Care Matters: analysis of the green paper for children in care

Last week’s green paper on children in care has been broadly welcomed by those working in the sector but, as Lauren Revans explains, doubts remain over funding and suggestions of GP-style social work practices

It is not often you hear almost universal praise for the government. But that was certainly how the sector greeted the long awaited  green paper on children in care last week.

Inevitably, some of the proposals have raised eyebrows and will require much greater exploration. And, of course, there is the perennial issue about whether or not the necessary resources will be forthcoming to deliver on the paper’s ambitions.

But concerns that earlier drafts of the paper from the Department for Education and Skills had focused far too heavily on education have been addressed, and Care Matters: Transforming the Lives of Children and Young People in Care has been widely welcomed for its positive tone, breadth of vision, and focus on the workforce.(1)

Foster care
Perhaps the most unanimous support has been reserved for plans to “professionalise” foster care and allow children to stay in foster care placements up to the age of 21. As expected, the green paper calls for the introduction of a qualifications framework and fee structure for foster carers. But, to popular acclaim, it also suggests backing this up with a new mandatory foster carer registration scheme.

Care Matters proposes a tiered model of foster care placements structured around the needs of children, with foster carers being trained, skilled and paid according to children’s individual requirements.

Launching the green paper, education secretary Alan Johnson insisted salaries would be “more than just a token honorarium”.

However, DfES officials have already warned that only those providing specialist care would be likely to end up drawing a monthly salary.

Fostering Network chief executive Robert Tapsfield is prepared to accept this – providing “almost all” foster carers receive some sort of fee on top of their allowances, reflecting the work they do. These fees and allowances must also continue at the same level when children choose to stay on up to age 21, he adds.

Early thinking is that tier one foster care placements would be for children with “few additional needs relative to those outside care” and would therefore be suitable – according to DfES officials anyway – for approximately three-quarters of the 60,000 children currently in care.

Tier two placements are described as being for children with “some additional needs”, estimated at about 12,000, including unaccompanied asylum seeking children and some children with disabilities. Tier three would be for children with “severe or complex needs requiring specialist care” allegedly totalling only around 3-4,000 children in the care system.

However, Tapsfield believes most children in care have more than a “few additional needs”, and says much more work needs to be done on defining the tiers to ensure the framework is helpful.

“The principle that there’s a tiered framework is right,” Tapsfield says. “But, as it’s outlined in the green paper, I would not expect many children to fall into tier one.” NCB chief executive Paul Ennals believes tier-three foster care is likely to follow the approach of the treatment foster care model already being piloted for 10 to 16 year olds whose conventional foster care placements perhaps aren’t working or who are in residential units (see case study).

This intensive, structured programme is about reinforcing positive behaviour and involves daily contact between the foster carer and the multi-agency treatment foster care team.

However, while treatment foster care placements last only 12 to 18 months, Ennals believes tier-three placements would not necessarily be short-term.

“Some children continue to need high levels of support for a long time,” he says. “I wouldn’t want to assume that one tier of foster care is for short-term support and another for the long-term.”

Social work practices
If acknowledging and boosting the role played by foster carers is the most popular proposal, the idea of introducing “social work practices” has undoubtedly caused the greatest unease.

The green paper suggests that these practices would be run by voluntary or community organisations, social enterprises or private businesses along similar lines to GP practices.

Each practice would hold a budget, provided through a contract with a local authority, which would be used for individual social workers to fund the placement, support and activities for “their” children. Members of the practice would have a financial, as well as a personal, stake in the organisation.

The model appears to be based on an idea by the head of children’s social services at Lewisham Council, Alastair Pettigrew.

Writing in a report published this week  as part of the What makes the difference? project to identify ways to improve outcomes for children in and leaving care, Pettigrew advocates following the example of the medical and legal professions and establishing private social work partnerships for looked-after children in local areas.

For Pettigrew, the key benefits of such partnerships, or practices, are more freedom for the social worker and more stability for the child. “The social worker will be committed for the long term, not just because of the commitment to the young person, but because of the worker’s commitment to the partnership of which they are a member,” he writes.

However, many in the sector have serious doubts. They fear that putting a lot of functions out to contract could undermine the very values of corporate parenting which the rest of the green paper seeks to strengthen.

Hampshire’s children’s services director and Association of Directors of Social Services incoming president John Coughlan (pictured) points out that, while social services have a long history of embracing all sorts of models of service delivery, they have also been criticised in successive reports for “obscurity in lines of accountability”.

He has concerns the same criticism could be levelled at future use of social work practices to deliver local authorities’ corporate parenting responsibilities. “We have got to explore ways in which services can be delivered,” Coughlan says. “But our worry is that there may be a sense of experimentation with these social work practices that doesn’t understand this issue of accountability for the local authority as corporate parent.”

These sentiments are echoed by Ennals, who also warns that the independent social work practices would lack the local authority’s ability to prioritise access to other services for “their children”, such as child and adolescent mental health services.

“They would not have that power,” he explains. “They would be small provider bodies and organisations, good at meeting individual needs but not so able to move the levers that bring priority to services.”

Budget-holding lead professional
An alternative way of trying to free-up social workers and bring decision-making closer to the child is through the budgetholding lead professional model already being piloted by 16 councils across the country.

The paper proposes more pilots to test this model specifically in relation to children in care, using different levels of budget.

At least one local authority will look at whether the lead professional – who is likely to be the child’s social worker – could hold the funding for the full cost of a child’s placement.

Devon is one of the councils already piloting the budget-holding lead professional role. John Shaw, lead officer for joint agency services at Devon children’s and young people’s service, says he can see how the model could be developed to really help local authorities establish a sense of parenting in relation to children in care.

