Overall placement progress

Only one of our three child-centred progress measures was available for as many as 223 children and young people at follow-up. This involved a rating on a four point scale (from ‘very well’ to ‘not at all well’) to assess how well the placement was perceived to have gone for the child over the follow-up period.107 Overall, the findings are positive, as shown in Table 8.1. Six-in-ten children were reported to be doing very well and the placement was rated as going quite well for almost one-third of children. Only one-ten-children were rated negatively. Where the placement was reported to have gone ‘not at all well’, none of these children were still resident at follow-up, and this was also the case for half of those that were rated ‘not very well’.

Table 8.1 - How well things had gone for the child over the follow-up period

Number Per cent

Very well 132 59

Quite well 69 31

Not very well 10 4.5

Not at all well 12 5.5

Total 223 100

At face value, these ratings appear to be somewhat higher than those found in more specialist studies of kinship care.108 Hunt and colleagues (2008) study of children placed with relatives through care proceedings rated over one-third (36 per cent) of placements as being problem free, a further 44 per cent as having some problems and one-in-five (20 per cent) as presenting major concerns. Farmer and colleagues (2008) study of kinship foster care rated 66 per cent of these placements as being satisfactory. Although comparisons are inevitably inexact, it perhaps suggests a tendency for Special Guardianship to be taken up by families where the chances of success appear to be quite good and where relationships between carers and children are more firmly cemented. As we will see in a moment, the strength of this bond at the outset proved to be an important predictor of how the placement subsequently went.

While the analysis that follows in this chapter is not focused primarily on the question of stability, it is important to emphasise the strong correlation that existed between how well the placement had gone for the child and whether or not they were still living there at follow-up.109 Stability is one 106

Although children subject to an SGO are not really in a ‘placement’ (it is rather a legal endorsement of a family arrangement), we continue to use the term placement for brevity and convenience (as is often the case in adoption). 107

The same question was asked of case file auditors and special guardians. Where information was provided by both, an independent judgement was made by the research team based on written information attached to the rating. The rules for making these judgements are outlined in Appendix B.

108

However comparisons can only be approximate as methods for rating placement success differed. These studies assessed the quality of placements through researcher ratings based on analysis of case files, which was only partially the case for this study, and used rather different criteria in relation to somewhat different samples. 109

Mann Whitney U exact: p<.001, correlation coefficient -.471, n=223. 153

obvious marker of placement success and ratings of how things had gone were considerably higher for intact placements. These issues will be pursued further in Chapter 10.

Two measures were employed in this study to assess emotional and behavioural difficulties in children. First, guardian’s completed the Strengths and Difficulties Questionnaire (Goodman, 1997) which was only available for the reduced guardian sample (n=95).110 Second, a simple four point rating of emotional and behavioural problems was available for most of the sample (n=202). Both of these measures were associated with how well guardian’s thought things had gone for the child.111 In relation to the SDQ, where guardian’s had rated things as going very well, 85 per cent of children fell within the ‘normal’ range compared to just 13 per cent of those who were rated as exhibiting clinical symptoms.

The cut-off points of the SDQ have been calculated so that only 10 per cent of children in the general population would be expected to have scores over the clinical threshold for severe emotional and behavioural problems (Goodman, 1997). Overall, 24 per cent of our sample had total scores above that threshold. While this is rather lower than one recent study of long-term fostered and adopted children, where 38 per cent of that sample were above the threshold (Biehal

et al., 2010), it is significantly higher than the population at large. As Biehal and colleagues found,

boys scored more highly for hyperactivity, but children with learning disabilities scored highly across all sub-scales. Overall, these findings highlighted the challenges that many guardians faced in coping with the behavioural difficulties presented by their children and, while these placements were lasting, wider research on fostering and adoption has made connections between the continuation of these problems and poorer outcomes both while in placement and after leaving care (Sinclair et al., 2005b; Wade and Dixon, 2006; Sinclair et al., 2007; Quinton and Selwyn, 2009a; Biehal et al., 2010).

Where children had lived with their special guardian before the order was made – and for a longer period of time – and most especially where the bond between primary carer and child was rated as being very strong at this point, the outcome at follow-up was better.112 Where the bond was

considered ‘very strong’, 76 per cent of children were also rated as having done ‘very well’ in placement, compared to 32 per cent where the bond was rated as ‘quite strong’ and just 15 per cent where it was rated as ‘quite weak’. In Chapter 3 we identified concerns, arising from a policy and practice perspective, about the risks that might accrue from SGOs being made quickly, before placement relationships had been properly tested. The evidence presented here suggests that there is reason to believe that this may well be the case and that strength of bond is an important predictor of how things will turn out some years later.

Finally, there were also some contrasting associations with this outcome that related to the role of the local authority before and after the SGO was made. An improved outcome was significantly more likely where the local authority had been highly supportive of the original Special

110

The SDQ provides a total score and scores for five sub-scales (emotional symptoms, conduct problems,

hyperactivity, peer problems and pro-social behaviour). The sum of the first four scales forms the total. A score of 17 or over is indicative of clinical mental health symptoms.

111

SDQ total score and outcome: Kendall’s tau-b: p=.005, t -.241, n=94; EBD measure and outcome: Kendall’s tau-b: p=.002, t -.203, n=200.

112

Whether lived with guardian and outcome (Mann-Whitney U: p=.032, n=223); duration (Kendall’s tau-b: p=.04, t .119, n=184); strength of bond (Kendall’s tau-b: p<.001, t .415, n=220).

