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Planning and supporting permanence in foster care

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1 Planning and supporting permanence in foster care
Gillian Schofield Professor of Child and Family Social Work Co-Director of the Centre for Research on the Child and Family

2 Care planning, matching and support systems for permanence in foster care  

3 What is permanence in foster care?
The security and well-being that comes from being accepted as members of new families. (Prime Minister’s Review of Adoption 2000) The development of a form of foster care that more nearly approaches a ‘family for life’, which is not seen as ‘second best’ and in which carers can act as parents. (Sinclair 2005:123)

4 Growing up in foster care – what permanence meant to Leroy (placed 8 -18)
(on foster care) ‘I felt as though I’d done something wrong and it was my punishment. But they were just really comforting and we just got on. I just learned to trust them over time, the longer I stayed here. It was my home, whereas before it was just somewhere I was staying.’ (on his foster mother) ‘My mum’s helped me a lot because she was determined for me to do well. That’s a really important thing, people, other people, believing that you can do well’. 4

5 Leroy - further reflections
(on his birth family) ‘They disowned me. Well it was upsetting at first but oh well, they’ll need me before I need them. Here is my home, if they want me they know where to find me. You can’t worry about it forever.’ (on social workers) ‘They are really helpful. They go through with you how much you’ve progressed.’ (on himself) ‘I have to have something to work towards - I just want to be the best I can.’ 5

6 Melanie ( placed 15 -17, aged 25 at interview)
The first time I met them, David, my foster dad, sat and talked to me as if I was somebody.. They were just brilliant, they turned me right round. If it hadn’t have been for them I wouldn’t have passed any exams, I wouldn’t have been able to read and write. Without them I wouldn’t have the life I have now.

7 Care Planning, Placement and Case Review Guidance and Regulations 2010
Permanence is the framework of emotional permanence (attachment), physical permanence (stability) and legal permanence (the carer has parental responsibility for the child) which gives a child a sense of security, continuity , commitment and identity. The objective of planning for permanence is therefore to ensure that children have a secure, stable and loving family to support them through childhood and beyond. Permanence provides an underpinning framework for all social work with children and families from family support through to adoption. (Para 2.3) NB Emphasis on ‘Legal permanence’ appears to exclude long-term foster care

8 Definition of long-term foster care as a permanence option (DfE 2010)
‘ Another important route to permanence is long-term foster care where attachments have been formed and it has been agreed through the care planning and review process that this is where the child or young person will remain until adulthood.’ (Para 2.4) NB May appear to exclude care plans that seek a new long-term foster care placement as a planned permanence option for a child currently in a short-term (fostering or residential) placement.

9 Care Planning Regulations and Guidance –and IRO Handbook 2010
Implications for planning / reviewing permanent foster care Helpful in focussing on the need for planning /review and for child’s well-being to be the key; also importance of IRO BUT Lacks differentiation of planning/role of IRO in different placements Focuses on planning – but planning to move not planning to stay? Lacks a vision of long-term foster care as a permanence option Risks diminishing the parenting role of long-term foster carers e.g. no automatic role at LAC reviews, pathway planning for leaving care

10 University of York comparative research studies on long-term foster care (2)
Biehal et al (BAAF 2010) Longitudinal study comparing adoption, adoption by foster carer and ‘long-term foster care’ – after 8 years [NB Long-term defined as ‘had lasted 3 years’ - so NOT based on formally planned placements ] Important findings – Stability in foster care was a cause for concern compared to adoption BUT not possible to compare like with like e.g. age, history of abuse were different No significant differences in emotional and behavioural difficulties, and education between long-term fostered and adopted children

11 UEA research studies on permanence in foster care
Growing up in Foster Care: 52 children followed up in three phases (Nuffield Foundation ) Part of the Family: 40 adults who grew up in foster care ( ) Parents of children growing up in foster care (partnership with Bergen / Gothenburg): Interviews with 32 parents, parent and social worker focus groups (ESRC ) Permanence in foster care: – care planning systems in England and Wales (BAAF/TFN/Big Lottery ) National survey of LAs (LAC and fostering) and IFPs Telephone interviews with selected agencies Three regional foster carer focus groups 11

