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Care Crisis Review - Options for Change
This briefing summarises the report Care Crisis Review - Options for Change. The briefing covers all parts of the report and the options for change are fully set out. This is a substantial piece of work worth considering in depth and which should help influence the development of policy and practice.
There are related reports which provide a wealth of background detail supporting the analysis in this report and the options for change including survey results from work with parents, children and professionals working in the sector. All the reports were published in June 2018. They are available at: http://www.nuffieldfoundation.org/news/sector-led-review-care-crisis-launches-today.
Summary of: Care Crisis Review - Options for Change
Section 1 - The Care Crisis Review
The Care Crisis Review was launched as a direct response to the challenge made by Sir James Munby President of the Family Division of the High Court in 2016 when he said “We are facing a crisis and, truth be told, we have no very clear strategy for meeting the crisis. What is to be done?” The crisis Sir James Munby was referring to, was the rapid and large increase in care order applications which reached record levels in 2017. Since 2007 public care applications in England have risen from just over 1,500 per quarter to over 3,500 in 3 out of 4 quarters in 2017. The number of looked after children has been rising steadily since the early 1990s, except for a period in the mid-2000s. Rates per 10,000 in England were just over 40 in 1994 and were over 60 in 2017. The increases in Wales have been as large and in the case of looked after children, rates have doubled in the same period.
These statistics have led to growing concern across the sector about the capacity available to the system to meet the additional demands. The concern is shared and echoed by bodies such as the Local Government Association (LGA), Association of Directors of Children’s Services (ADCS), The National Audit Office, the All Party Parliamentary Group for Children (APPGC) and the Chair of CAFCASS. Third sector organisations have also been vocal in expressing their concern.
The review was funded by the Nuffield Foundation. The Family Rights Group undertook a scoping exercise to inform the review. The review was sector led and brought together across England and Wales: the judiciary and local government, CAFCASS and CAFCASS Cymru, third sector organisations and alliances, the Offices of the Children’s Commissioners, Ofsted, Lawyers and social care practitioners and young people and adults with experience of the care system. The review aimed to be both inclusive and collaborative.
The review recognises the value for children and families of care episodes and court proceedings. It says:
“Discussion about change can sometimes run the risk of implying that everything is wrong with what is happening at present. This is not the starting point for this review’s focus on care episodes and court action. The use of care and the family courts are right for many children…..Similarly, parents and other family members point to the help they receive for themselves as well as their young relatives from those working in the children’s social care and family justice system. These sentiments were acknowledged throughout the work of the Review.”
The review has produced options for change across the system.
How the review was conducted
The review was chaired by Nigel Richardson former Director of Children’s Services for Leeds City Council and facilitated by the Family Rights Group. Work included an academic review of evidence. A stakeholder advisory group was established to steer the review’s activities. Over 2,000 people across England and Wales took part in the review through discussions and other means that enabled a wide range of contributions from the sector, family members with knowledge of the system, adults who spent some of their childhood in care and children and young people in care. There were written submissions and meetings with organisations with an interest such as ADCS, APPGC and officials from the Ministry of Justice, the Department for Education (DfE) and the Welsh Government.
What the review has produced
The review has produced two main reports. The report this briefing is focused on which is about options for change and an academic review of evidence about the nature of the crisis and the factors contributing to it. This latter report includes feedback on emerging findings collected through the listening exercise. Summary analyses from the surveys and focus groups are also available through the link given in this summary.
Section 2 - Information about the Crisis and Key Contributory Factors
This section of the report summarises information from the academic report. The report identifies the overlapping factors, which are complex and difficult to disentangle, that are contributing to increasing numbers of children entering care and care proceedings. Beneath the national statistics there are marked regional and local variations in rates of care order application and of children in care. Apparently similar local authorities can have marked differences in their rates of children in care and these variations are not fully understood.
The report recognises the strong links between socio-economic factors such as levels of deprivation and the likelihood of children coming into care. Austerity means local authority spending is not keeping pace with demand for children’s services.