“Parents can access support or provide support for young people, so you need to look at how you can support children in care with truly personalised services that are more accessible, more local, more immediate. Access to certain levels of finance is critical in that.”

But, while few would argue with the budget-holding lead professional concept, the amount that should be devolved is a more contentious point.

“Certainly what we want to do is free up part of the decision-making within local authorities so social workers can make unilateral decisions in the way a parent would about things such as a child going on a school trip or buying a musical instrument,”

Coughlan says. “But, against the full costs of a looked-after service, these are small amounts of money.

“If you are talking about lead professionals being in charge of full budgets, that brings significant complexities. For some children, this is a significant amount of money. How do you manage the accountability and probity in such a system?”

Coughlan says he also fails to see how either the budget-holding lead professional model or social work practice model would be able to get to the heart of the central problem of such a large portion of the children in care budget being spent on a very small number of children. He warns that, while local authorities do at least manage to cap costs for some services, with fulllevel delegation costs could “spiral out of control”.

Funding
While publication of the green paper may have been met with praise, it was also met with one very large question: how will its many ideas be funded?

As is the custom with most government announcements these days, there is no mention of money throughout the document other than a commitment to take decisions on proposals “with cost implications” in the context of the 2007 comprehensive spending review.

However, despite assurances that the Treasury “does have a heart”, the education secretary has already played down these potential cost implications and implied that it is the system for children in care, rather than any lack of funds, that is the problem.

But, while improving the system may be part of the answer, few would agree that this is the whole solution.

“Certainly, there are question marks around the effectiveness of spend on service,” Coughlan concedes. “But there’s a preventive agenda within this paper. And you can’t achieve the preventive services in advance of closing down the intensive services. And you can’t reduce the number of children looked-after until we fund prevention.”

Key Proposals
Preventative Work:
● Develop work with families to try and keep children out of care wherever possible, using models including intensive wholefamily therapy and family group conferencing.
● Consider giving other agencies such as schools and health services access to the information on children in care held by social workers.

Corporate parenting
● Ensure all local authorities develop a pledge for children in care, setting out what they can expect to receive.
● Explore the feasibility of piloting new independent ‘social care practices’ which contract with the local authority to provide services for children in care.
● Pilot the budget-holding lead professional model for children in care.
● Replace the ‘independent visitor’ scheme for children who have little or no contact with their birth family with an ‘independent advocate’ scheme for a wider group of children in care.
● Ensure all local authorities set up a children in care council.
● Consider the idea of independent reviewing officers being employed by an independent agency instead of local authorities.

Care placements
● Introduce a tiered framework of foster placements, underpinned by a new qualifications framework, a fee structure, registration requirement, and revised national minimum standards.
● Pilot regional commissioning units to buy placements for children in care.
● Reintroduce a statutory duty for social workers to visit children placed in children’s homes.

Education:
● Consider expanding the use of boarding schools for children in care.
● Ensure that children in care do not move schools in years 10 and 11, unless it is clearly in their best interests.
● Allocate £500 a year per child in care for social workers to spend on supporting and improving their educational experience.
● Strengthen the role of the designated teacher for children in care.
● Pilot the role of a “virtual head teacher” who will drive up standards and report on progress in the education of children in care across a local authority area.
● Require Ofsted to carry out a regular inspection of how each local authority is meeting the educational needs of its children in care.
● Consider a new power for local authorities to intervene in schools performing poorly in relation to children in care.

Health:
● Ensure every child in care has a named health professional.
● Introduce screening for substance misuse as a routine part of regular health assessments for children in care.

Leaving care:
● Pilot a veto for young people over any decisions about moving on from care before they turn 18.
● Pilot allowing young people to continue to live with foster carers up to the age of 21.
● Top up the child trust fund of every child in care with £100 per year.
● Introduce a £2,000 national bursary for all young people in care who go on to university.

Case study
North Yorkshire is one of 19 councils piloting treatment foster care, based on a model imported from Oregon in the US. It is a very detailed, regulated programme for children with complex needs, where positive behaviour is given a value and young people earn rewards by demonstrating it.

Prior to the pilot, the council had already been running a specialist fostering scheme involving full-time, professional, fee-based foster carers.

Paul Reddiex, the council’s treatment foster care programme manager, describes the move from specialist fostering to treatment foster caring as a “wonderful leap up”.

“It compensated for some of the weaknesses we had in specialist fostering,” he says. “The carers never really had the clinical input and direction that treatment foster carers receive. We never really had the time to develop their training and skills in
the way I would have liked.

“It’s a really excellent, supportive model, and the carers like it. They feel like they have a toolkit; something to work with. With conventional fostering, we tend to place damaged young people with foster carers without giving them a clear idea of
how we want them to parent. But the Oregon model is very clear about ‘this is how we want you to do it’. And I am reasonably optimistic that we will see some dividends.”

Pam Langley, 60, is one of North Yorkshire’s approved treatment foster carers. After running her own business in the hotel trade for 22 years, Langley sold up and got involved in youth work, and then spent two years working for the Entry to Employment scheme assisting school leavers. It was through this work that she heard about the treatment foster care scheme.

Langley describes herself as a professional foster carer and although she says the £400-a-week fee is peanuts, she sees this as inevitable. “It’s not only full-time employment,  it’s 24 hours a day, seven days a week – and when you break that down to
hourly pay, that’s not a lot.”

Additional information
(1) Care Matters: Transforming the Lives of Children and Young People in Care, DfES, 2006

Contact the author
lauren.revans@rbi.co.uk

This article appeared in the magazine, issue dated 19-25 October, under the headline On the right track