12 ‘Long-term’ and /or ‘permanent’-single and dual systems
Practitioner/manager views 2007 ‘Long-term foster care is a positive permanence option and should not be seen as second choice.’ ‘A foster placement can never be truly permanent without a legal order so we have to call it long-term.’ ‘We call it permanent foster care. You cannot call it long-term foster care because that sounds like it has an end. The last time I used the expression ‘long-term’ was when I parked my car at the airport.’ ‘I think we try and use the term permanency, but I have used it interchangeably (with long-term foster care) in this conversation and I think lots of people would.’

13 Care planning for permanence in foster care (Nuffield Foundation 2008-10 )
Follow up study in partnership with six local authorities – all committed to permanence in foster care, But with different planning systems/different meanings/ different panels 230 cases: care planning profiles from the files for children with a plan for permanence in foster care 2006/7 40 interviews with foster carers (LA and IFP) 20 interviews with children/young people (cared for by these foster carers) 6 practitioner / manager focus groups – one in each LA Study of commissioning of placements from the independent sector

14 The sample of 230 children Age at long-term plan:
Under 5 - 9%; %; %; Gender: male % (121); female %(109) Ethnicity: White British 80% (184); Black and minority ethnicity 20% (46) - range across LAs 0-61%

15 Other factors Abuse and neglect: Emotional and behavioural problems
Almost universal: neglect 93% and emotional abuse 93%. Range: physical abuse 36-86%; sexual abuse % Emotional and behavioural problems 64% with moderate to severe emotional and behavioural difficulties Parent difficulties e.g. mothers 60 % mental health problems, 33% alcohol, 33% abuse in childhood, 31% drugs BUT missing information on parents (especially fathers)

16 Permanence and legal status
Children on care orders % (198) Children accommodated s % (28) Other (e.g. freeing order) % (4) NB No significant differences between authorities Care orders were often initiated some time after children were first accommodated 17 children had a current plan for special guardianship 2 children had a current plan for adoption

17 Age and permanency planning: important messages from this research
LAs are - at agency and individual practitioner level -continuing to plan for permanence in foster care into adolescence. This plan may be to secure an existing placement or to seek a new placement with permanence in mind Older children clearly needed this security / many valued it. BUT how individual children feel about the messages of permanence at different ages needs to be taken into account in procedures/practice.

18 Pathways to permanence across the sample
Children who had a failed reunification after they first entered care: 14% (31) Children who had a previous plan for adoption / had an adoption breakdown: 25% (58) / 4% (10) Children who remained in their first placement: average19.6% (range 5-31%) The average number of care placements: 3 (range 1 – 23 in individual cases) Matching for permanence in existing foster placement: 68% (range %)

19 Time in years between stages-issues
Systems that took cases to fostering or adoption panels were likely to take longer overall BUT Several LAs were including long-standing placements in new permanence procedures– added to average times Decision to delay or not take a case to a panel for confirmation may be good practice in some cases Other factors e.g. ethnicity, did not add to delay

20 Stability Just over a fifth (22.2%, 51) of children experienced the ending of a long-term/permanent foster placement which was planned for in the target period 2006/7.  Endings could be initiated by carers, children- or by social workers There were no significant differences between authorities Similar numbers of ended placements were confirmed (54.9%, 28) or unconfirmed (45.1%, 23) NB Confirmation is not irrelevant in individual cases – but other factors count more e.g. quality of carers /of the match.