The report provides information on what children, young people and families say and reflects their concerns that they do not get the help they need to stop problems escalating, have different perspective from professionals about what the concerns are and what needs to change and want partnership and not be done to. They want their wider family resources used.
The legal and policy frameworks in England and Wales and the principles which underpin them remain uncontested in the sector. Practitioners reflected their frustration at not feeling supported to implement the principles of the rights and duties underpinning the key legislation and that they have little time to establish relationships with children and families amongst other issues.
National statistics showed that child welfare services are increasingly geared towards protective interventions and services. Work to support families to overcome social, emotional, economic and physical adversity is being marginalised by risk assessment and monitoring.
The report notes that many contributors expressed a strong sense of unease about a culture of blame, shame and fear affecting those working within the child welfare and family justice system. Contributors thought this was resulting in a growing sense of mistrust between those working at all levels and between families and professionals.
Section 3 - Before Care Proceedings: Findings and Options for Change
Evidence for interventions
The report draws attention to the growing body of evidence about the approaches and interventions that are proving effective in responding to the problems and needs of children and families. Much of this evidence has been brought together through the DfE Children’s Social Care Innovation Programme and the work of the Early Intervention Foundation, the research overviews commissioned by the Department of Health and Social Care and the DfE. The report highlights the key messages from the innovation programme which are consistent with the messages from the wider body of earlier research.
The messages resonate with what local leaders told the review. They wanted to work with approaches that “started from people’s strengths ... were respectful and empathetic ... asked people what they wanted ... listened to concerns and saw the family as a whole ... were relationship based ... expected clarity and transparency from professionals and family members” and had “clear systems for holding each other to account”.
The report provides some short case studies of promising practice.
The review acknowledges the difficulties of implementing messages about good practice and suggests as an option for change:
1. Good systems and practice
That social care leaders and partner agencies regularly review their organisation’s systems and practice against the messages from research about (a) effective interventions and relationship-based practice and (b) agency vision.
Partnership with families in a risk-averse climate
The review noted the impact of a risk averse and blame culture that pervades this area of work. This culture affects decision making throughout the system. It can undermine partnership between agencies as well as between families and professionals. Contributors wanted to see a society wide conversation about what is wanted for children and families and a re-emphasis on the message from the Munro review that taking risks is inherent in children social care and child protection work. The report reflects the messages from research that leaders play a key role in setting the culture of their organisation and in leading cultural and practice change such as relationship-based approaches and restorative practice approaches.
The review evidence underlines that relationships lie at the heart of successful developments in practice. It notes the shift to developing work on how to better gain the trust of children and parents rather than regarding it as the family’s failure if they do not engage. Part of the focus on relationships is to pay attention to the realities of the lives of children and families including the impact of poverty and economic hardship.
The Options for change suggested are:
2. Training and development
That the importance of, and the legal basis for, partnership and co-production with families, promoting as well as safeguarding children’s welfare and a whole family approach, is given a central role in the training and development of social workers in England and Wales.
3. Statutory guidance
That in England Working Together, and in Wales the relevant Code of Practice and All Wales Child Protection Procedures, are reviewed and amended so that the principles underpinning the legislation, including partnership and co-production with families, are clearly expressed and the processes for managing individual cases reflect the messages from research on the effectiveness of relationship-based practice. That a requirement is placed on the statutory safeguarding partners named in the Children and Social Work Act 2017 Act, to draw on children and families’ knowledge and expertise to inform service design, policies and provision.
That Ofsted and Social Care Wales take account of the messages from this report so that their work, including inspections and any planned research, takes account of the duties on local authorities to support families and to promote children’s upbringing within their family, including the organisational and practice ethos and approaches likely to achieve this.
Promoting and safeguarding welfare/well-being - responsibilities of all agencies
There was a clear message to the review that the help and support to children and families that may reduce the likelihood of children entering care cannot be provided by children’s social care alone.
