news analysis of new adoption standards and interviews with Denise Platt and Sarah Mullally

(It may be advisable to print this document as it is
long)

The adoption register and national standards have arrived, but
while they are tested in pilot runs, tension still exists between
speeding up adoptions and finding and funding the right family.
Sarah Wellard investigates.

The ‘catch-up’ exercise for the adoption
register

All councils are required to take part in a “catch-up” exercise
to ensure records on children waiting for adoption and approved
adopters are up to date.

The DoH will facilitate local briefing sessions, after which
councils will be asked to review the cases of all children waiting
for adoption, and check whether there are any potentially suitable
adopters in the pipeline. Councils will then complete a register
input form for each child and approved adopter.

Quality Protects regional development workers will set up
meetings with groups of adoption agencies to share details of
children and adopters waiting in their region. Information about
children who wait the longest and parenting skills in short supply
will be analysed to inform a recruitment strategy.

Once local and regional action has been taken, details of
children and adopters waiting will be submitted to the national
register to generate possible links.

Department of Health, Paving the Way – The ‘Catch
up’ Exercise for the Adoption Register (Local authority circular
LAC (2001) 21, August 2001, available from www.doh.gov.uk/adoption

Draft standards

For adopted adults and their birth relatives:

– The welfare, safety, needs and wishes of adopted adults and
others concerned with the adoption to be the first
consideration.

– Adopted adults and birth siblings to be provided with
information by agencies about local and national support groups and
services.

– Agencies to advise and help adopted adults and their birth
siblings separated by adoption wishing to make contact with birth
relatives.

– Adopted adults and birth siblings who request information from
adoption agencies to receive response within three months.

– Adopted adults and birth siblings to be informed of their
right to make representations and complaints.

Department of Health, Adopted Adults and their Birth
Siblings – Draft National Adoption Standards for England and
Practice Guidance, DoH, August 2001

Two key elements of the government’s drive to increase
adoptions from care were put in place last week, with the launch of
the new national adoption register for England and Wales and the
publication of national adoption standards for
England.¹

Health minister Jacqui Smith confirmed that the three-year
contract to run the adoption register has been awarded to the
charity Norwood Ravenswood. The idea behind the register is to
reduce delays and increase the number of children adopted from care
by placing details of all children awaiting adoption and all
approved adopters on a central database.

Ruth Fasht, director of Norwood Ravenswood and the Norwood
Adoption Society, has no doubt the system will increase the chances
of children being placed. She says: “It’s so simple it’s amazing it
hasn’t been done before.”

She points out that the register will be more than just a simple
matching exercise: “A professional team will undertake what I call
the creative bit – the sensitive scrutiny of information from the
system. It will be child-centred. Suggested matches will be looked
at and discussed for their potential to provide children with new
families.”

A list of possible matches will be sent to the child’s social
worker, and it will be for them to investigate further. There will
be no charge for using the register.

What is not clear is whether ministers’ hopes of a large pool of
potential adopters will be realised. “We don’t know the number of
families in the voluntary sector waiting to adopt,” says Fasht.
“Very few voluntary adoption agencies have responsibility for
children, but they are often the first port of call for people
wanting to adopt.”

Fasht believes the system will also help focus the recruitment
process, by highlighting mismatches between children waiting for
adoption and approved adopters. It is widely believed that there is
a shortage of places for older boys, sibling groups and children of
mixed race, but no one knows for sure, because the data is not
collected.

Over the next nine months, existing information about children
and families will be submitted by councils and voluntary adoption
agencies for entry onto the register. This will be a three-stage
process, with the pilot phase beginning this month. Most of the
councils and agencies participating in the pilot are already part
of consortia sharing information regionally about children and
families. The pilot agencies are the South West Adoption
Consortium, the Manchester Consortium and three London
councils.

Westminster Council is one of the councils asked by the
Department of Health to pilot the register. Louise St John Howe,
cabinet member for social services on Westminster Council explains:
“We see the register as a continuation of the work Westminster is
already doing with Hammersmith and Fulham, and Kensington and
Chelsea Councils. We work together well, which is presumably why we
have been selected. We very much welcome the register and believe
it should help speed things up.”