21 Support for the children, carers and placements
Social work support: Some excellent practice in LAC and fostering- but too frequent changes in LAC social workers in some cases. Education: File data and interviews with carers suggested active support – in school and at home. Emotional and behavioural difficulties: Variable CAMHS support for children and carers across LAs–some excellent i.e. not only in crisis Contact: A major issue for all children and carers (and birth relatives). Frequency, venue and supervision NB Not clear in all cases that a support plan was available at the point of the permanence decision

22 LAC reviews in permanent placements: positive and negatives for children
Because I want to hear what they have been saying about me and…I just like being there, so I can sometimes get things off my chest and talk to people about it. (Girl, age 12) He don’t like the fact that he has to fill a form in because, he says, ‘Well you are saying you are a long-term mum and that is what they say you are, a long- term mum. You are our mum and then they come here and they say ‘Do your carers look after you well?’ (Foster carer) Why have they got to know about me? Don’t tell them mum, don’t tell them about us.’ (Carer reporting what her foster son - age 11, placed at 5 - had said

23 How are decisions made? Different LA meetings and panels
Common but have no statutory force, regulated activities, set membership e.g. Professionals meetings, planning meetings Statutory and used according to regulation e.g. LAC reviews Locally devised and used to manage permanent foster care/or monitor the care system e.g. permanency referral meetings, a Children’s Panel Statutory but used for varied purposes in relation to permanence in foster care e.g. Fostering Panels, Adoption and Permanence Panels NB All interact /run alongside court processes and plans

24 Permanence procedures 1) Meetings between practitioners
LAC worker and manager / LAC and fostering service May be informal or systematic e.g. ‘professionals’ meetings, including legal advice. Documentation: may involve assessments / matching matrix Participation: less likely to include child and birth parents. May include foster carers/school/health Potential benefits: Brings together quickly those with expertise and closest to the child and the carers – may avoid delay. Potential challenges: Informal - may not be fully minuted or require detailed assessment documentation from workers.

25 Permanence procedures 2) LAC review
First level of statutory meeting and used by all local authorities as part of planning for permanence For some local authorities is the last formal stage Potential benefits: 1) Statutory/regular 2) Participation is often wide – child/carers/parents 3) IRO role Potential challenges: 1) Ambiguity as to whether plans are ‘only’ reviewed or are recommended / made ) Documentation is very varied 3) Seniority/expertise? ) when does the ‘planning’ for permanence phase stop and supporting /reviewing a confirmed placement begin?

26 Permanence procedures 3) Permanency fostering team
Senior practitioners in the fostering service who have responsibility for monitoring/facilitating permanence plans. e.g. hold a permanency referral meeting Facilitate the assessment /matching/placement - arrange for case to go to fostering panel for final approval/confirmation Potential benefits: 1) Specialist practitioners actively promoting permanence 2) Clear procedures 3) Specific documentation Potential challenges:1) May need to be linked into LAC review system 2) Not easy to get social workers to meet timetables [NB Good matching at this stage, but then final confirmation at panel may be delayed]

27 Permanence procedures 4) Children’s Panel / Permanence Panel
Area based panel, chaired by service manager, attended by IRO, meets regularly to monitor plans for all looked after children Will ensure permanence plan in foster care is in place and confirm the match Potential benefits: 1) Senior and independent 2) efficient and may avoid delay in making/confirming placements Potential challenges: 1) Panel has wide agenda, may only be able to ask for/consider limited documentation ) Professional participation only – need evidence of appropriate practice/consultation with children, carers, birth relatives

28 Permanence procedures 5) Fostering Panel
Where match is with existing child, fostering panel may focus on change of carer approval for the named child Be involved in final confirmation of the match/placement Potential benefits: 1) External scrutiny of match 2) official recognition valued by some carers/children 3) Detailed documentation 4) Participation by carer/child Potential challenges: 1) Risk of delay related to the documentation / panel dates 2) Fostering panel expertise in matching? 3) Some carers find it intrusive/irrelevant 4) Some children feel panel requires too much commitment /cuts them off from birth family

29 Permanence procedures 6) Adoption (and Permanence) Panel
May be involved at best interests decision stage May be involved in final confirmation of match/placement Potential benefits: 1) (if used for best interests) to ensure that adoption / SGO has been considered 2) Expertise in matching 3) Adoption level documentation for the decision and on file Potential challenges:1) Risk of delay related to the documentation / panel dates 2) Fostering is different from adoption –needs different expertise?

