orphan who was fostered as a child. 

He says religion plays an important part in a Muslim's life but this can be forgotten when Muslim children are fostered by people who do not share the same faith. "Preserving the child's identity and ensuring they have continuity in their lives can be done by a specialist agency," Amaan says. "Sometimes it is just impossible for social services departments to develop these needs because they do not have the necessary insight." 

So far, the London-based agency has 14 Muslim carers from different ethnic backgrounds on it books and is currently placing three children. It advertised for carers by e-mailing its details to Muslim professionals. It is also advising local authorities on how to best help the Muslim children in their care. All the service's policies and procedures, including culturally sensitive training for foster carers, include an element of Islam.

HIV/Aids   

Fosterplus provides general foster placements in England, Wales and Scotland. It also represents Debbie Lewis*, a foster carer who specialises in caring for HIV-positive children (see case study). It is trying to place more HIV-positive children with her as she has two empty places. 

The private foster agency pays an allowance for each child as well as fees to the carers. It pays more than £300 a week for foster children without any additional needs while those caring for children with complex needs receive more than £400 a week. Each foster carer also has an hour's supervision every fortnight with a social worker in their own home.  

Peter Ratcliffe, an area manager for Fosterplus, says the agency pays more money and provides more supervision than some local authorities.  

The agency is often asked for foster carers to look after autistic children but it does not have enough carers with the right skills. Ratcliffe says: "People do lack the skills and the inclination to learn them. Looking after an autistic child is challenging and some families may feel they may not be very good at it when in fact they could be."  

The company tries to address this by advising some of its foster carers that they may become suitable for more specialist placements as they are trained. Ratcliffe says: "Ordinary fostering is challenging but when people are prepared to foster a child with different needs it is brilliant because these children desperately need it."

Case study   

Debbie Lewis* knew her family's secret was out when eight of her neighbours gathered, screaming abuse, outside her house one morning four years ago. They had discovered her foster son, Michael*, then six, was HIV-positive and they were very angry. "They were shouting 'He's got Aids and we don't want him in our village'. It was like a modern day lynching."  Fearing for their lives Lewis grabbed Michael, his medication, her 12-year-old son, Jack*, and their dogs and fled in the car. She only returned to the village a few weeks later to organise the sale of her home. Now the family live in a town elsewhere in south west England and no one, bar two friends and some professionals, know about Michael's status. He and Jack only discovered it that day. "Michael told me: 'I just want to be human like the rest of the children. I feel like something out of the rubbish'."  Lewis became Michael's foster carer when he was five after his natural parents died from an Aids-related illness and he was placed with her by her local authority. Two years ago she took out a residence order on him. "He is my beautiful child and I love him to bits," she says. 

She had always wanted to be a foster carer and decided to build on her career as an HIV specialist nurse and combine the two. Lewis ensures Michael takes his drugs at the correct time and her home is equipped with a special water filtration system required by immuno-suppressed children. She also provides regular respite care to other children with HIV and hepatitis. 

Specialist foster carers dealing with HIV-positive children need to be aware of the social stigma the disease attracts. "It is an isolating illness and you have to remember that people pass information on," Lewis says. She believes foster care providers should create a network of support for specialist carers, something in which she would gladly be involved. "At the beginning it would have helped to say to someone else 'How did you cope with this?'."  

* Names have been changed