Westminster regularly places children outside London where no
local family is available. Just over 7 per cent of children in care
in the borough last year were adopted, compared with just 4 per
cent nationally.

The government hopes the national adoption standards will tackle
variations in performance between councils and ensure more
consistent, high quality services. It is acknowledged that adoption
services have tended to be the preserve of the voluntary sector and
a few dedicated practitioners in local authorities. The new
standards should give adoption greater status and priority within
children’s services and also promote good child care practice more
generally by emphasising the importance of purposeful planning from
when a child first enters care.

The standards have been widely welcomed, but there are doubts
about whether the timescales can be achieved in practice. Under the
standards, a replacement family is supposed to be found within six
months of approving a child’s adoption plan. This may be reasonable
for a 10-month-old, but is hardly realistic for a 10-year-old with
complex needs.

There are also concerns that the expectations for the register
and national standards are unrealistic. Many of those working in
adoption believe there is no quick-fix solution to increasing the
numbers of children adopted from care, because the real problem is
the shortage of people willing to take on older children, who may
have disabilities or have been damaged by their early
experiences.

Research shows that children who have been taken into care
because of abuse or because of their challenging behaviour are at
risk of experiencing placement breakdown, whether they are placed
in foster care or are adopted. To make adoption work for such
children, sensitive and intensive post-adoption support is
needed.

Although the government has made available additional resources
for adoption services through the Quality Protects initiative –
some £66 million over three years – much of this is likely to
be spent on the front end of adoption to increase the number of
placements. Not much of this money is likely to be left for
post-adoption support, as Anne van Meeuwen, adoption adviser at
Barnardo’s, points out: “We need to address the provision of
support services and adoption allowances if we are to make a
significant difference to the numbers of people coming forward to
adopt,” she says.

Until now, the government’s review of adoption has focused
exclusively on the needs of children. So last week’s publication of
draft standards and practice guidance on adopted adults and their
birth relatives is long overdue.²

At the moment practice is patchy. Helping birth mothers and
siblings contact adopted adults is something of a grey area legally
because, although the Adoption Act 1976 allows adopted adults
access to their original birth records, no similar right was
granted to other members of the birth family.

The government is not proposing to change the law, as many
campaigners had hoped, but the new draft standards make clear that
agencies should be prepared to offer advice and help to people
wishing to renew links.

Ann Haigh, project leader of Barnardo’s counselling services,
wants to see a duty on local authorities that goes beyond acting as
an intermediary between adopted adults and their birth relatives
and encompasses provision of support services. Renewing contact
with long-lost relatives is a delicate and complex matter. Birth
mothers may set their hearts on establishing new relationships with
relinquished children, now adults themselves, but adopted people
may not want contact.

Haigh says: “The standards and guidance should improve
consistency and quality and that is very helpful. But it will still
be open to interpretation by individual authorities whether to
provide a service.”

As well as providing counselling for adults adopted through
Barnardo’s adoption agency, Haigh’s project also provides support
groups for birth mothers. Services like this don’t come cheap.
Barnardo’s and other voluntary sector adoption agencies, such as
the Children’s Society, fund this work out of voluntary income. But
when resources for post-adoption support for needy children are
already over-stretched, few councils regard providing services for
adults as a priority.

¹ Department of Health, National Adoption Standards
for England; Draft Practice Guidance to Support the National
Adoption Standards for England, DoH, August 2001.

² Department of Health, Adopted Adults and their
Birth Siblings – Draft National Adoption Standards for England and
Practice Guidance, DoH, August 2001

——————————————————————————————————————

Denise Platt and Sarah Mullally are in the driving seat
of social care reform. Talking exclusively to Lauren
Revans and Jonathan Pearce, the women describe where
they will be steering social work.

