Crisis? What crisis?

Bullock, Roger

My May bank holiday reading was disturbed by a statement from Robert Tapsfield, CEO of the Fostering Network, that the 'fostering system is on the brink as the number of children in care soars'. (1) A combination of the need to find 8,750 new placements next year, a 27 per cent cut in expenditure between 2010 and 2014 and a 14 per cent annual attrition rate are responsible.

Attrition is especially worrying as it undoes so much of the effort to get placements established. We know what leads to the retention of carers from studies by Ian Sinclair's research team (2) and further exploration of their findings in the article on placement stability by Roger Norgate and colleagues in this edition.

The influential factors include tailoring placements to carers' preferences, competence, family composition, social networks and employment situations. Also important is providing comprehensive information on the child's background, wishes and expectations, the task ahead and sources of support.

A dedicated and responsive out-of-hours team and ready specialist advice when needed, along with respite care facilities and out-of school care arrangements, are also helpful. Equally important are regular discussions with social workers, prompt responses to requests and a protocol for dealing with allegations, ensuring that this acknowledges the emotional needs of everyone affected. Contact with other foster carers using modern communication methods also helps.

Next comes training, with experienced carers involved to harness the word-of-mouth communications found to be so effective. At best, it offers a logical progression in skill and knowledge, provided at convenient times in pleasant surroundings, and pays attention to the emotional demands of the work, especially those associated with contact between the child and birth relatives.

In short, carers need to feel they are part of a team enjoying a constructive relationship with the welfare agency, especially with regard to planning, appointments, phone calls, respect for their views and conveying positive but realistic messages about foster care to the wider world.

Finally, there is the thorny issue of finance. Rewards need to be adequate and continuous--including salary, pensions and retainer fees. The system for making payments has to be efficient, reimbursing the true costs, allowing for wear-and-tear expenses and acknowledging opportunity costs, especially when well-paid employment for women is available locally or there are other uses for spare bedrooms. Some devolution of budgets to carers indicates respect for their role.

This is a pretty extensive 'wish list', but several recent journal discussions on support for carers suggest five further points:

* First, foster carers are often referred to in the plural yet the focus is usually on foster mothers. There can be differences in the commitment, determination and tolerance of different members of the foster family.

* Second, frustrations clearly arise when carers who are experiencing problems cannot get the help they think necessary. A common situation is when a child's behavioural or emotional difficulties are ignored by other agencies or when responses are slow. As Norgate and colleagues found, Child and Adolescent Mental Health Services (CAMHS) are a frequent target of such criticism. This situation arises not because CAMHS are indifferent to children's needs or set out to be awkward, but because it is often the case that what is making life difficult for foster carers and perceived as a threat to placement stability is not seen as a priority. CAMHS will explain that they deal with children who are suicidal, anorexic, deeply depressed or dangerous, and the challenging behaviour that is driving foster carers mad is less acute and life threatening than these other conditions, and has to wait its turn. (3) This can cause immense frustration and bad feeling and explains a lot of non-cooperation. Arrangements for a quick response and/or advice before the full service is considered--perhaps under some quid pro quo arrangement--is one way of easing such tension.

* Third, it is often difficult for foster carers to comprehend the reasons for decisions because they do not appreciate the place of their work in the context of their child's long-term needs. What makes sense now might not be functional for the child's future, for instance with respect to contact with birth relatives and withdrawal from education or leisure activities.

It would help foster carers' self-esteem and confidence and overcome accumulated fatigue if they could be made aware of the whole plethora of services for separated children and the role of different types of fostering in them, incorporating relevant child development theory. This would show how good work in one area of a child's life at one point in time can have benefits in the future, even though it might not be obvious in the turmoil of day-to-day family life, and when feedback is rare.

* Fourth, the life histories of looked after children show that a lot of people, including foster carers, have worked hard to help them. But although the parts may be excellent, they do not always add up to a satisfactory whole and long-term outcomes can be disappointing. While there are some obvious discontinuities, for example leaving care at 18 or moving from adolescent to adult mental health services, others are less obvious and some are exacerbated by the care experience.

* Finally, we cannot ignore the looked after system itself and this is why the press report is so alarming, particularly as Norgate and colleagues' recommendations are likely to sink in the present economic circumstances. If current arrangements are really too moribund to meet the needs thrust on them, some blue-sky thinking and radical (but responsible) experimentation across all services become the only way forward. (4) Reform not revision then becomes the order of the day--but that's another matter whose stage call seems ever nearer.

STOP PRESS

BAAF is delighted to announce that from March 2013, Adoption & Fostering will be produced in partnership with Sage Publications, one of the world's leading independent academic and professional publishers. Working with the same editors, this new arrangement will significantly increase the journal's global outreach, thereby helping to improve the lives of children unable to remain with their birth families, wherever they may be. There will also be significant benefits for BAAF members and subscribers--details to be announced in the next edition.

(1) The Independent, 7 May 2012

(2) Ian Sinclair, Fostering Now: Messages from research, London: Jessica Kingsley Publishers, 2005, pp 114-5

(3) See, for example, Vostanis P, Bassi G, Metzler H, Ford T and Goodman R, 'Service use by looked after children with behaviour problems: findings from the England survey', Adoption & Fostering 32:3, pp 9-22, 2008

(4) Apart from complete privatisation and a free market

Roger Bullock is Commissioning Editor of Adoption & Fostering and a Fellow, Centre for Social Policy, Social Research Unit, Dartington, UK