30 Children, families and planning for permanence in foster care
The most important factor for good outcomes is likely to be the quality of the foster family experience and the match between the needs of the child and the skills, hopes and expectations of the foster carers Care planning and the quality of social work practice with children, foster carers and birth relatives can make a difference in maximising the potential of any placement to succeed. BUT Planning procedures and practice need to be sensitive to the needs and circumstances of each child, each foster family and each birth family.

31 Successful planning and support for permanence in foster care?
Where do the main challenges lie? the very concept of permanence /family membership in foster care? the difficulties of the children? the availability of suitable/committed foster carers? the availability of social work time to support all parties, including the parents? the availability of support from other agencies? transitions to adulthood? What contribution can care planning make? Social work practice? Decision making – the forum, documentation, participation? Do we need national or local systems?


33 Carers’ and children’s experiences of permanence in foster care

34 Carers and children - roles and relationships
Providing a secure base Bonding/commitment to the child Managing flexible roles as carer/parent Doing and displaying family Children’s experiences of dual family relationships

35 Carers need to provide a secure base (

36 Availability – helping the child to trust
Stella (carer) and Lisa ( when placed) Lisa had been rejected by her birth family and then her adoptive parents- who had kept her sister ‘In those initial times we chatted a lot- we would start tea at 5 o’clock and we would still be sitting talking at 9- just talking and talking and talking. One social worker said ‘It’s like Lisa is in continuous therapy’ Lisa will still now want to go over something I think we have gone over a million times, but obviously it needs that one more time and it is just a matter of giving your time really...’

37 Sensitivity- helping the child to manage feelings and behaviour
‘She wants to be good all the time. I think it is because she was moved from pillar to post.’ ‘Lisa came with an awful lot of labels and having worked with children for a lot of years you get a sort of feeling- and I looked at Lisa and thought, this isn’t an eating disorder and this isn't an attachment disorder. But what is behind this? You have to become a detective –but you are looking into a child.’

38 Acceptance – building the child’s self-esteem
‘Sometimes Lisa felt the need to play Barbies and Polly Pocket when she first came. She wanted to get out the baby toys and she would come and sit on my knee with her thumb in her mouth and she had loads of help... So now she sees me as a pillar of strength.’ ‘We started her on karate mainly to build her self-confidence. She has recently taken an interest in ‘Take the Reins’ which is a charity for disabled people who go riding and she is a volunteer. She is a Young Scout Leader now too.’

39 Co-operation-helping the child to feel effective / be co-operative
‘I will meet the child half-way, I will allow the child to develop, show the trust. I do have strong boundaries at home and we do have rules. But I think it is more about listening to the child, hearing what the child is saying, because they are all different… When Gemma first came she was a Goth – so it was all dark make up and chains and belts…but now she is an ordinary school girl…very happy, outgoing, willing to help with the other children and doing very well in education. She has turned out really lovely and it is all credit to her really.’

40 Part of my family I think the line between Nadine being a placement and a part of my family is very blurred now. There isn’t ‘she is my foster daughter’, she is my family and I think that is the biggest thing. Other people say how can they be part of your family when they are not blood relations and they have got families of their own, but they are.

41 Family membership - helping the child to belong
‘I think there are too many people at meetings. I am solely there to be her mother…you have probably got, I don’t know, fifteen or sixteen different workers involved in one person. She doesn’t need me being a professional and talking jargon just because everyone else does. I am just there to be Mum, that is what I am trying to do, first and foremost, I am her Mum.’

42 How can the secure base star be used in practice?
Assessing and supporting children/parents/carers Matching children with carers – identifying strengths and difficulties in placements Setting positive goals with carers for each secure base dimension, suggesting caregiving approaches and monitoring progress Assessing and providing help to families/placements /children in difficulties NB All foster carers and workers need a secure base (

43 Carer bonding / commitment - importance to children of all ages
Carer’s commitment to this child that will endure Child is special, unique, treasured, valued Feelings may occur for a child of any age (including teenage) Feelings may be there at the beginning or develop over time Concept could be helpful in assessment of existing placements N.B. Important conceptual links between this study of carer relationships in middle childhood/ adolescence and infant studies in USA by Mary Dozier (University of Delaware). 43