154

Guardianship application.113 Potentially, this is an important finding since it implies that where local authorities have concerns about the placement and are less supportive of the SGO application, the evidence at their disposal at that stage is associated with how things subsequently turn out. A better outcome was also the case where guardian’s felt well prepared for the task that lay

ahead.114 In contrast, provision of more services to the child and/or guardian after the order was made was associated with a more negative outcome.115

This is a very familiar finding in relation to children’s social work services more generally (Sinclair, 2005; Dixon et al., 2006; Biehal et al., 2010). It generally means that services tend to be provided in response to difficulties being experienced by children and their families. Given the scarcity of these resources and the often high thresholds for accessing services, these difficulties often have to be quite serious before intervention occurs. Although interventions do not cause these

problems, many interventions are short-term, when the need may be for longer-term support, or insufficiently intensive to resolve the problems they seek to address, perhaps especially where children’s behavioural problems are severe and not easily amenable to change. This finding features in relation to all outcomes considered in this study. It also reflects the concerns of

practitioners reported in Chapter 3, where many were quite aware that they were unable to provide longer-term services of sufficient intensity to meet the needs of Special Guardianship families. Some teams reported being so stretched that it was difficult even to make the occasional phone call to their families to see how things were going.

Multivariate analysis, combining variables significantly associated with overall placement progress, was used to create a ‘model’ that best predicted how things had gone for the child (see Appendix B for further details). A combination of two factors was found to make a significant contribution, once account had been taken of other relevant variables. The rating given at follow-up was higher where:

• The bond between carer and child had been rated as strong at the time of the SGO (p<.001).

• Children were not rated as having more serious emotional and behavioural problems (p=.029).

As suggested above, therefore, the strength of the relationship between special guardian and child at the outset coupled with an ability to manage the behavioural challenges that children presented predicted a more successful outcome at follow-up.

Most children were reported to be doing well. Alongside the rating provided by guardians, space was provided for them to write a note of their reasons for making the assessments they did. Where

113

This variable was highly skewed, with local authorities highly supportive of 78 per cent of the applications. A binary variable was therefore used to classify highly supportive/less supportive (some degree/not very). Mann-Whitney U exact test: p=.008, n=221.

114

Preparation score by outcome: Kendall’s tau-b: p=.035, t .181, n=98. The preparation score sums together related variables assessing the information and advice provided to carers at the time the application was being considered and their confidence in a SGO being the right order for them. It is described more fully in Chapter 11.

115

Child services score (combining therapeutic, behavioural and educational services) and outcome: Kendall’s tau-b: p<.001, t -.297, n=185; Guardian services score (combining social work contact, financial and birth family services): Kendall’s tau-b: p=.015, t -.165, n=169.

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things had gone very well, the comments from special guardians pointed to the close family relationships that had developed over time, the strong affection that had grown and to a pride in the hard-won achievements that children had made, often from quite disadvantaged starting points.

‘Because he wouldn’t be anywhere else and we wouldn’t be without him. The bonds are

too close. He means everything. He’s come on leaps and bounds in every way.’

‘She is just a part of the family. I couldn’t imagine her not being with us.’

‘He is now a happy and well-adjusted little boy who started off life with various

difficulties…He is making good progress in school with excellent reports. It was difficult,

at first, with other family members, and was very hard at times.’

‘I have done the best I can to raise him. He’s doing very well in school. He sees his family, both the maternal and paternal sides. He has given me a reason to improve

myself and I have become a better person.’

These brief comments also point to the challenges that have had to be faced along the way. Although all of these children were doing well, the emotional and behavioural legacy of their past experiences was still evident as, in some instances, was the personal cost of taking on their care.

‘Although there are emotional and behaviour issues which are quite perplexing to

handle, I think we are handling things as well as possible. She is reasonably happy, but

her circumstances lead to some anxiety.’

‘My child is very happy, looking healthy, enjoys school and is confident. She was very

shy, lacking in self-esteem, but she is now becoming a different child. As for me, I enjoy having her, but it has affected me financially and in my social life. I haven’t been on

holiday once in six years.’

‘Although there were quite a lot of problems in the beginning, the situation has now

stabilised.’

Doing well, therefore, did not mean the absence of problems or the presence of only minor ones, the rating was more likely where the bond between carer and child had become strong and where the difficulties that existed had become more manageable, where carers felt they were in control or where improvements could be discerned, often after a rocky start.

Unfortunately no comments were provided by guardians where their child was rated as not doing very well and only one grandparent in the interview sample had given this rating. However, the description of her life with her grandson that follows is illustrative of the difficulties of providing care for children with complex needs, of the close affection and commitment that is needed to sustain it and of the personal cost that may frequently be involved.

Gareth, now aged seven, had lived with his paternal grandmother, Julie, since he was 13 months old. Previously he had been in foster care and he had moved to his grandmother at the time the SGO was made. He no longer has contact with his birth mother and just occasional contact with his father. Gareth has long-term and complex health problems linked to his birth mother’s

extensive drug and alcohol addiction while pregnant. He has also been diagnosed with autism and ADHD. His grandmother, a single lone carer, spoke of him with great affection. She has tried hard to engage him in activities he likes, such as swimming and drama, although he lacks friends and is quite isolated, and has ‘fought tooth and nail’ to get him additional one-to-one tuition at school where he struggles to keep up and exhibits quite serious behavioural problems. She took great pride in his achievements. She said that he can be very funny and loving, but that he can also be very aggressive when frustrated – ‘he takes his frustrations out on nanny’. His aggression had got rather worse with age. She gets by through ‘taking one day at a time’. Overall, she felt that she had received quite good support from health services (including a health visitor and CAMHS), but that support from social care and education had been lacking. Providing care had exacted a high personal cost. Her life plans had been rewritten and opportunities to take a break were rare: ‘I haven’t had a night out. I don’t know what a night out is anymore’.