a sense of place

For many people who provide foster care for disabled
adults, the government’s new regulations, designed to raise the
overall quality of care, represent an unwelcome burden. They could
even prove self-defeating as carers decide to opt out. Natalie
Valios reports.

You have fostered disabled children for years with no problems.
They have become members of the family and you count them as your
own. They call you mum and dad. They turn 18 and want to stay in
the family home. The arrangement becomes an adult placement and
that is when the problems begin.

Adult placements are an alternative to residential care: a
flexible form of accommodation and care for vulnerable adults aged
18 or over who need support, such as older people, disabled people,
and people with learning difficulties or mental health problems.
Placements are provided by ordinary individuals and families in the
community, giving a vulnerable adult the opportunity to share in
the carer’s life.

Adult placements are based on the fostering model. Carers
provide a variety of services from long-term and short-term
accommodation and support in the carer’s home, to day care support,
befriending, sitting services and support to people in their own
homes.

Before implementation of the Care Standards Act 2000, two groups
of adult placement carers were exempt from regulation: those who
cared for somebody who had been “ordinarily resident” for more than
five years, that is former foster carers; and short break carers
who provided less than 28 days’ care a year.

The government decided against carrying these exemptions forward
into the new regulatory regime. And while Scotland and Wales opted
to regulate adult placement schemes – rather than individual adult
placement carers – in England the government ruled against this
approach. The upshot is that all adult placement carers providing
accommodation and personal care in their own home in England now
have to register with the National Care Standards Commission. A
separate set of 30 national minimum standards for adult placements
are designed to take account of the domestic nature of
provision.¹

The outlook is worse for former foster carers who have not
registered with their local adult placement scheme, as they will
have to register as care homes and comply with the accompanying
more stringent national minimum standards.

Registration involves a one-off payment of £300 and then an
annual fee of £100. Former foster carers will face two
inspections a year, one announced and one unannounced. The main
carer will also be expected to gain an NVQ2 in care. These
conditions are causing distress to many former foster carers who
question their need for a qualification to care for someone they
regard as part of the family and whom they have successfully
supported for many years.

The freedom of the individual in the placement to stay with
other family members or friends overnight could also be curtailed
as they will also have to register. As a result, foster carers are
sometimes not continuing their placements after the person living
with them reaches 18, says Sian Lockwood, chairperson of the
National Association of Adult Placement Schemes (Naaps). “It is
also affecting the viability of some long-term placements that are
supported by short-breaks carers and is likely over time to have an
impact on the ability of some families to continue to care for
their vulnerable family member,” she says.

Ironically, while the regulatory regime is designed to ensure
consistent standards, these will continue to vary because some
services provided by adult placement carers remain outside
regulation, including home-based day care and befriending.

Naaps has 156 adult placement scheme members supporting 6,500
carers who provide services to about 10,000 vulnerable adults. It
supports the need for rigorous and appropriate regulation, but this
approach doesn’t sit comfortably with adult placements, says
Lockwood. The fear is that regulation will limit the flexibility of
services offered through adult placement schemes.

“My huge anxiety is that we are losing the very carers that the
government values, the good-hearted people who want to give someone
accommodation and support because they want to give back to the
community. They aren’t going into it as a business,” says Lockwood.
“If we aren’t careful, the only people left will be those who are
geared up to do this as a business. They are only one end of what
adult placements are about and the ultimate losers will be the
users who are left with no options.”

Gwylfa Evans, social services director at Oldham Council, is
well aware of the issue because one family in his authority has
been vociferous in bringing it to his attention (see panel). Evans
wants consistent standards but says registering individuals will
result in placements becoming institutionalised, which he is loath
to see happen.

Registering the scheme rather than the individual carer would
mean that the local authority would be responsible for maintaining
standards in the scheme and the standards authority would inspect
it to make sure it was doing the job properly.

“It would bring in good standards across the country,” adds
Evans.

Naaps accepts that for the time being the government has decided
not to regulate adult placement schemes. In the meantime, it wants
the government to reinstate the two previous exemptions – and it
has backing from the National Care Standards Commission. All three
are in talks, and Heather Wing, NCSC director of adult services, is
confident that the government will change its mind.

Former foster carers and short-term carers should have
registered by April but many have refused. Meanwhile, the NCSC is
stuck between a rock and a hard place. It played no part in
drafting the regulations, the act, or the minimum standards, and it
empathises with the plight of these carers. But it is legally
obliged to prosecute anyone who refuses to register. However, it is
in no hurry to use these powers before the government’s decision is
known. Wing says:”We want to be reasonable. We can’t abdicate our
responsibility to protect vulnerable people, but some people do
need to be taken out of the regulation approach.”

Unless this happens, the standards brought in to protect these
disabled people could be the very thing that leaves them more
vulnerable.

¹ Department of Health, Care Homes for Younger Adults
and Adult Placements, The Stationery Office, 2002

For more information go to www.doh.gov.uk/ncsc or www.carestandards.org.uk

Part of the family

Kathleen and Ray Navesey were approved as foster parents for
Janet Huxley 21 years ago. They met Janet when their daughter Adele
was in hospital having her appendix removed. Unknown to the family,
Janet had lived on the hospital’s children’s ward since she was a
baby. She has cerebral palsy and severe learning difficulties, and
needs 24-hour care.

A few weeks after Adele was discharged from hospital the local
paper ran an article on several disabled children who needed foster
parents, including Janet. Kathleen contacted Oldham social services
department to inquire about fostering Janet and after about a year
she came to live with them.

When Janet became 18, the arrangement transferred to the adult
placement scheme. Recently, workers from the scheme advised the
family on the need to register as an adult placement carer under
the Care Standards Act 2000.

Dawn Navesey, Kathleen’s other birth daughter, says: “Janet is
very firmly our sister. She is seen as a daughter, sister, auntie,
granddaughter within our family, not as a client in an adult
placement scheme.

“She is not cared for as a client but as part of a loving
family. My mum is not a “carer”, she is Janet’s mum in all senses
of the word.”

Janet’s opportunities to develop relationships, have a valued
role in the community and be loved as an individual have been
greatly enhanced by her being part of the family, says Dawn, who
manages housing services for people with learning difficulties at a
voluntary organisation. She believes the care standards are in
conflict with the ethos behind the white paper Valuing People,
which states that people with learning difficulties must have
inclusion, independence, choice and the same rights as other
citizens.

“I appreciate the need for standards to protect vulnerable
people but I feel that individual cases like Janet’s could be
addressed differently in a more person-centred manner,” she
adds.