Options for change:
5. Multi-agency collaboration
That in England, Working Together to Safeguard Children is amended to place greater emphasis on the role to be played by key partner agencies, in addition to that played by children’s social care, in assessing and meeting the accommodation, health and educational needs of children and their families.
That in England, safeguarding partners (as defined by the Children and Social Work Act 2017 and Working Together) ensure that their plans for action, and the scrutiny arrangements they develop, include a focus on children and families on the edge of and in the care system, and that there is an expectation that all partners work together to prevent children coming into or staying in care unnecessarily.
That the Welsh Government Improving Children’s Outcomes Ministerial Advisory Group new work stream, on reducing the need for children to come into care, includes a focus on facilitating and improving joint working between agencies.
Making Family Resources work better for children
A recurring theme of the review was the value of taking early opportunities to engage with a child’s family. The review supports the Family Group Conference (FGC) approach. The review proposes as one of the options for change that:
6. Family Group Conferences
There is a long term goal of ensuring that all families are offered an FGC before a child is moved into the care system.
The review also identified differences across England and Wales in the use of Family and friends care. There was evidence that local authorities are not giving sufficient priority to implementing the 2011 Family and Friends Care: Statutory Guidance for Local Authorities which applies to England. The review suggests:
7. Family and Friends Care
That this existing guidance is strengthened to reflect the messages from the review and that local authorities renew their focus on this area of practice. For Wales that amendments to the Improving Outcomes for Children Framework make reference to the importance of family and friends care.
Advice and advocacy services
A recurring message for the review was the need for families to have access to good advice and advocacy. Good advocacy services can help parents understand the issues of concern, know the options available to them and with this understanding care proceedings can sometimes be avoided.
8. Advice and advocacy
The review proposes that wider provision of free, independent, specialist legal advice for families provided by the voluntary sector and funded by Government. The review also advocates the Ministry of Justice considers the impact of the lack of accessible free, independent advice and information for parents and wider family members on the number of children subject to care proceedings or entering or remaining in care and the public purse.
Use of ‘voluntary’ care to support children and families – s.20 England and s.76 Wales
Discussion about section 20 and section 76 and their use featured prominently in the review. Contributions to the review emphasised that these can be helpful provisions while also hearing evidence of their misuse. The review heard a clear message that further statutory guidance is needed. The option for change proposed is that:
9. Voluntary Care
Amendments are made to the relevant statutory guidance to included good practice in the use of section 20 in England and sections 76 and 34 in Wales.
Formal pre-proceedings process
This formal process is triggered when the local authority issues parents with a ‘Letter before Proceedings’. The statutory guidance is brief and concerned primarily with process. There is some evidence that cases are being diverted from proceedings at this stage. The evidence to the review is that practice is variable. Suggestions were made for having more detailed good practice guidance on the pre-proceedings process. The option for change proposed is that:
10. Pre-proceedings practice
A working group is set up to agree amendments to existing pre-proceedings guidance which incorporate messages about good practice and include guidance on bets practice on pre-birth assessments and removal at birth.
Section 4 - During Care Proceedings: Review Findings, and Options for Change
Timescales for care proceedings
Contributions to the review were positive about the changes to care proceedings introduced through the Children and Families Act 2014. The introduction of a time limit for proceedings had resulted in the majority of cases being completed more quickly. There was concern about an overly rigid approach to applying the timescale. The overly rigid approach was based on timescales being the sole measure of performance in care proceedings. Additional measures would be helpful. The option for change proposed is that:
11. 26 weeks as a performance target
The National Family Justice Board, in consultation with stakeholders and families, review the performance management targets for the family justice system and revise the approach to measuring timescales, so that there is a greater focus on understanding the reasons for extensions whilst avoiding unnecessary drift and delay, and greater attention to longer-term outcomes, such as whether children come back into proceedings.