44 Special feelings – Sacha’s arrival and development in the foster family
‘Um well I remember it was June and quite a hot day and she came walking down the path with thick tights on. I think she had been determined to put these colourful thick tights on, a little dark haired girl, coming to the door with the social worker, needing protecting, you know, she was lovely.’.. ‘Well she is very confident now actually. I have had people say you would never believe she were in foster care, she is a very confident and sensible child you know and doing very well at school… She goes dancing a lot, she shows us what dance she has learnt. There aren’t many times I don’t get a show every night.’ (Carer of Sacha – placed at 6 now 12)

45 Shared sense of birth - rebirth in the foster family
I cannot imagine a time before Kelly and Kelly cannot imagine a time when she wasn’t here. She says her life didn’t begin until she was nine. ( Carer for Kelly, 14, placed at 9) I wish that this was my real family, yes that is what is annoying about being in foster care, it is not really my birth family....Yes it is just that they are more like a family to me. It is just I wish I had been born into it. (Lauren 17, placed at 14) Because of my age and my parents’ marriage and everything it fits in almost exactly that I am almost their actual daughter. My dad and I have a little joke every now and again, I say ‘Dad do you feel glad that you skipped the pregnancy part?’ and he goes ‘Oh yes I am glad I skipped that bit!’ Rosie (14, placed at 11)

46 Role identity in permanent placements- carers and /or parents?
Permanent foster placements can be successful where carers have different primary role identities Primary identity as foster carers, but also accept the role of parent Primary identity as parents, but also accept the role of carer Problems can occur where Foster carers who identify exclusively as carers but do not take on a parenting role / commitment Foster carers who identify exclusively as parents but do not accept carer role/responsibilities 46

47 Carers who identify as carers but accept the parenting role
Carers who identify themselves positively as foster carers e.g. enjoy their professional role /skills and their partnership with social workers value their training opportunities, work positively with the child, including regarding being in care support birth family as well as foster family identity AND Accept the role of parents fully committed to the child as a family member welcoming the prospect of the child being part of the family into adulthood 47

48 Case example: Jane and Patrick – route to permanence
Jane and Patrick’s own children had grown up and they were experienced carers - more than 80 placements. Jane was Chair of the local Foster Care Association, ran a foster carer support group and operated a telephone help line. Marie came to Jane and Patrick for respite care (age 13) from a short-term foster placement, but asked to stay After 4 years Marie continues to do very well - the whole family celebrate the anniversary of her arrival by going for a meal of her choice. 48

49 Meaning of ‘permanence’ to Jane- as a carer - and as a parent
‘In my mind permanence is a word that means a lot. It means that Marie is never going to leave, not when she’s 18,19, 20 or whatever. If she goes to university, not when she’s 25. She’s always going to be part of our family. I am sure when she’s 36 and has got her own children, she will be bringing them to us, I will probably be looking after them. We are always going to be her Mama and Papa.’ 49

50 2. Carers who identify themselves as parents but accept the role of carer
Carers who identify themselves positively as parents e.g. motivated to build a family emphasise normalising the child’s experience / acting as any parent would use their own family and friends as support systems AND Accept the role of carer e.g. Understand their role as carers on behalf of local authority Like to know the social work system / support is there for them and the child 50

51 Case example: Sandra and Pete- route to permanence
Sandra and Pete had decided not to have children of their own but enjoyed teenagers and felt they as a couple had something to offer a teenager long-term They were approved for short-term, but were approached to take Rosie (then 11) as a first and long term placement Rosie (now 14) – had experienced abuse and neglect in her birth family up to age 3 when she came into care Six fostering placements; adopted age 5; adoption disrupted age 8; residential care for 2 years. Rosie has thrived in this placement 51

52 Sandra wanting to create a normal family – but likes support as a carer
‘We made a conscious decision that we were not going to ask for respite breaks, because Rosie needed to become part of our family.’ ‘I wouldn’t be without the social workers… because they understand the difference between being a carer and being a parent, which your family don’t understand. And we have a support group once a month so if you have something that you need to talk about that is very helpful to be able to meet with the other carers and I do quite a lot of training courses.’ 52