Last month’s shift towards a “delivery-focused” Department of
Health saw the tearing down of internal boundaries between public
health, the health service and social care. Significantly, this
involved the more integrated future of health and social care
services being placed jointly in the hands of the chief inspector
of the Social Services Inspectorate, Denise Platt, and the
country’s chief nursing officer, Sarah Mullally.

Together, Platt and Mullally will be responsible for the
development and direction of the care trusts which form the central
plank of the government’s modernisation agenda. The voluntary NHS
bodies were brought in under the Health and Social Care Act 2001 to
commission and provide delegated health and social care
functions.

Of the first nine care trust pilots announced last month, at
least five will focus on mental health issues. Under the
reorganisation, specific responsibility for mental health policy,
services and legislation lies with Mullally, along with policy on
health and social care for people with disabilities and long-term
conditions, policy on nursing, midwifery and health visiting,
policy on allied health professions and service user
involvement.

Up to four of the pilot care trusts will focus on older people.
Platt has specific responsibility for health and social care
services for this client group, as well as for children’s services,
maternity and health services for women, general social care policy
and the Social Services Inspectorate.

“We will work very closely together,” Platt says. “We work with
and meet together with the same ministers. Then together with our
ministers we talk to the secretary of state.”

Mullally says: “Historically, Denise and I have worked closely
together, not least on issues around older people, around children,
around discharges. With all of those, you can’t separate out what I
was doing before around nursing and user involvement from social
care provision. Older people is a good example – there are issues
for social care, for nursing, as indeed there are for user
involvement. People using those services don’t see those
divides.”

Until last month’s reorganisation, Platt was joint head of the
Department of Health’s social care group. She denies that social
workers and social work values will become lost in the more
integrated health and social care systems of the future, and
believes that although social workers will find themselves working
in a whole range of new environments, their identity as a
profession will remain intact.

“The challenge of the new agenda if you are a social worker is
that your career is not now going to be in something called a
social services department,” Platt says.

“Social workers are going to be in many different environments,
working with a range of professionals, and they’ll need to be
confident of their skills and what it is they offer.”

It is crucial, in her opinion, to identify the “unique
contribution” social workers can offer, and ensure they are trained
and deployed for specific functions while still able to influence
the wider social care agenda.

For Mullally, this will involve social workers revisiting the
ways in which they have traditionally worked.

“The boundaries are changing and that is something social
workers will have to contend with,” she explains. “There is an
issue for them around understanding how they utilise the breadth of
skills they have.

“There’s a responsibility around that in how we support people
through training, as well as listening to their concerns around it
and moving forward,” she adds.

Mullally cites social workers’ client-centred approach as one of
their more distinctive features. “If there’s a nurse or doctor
providing care, they will have a real focus on the individual. But
as you move up slightly in health they often become system-focused,
whereas I think social workers always remain client-centred. They
have a really strong ethos – their centre is very much community,
individual, social health.”

Aligning these different working practices is part of the
challenge of creating a more integrated service and placing service
users, patients and carers at the centre, Mullally states. “You
can’t underestimate that if you bring groups together they will
bring luggage with them.”

Platt suggests that social workers in diverse locations will be
able to “anchor their professional identity” in the General Social
Care Council and use the Social Care Institute for Excellence to
keep up to date with the latest social care ideas. The DoH
envisages her convening meetings with the heads of all the new
social care bodies to ensure shared thinking on the quality
agenda.

While accepting that the current difficulties facing social
services are partly due to pressures of rising costs in both
children’s and older people’s services, as well as the economy
pushing up salaries and wages, Platt believes it is also essential
to take a critical look at traditional methods of service
delivery.

“It is not yet entirely clear – and our Best Value reviews are
showing this – that the configuration of these services is in the
right balance. It’s not entirely clear that we’ve got all the money
in the right place to deliver effective services,” Platt
explains.

“Just to throw more money at it before we’ve really looked at
what we are asking services to do and how we are asking them to
deliver is the wrong way round.”

Part of the current cross-cutting spending reviews of children’s
services and public sector workforce will address these issues.

“You can’t deny that it is tough to supply services at the
moment,” Mullally accepts. The question, though, is why.