Drawing on support from family and friends
The review noted the good practice of contacting family and friends in good time before proceedings start. However, all too often this does not happen and family and friends are then having to make life changing decisions quickly, with little time to take advice or reflect on the decision they are being asked to make. The time available to assess family and friends carers during proceedings was contrasted with the time and attention available for assessing and approving prospective adoptive parents. It was suggested courts needed to allow sufficient time for assessments especially when this involve relatives who live overseas.
Changing the culture in care Proceedings
The review heard evidence about the impact of court proceedings on parents which reflects the findings from research studies. Too often parents feel alienated, confused and attacked in court and this can lead to disengagement with the process and hostility towards support services. The review heard about the work of the Family Drug and Alcohol Court (FDAC) as a court process that is less adversarial and antagonistic than ordinary care proceedings. The option for change suggested is that:
12. Court proceedings
That the DfE and the Ministry of Justice take forward the lessons from the FDAC problem-solving model of care proceedings so that this approach is extended, to become the normal way of hearing proceedings in the majority of cases.
That the Nuffield Family Justice Observatory explores international examples of the use of mediation in public care proceedings.
Section 5 - After Care Proceedings: Review Findings, and Options for Change
Reunification with Parents
The review recognised that reunification is an important permanence option for children, but the research evidence indicates that it requires adequate planning and support if it is to be sustained. Responses to the review drew attention to the consistent research findings about practice likely to improve decisions about which children can go home safely. The option for change is that:
Greater use is made of the NSPCC good practice guidance and tools on reunification.
That in Wales, the Improving Outcomes for Children Framework could include reunification as part of permanence and the Code of Practice on looked after children could be reviewed and amended to include more detailed guidance on good practice in relation to planning and supporting return home.
Placements with family and friends, unrelated cares and adoptive parents
The review submissions explained that the majority of children placed away from home whatever their placement or legal status are likely to have high levels of need and require support and help often on a long-term basis. Provision of such services can help reduce the risk of placement breakdown. The option for change proposed are that:
14. Family and friends care
That family and friends carers are granted the right to a period of paid leave, as adopters are entitled to, to help a child settle in with them. That family and friends carer households are exempted from the benefit cap and the spare room subsidy.
That in Wales, the Code of Practice on looked after children is amended to include more detailed guidance about why and how placements with relatives and friends might be supported.
15. Post-proceedings support for carers
That in both England and Wales there is renewed commitment to ensuring that the therapeutic, practical and financial needs of children and family and friends carers are met.
Working with parents whose children have been removed
A clear message to the review was that the failure to support parents whose children have been removed leads to further statutory intervention for many parents. Lack of support also has an adverse impact on the chances of parents giving their separated children the best support that they can in adjusting to their placement whoever that is with. The evidence to the review suggested what is required is flexible, persistent and relationship-based approaches. Whatever the nature of the support it needs adequate and dedicated funding.
The review heard about different practice models including the FDAC noted above, and the PAUSE programme in England and REFLECT Porgramme in Wales. The report gives examples of other services.
The option for change proposed is that:
16. Post-proceedings support for parents who have their children removed
That safeguarding partners and Health and Well-being Boards in England, and Partner agencies in Wales, working with the third sector, ensure that dedicated support is provided to parents whose children have been removed as result of care proceedings. Such support should be informed by the messages from research about the heterogeneous nature of parents and should involve practical, flexible, relationship-based approaches that address the factors that led to the removal of the children and address the impact of the children’s removal on the parents.
Section 6 - Change Across the System: Review Findings, and Options for Change
Communication between the family justice system and children’s social care
The review heard evidence of good relationships in some areas and of mistrust and tension in other areas. There was a wish for much greater dialogue to help reduce mistrust developing. A recurring suggestion was that Family Justice Boards could play an important role in fostering opportunities for stakeholders to come together. It was felt the National Family Justice Board’s role had become diminished and this was regretted. There was a clear desire for the Boards and networks to have an integral role in joining partners together.