53 3. Role identity exclusively that of carer
Carers who may accept a child as a long-term placement with a permanence plan BUT do not take on the parenting / permanence role in relation to this child e.g. may not fully include child in family may anticipate without question this child moving on and out of the family at 18 or before. 53

54 4. Role identity exclusively that of parent
Carers who wish to see themselves as parents Carers who want their relationship with this child to be how they expect a parent - daughter/son to be. BUT tend to reject carer identity and its implications may not accept the need for training may not help the child manage care identity may form an alliance with child against ‘the system’ 54

55 Defining, doing and displaying family – in foster care
Narratives are seen as stories which people tell to themselves and to others about their own family relationships, which enable them to be understood and situated as part of an accepted repertoire of what ‘family’ means. Finch, J. (2007) ‘Displaying families’ Sociology 41 (2) pp

56 Doing family and earning the right to be ‘my mum’
When you think about what a mum is and what a dad is and I compare it to what my mum and dad were like - I know they loved me, but they didn’t do their best by me which they should when you bring a child into life I suppose. And I just see [carer] as my mum, she is doing well for me. (Girl, age 17)

57 ‘Doing’ and ‘displaying’ family - to the child and (with the child) to the world
The core message of ‘display’ is ‘these are my family relationships and they work’ (Finch 2007) Foster families (and other ‘chosen’ families) seek legitimacy, often through ‘displaying’ that they are ‘the same’ as cultural ideals of family. Cards, rituals, celebrations, weddings, funerals – and their relationships

58 The child’s family membership in the foster family
Family membership was established for children through: Messages about placement length from social workers Verbal reassurances from carers about the future Children perceiving carers as doing extra and going beyond their ‘duty’ Positive relationships with other foster family members Recognition by professionals Acceptance by birth family? 58

59 Typology of children’s sense of family membership
Children’s sense of foster family (FF) membership interacted with feelings about their birth family (BF). Children’s perceptions of the role of foster family and birth family differed widely – Dual membership (with the foster family and birth family) Exclusive membership (with the foster family) Mixed membership (secure with the foster family, but anxious / uncertain with the birth family) Limited / uncertain membership (limited with the foster family / preoccupied with the birth family) 59

60 Dual (foster and birth family) membership
With mum, I talk to her about things. But with [carer] when I talk to him about things he helps me with them, whereas mum she is not quite as good with things like that. But she is still there and she is still mum, so I talk to her about things and what I am doing. Do you ever feel torn between the two families? No, no, My mum is my first family and this lot are my second family. I call [carer] my dad. (Boy aged 17)

61 Exclusive foster family membership
‘Dad, no chance, I don’t want to see him. No, I don’t want nothing to do with him anyway. Mum I used to, but no more. She couldn’t look after us and she made loads of promises and broke them all’ ( Girl, 14)

62 Secure foster family membership/ uncertain birth family relationship
Children in this group: Felt sadness that they could not live with their birth parents, but had accepted the foster carers in the parenting role. Understood their birth parents’ care had been inadequate, but had mixed feelings towards parents– angry but also defensive and anxious. Often tried to satisfy birth parents’ emotional needs at contact. Enjoyed life in the foster family and wanted to stay with the foster family post 18 or come back to visit post 18. 62

63 Limited foster family membership/ pre-occupied with the birth family
Children in this group: Were mainly settled in placement, but had a sense of ‘biding time’ until they could be back with birth parents. Valued holidays and celebrations, but did not talk about many other themes of foster family membership. Felt loved by carers, but also had anxiety about their carers’ feelings towards them Saw the permanence plan as ‘kidnap’. ‘I realised it was until I was eighteen years old…I thought surely they can’t keep you away from your family that long, but it turns out they can.’ (Boy, age 11)

64 Foster children’s advice
To carers ‘Foster carers should give children their love and care, do the best you can, be proud of them, love them for who they are, even though they are not yours just love them for who they are.’(Girl, age 14) To foster children ‘Think about it as you are in a better place, you have still got the other end of the phone, and you are with people that will care for you and love you and everything is going to be alright.’ (Girl, aged 12) 64

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