The option for change is that:
17. Family Justice Boards
That the role and purpose of the National and local Family Justice Boards and the Welsh Family Justice Network be reviewed, with particular emphasis on:
• developing and working to a far broader understanding of good performance than the timeliness of concluding care cases
• multi-disciplinary training and knowledge exchange
• discussion of local practice, and
• children and families helping design systems to ensure that their voices are heard.
Using families as a resource or policy and service development and review
The review notes the wide acceptance of the importance of children and young people’s voices being heard in service and policy development and review. The review heard that despite the good intentions many young people in care and care leavers feel their voices are not heard. A theme running through the review was that parents and families of children engaged with children’s services are rarely invited to contribute to service and policy development and provide feedback. A clear message to the review was for greater opportunities for parents and family members, who are involved with children’s social care and the family justice system, to be in regular conversation with leaders of services and with leaders of the family justice system.
The review proposed as an option for change that:
18. Families as a resource in service design and development
That local authorities adopt Mutual Expectations - A charter for parents and local authority children’s services, developed by Your Family/Your Voice.
That in Wales, the Improving Outcomes for Children Ministerial Advisory Group’s three-year framework reflects the value of involving children and families in the design, review and auditing of services. That this lead is replicated by other public bodies, including local authorities in England and Wales.
Responding to the impact of poverty, austerity and cuts to budgets
The review found frustration, despair and anger about the detrimental impact of poverty, cuts and austerity on the lives and life chances of vulnerable families. Similar feelings were expressed about the impact of financial constraints on the services trying to help families. The review heard the evidence about the link between poverty and care.
Options for change were that:
19. The impact of Government policies
In line with the ADCS call for action, “a new ‘children and young people impact assessment’ for government departments and other public bodies [is developed] to use alongside existing equalities impact assessments” and that the “Department for Education lead a cross-government review to understand better the reasons for, and links between, rising levels of child poverty and demand for children’s statutory services. This review could then form the basis for the development of a child poverty reduction strategy for England.”
That the Department for Work and Pensions and the DfE lead a cross-government review, in consultation with the devolved administrations, into the impact of benefit rules and policies, and the projected effect of planned benefit reforms, on the numbers of children entering or remaining in care.
That, consistent with the Family Test, the relevant government department or devolved administration considers the possible impact of any proposed policy reform on children and families involved or likely to be involved in care or family court proceedings.
The review was also made aware of the widespread support for the call from Local Government Association (LGA) and ADCS for additional government support for children’s social care in England. The option for change is that:
20. Shortfall in resources
That the UK Government acts on the call from the LGA and ADCS to make up the £2 billion shortfall predicted for children’s social care in England by 2020 and the Welsh Government acts on the call by WLGA, AWHOCS and NAS to commit to the life chances of children and young people by acting urgently to address the growing funding gap.
Additional support to develop good practice
That, in addition to the £2 billion required to make up the funding shortfall, a Government ring-fenced funding stream is made available to local authorities to help them work with their community, partner agencies, and young people and families to:
• safely avert children having to enter or remain in the care system, and
• work effectively with parents, including providing post-proceedings support to tackle some of the reasons why some parents have children removed repeatedly.
The grant, available to all English local authorities, would be awarded on the basis of an approved local plan, which has the support of the local authority’s partner agencies including their local Family Justice Board and sets out what steps the authority is taking to address the Review’s findings.
Research matters: learning from those with experience of the system
The review discussions about family involvement included the role of children, parents and carers in research studies. Contributors to the review stressed the importance of learning from those experiencing services.
The review also identified a substantial list of gaps in knowledge about children’s care. This list includes items such as the ethnicity of children in care and care proceedings, the overall impact of the provision of early help and support services, the changes in professional knowledge over time for example about the impact of neglect and many other topics.
The option for change is that:
21. Research matters
There is a presumption that the methodology of research studies exploring practice with, and outcomes for, children and families incorporates the experiences of family members.
That research funders and research centres are briefed about the gaps in knowledge that have been identified during the Care Crisis Review.
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