Residential and foster care, and care provided by family and friends

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3.7 The PDG recognised that stability of placement, quality of care, stability of

education experience and planning for permanence are as applicable to children and young people in residential care as they are to those in foster care. Failure to address these issues risks compounding existing health and social inequalities and increases their vulnerability to social exclusion as young adults.

3.8 The PDG noted that children and young people placed in residential care are some of the most vulnerable and traumatised individuals in the looked-after population. They also recognised that fostering is a complex task that requires a rehabilitative and therapeutic approach and an understanding of the

challenges and rewards of caring for children and young people, some of whom may have experienced abuse and neglect.

3.9 The PDG heard evidence that foster carers who deliver high-quality care have

a consistent parenting style that combines clear guidance and boundary setting with emotional warmth, nurturing and good physical care, and so develop a strong sense of belonging. Evidence also suggests that social workers and other practitioners in frontline roles are good at identifying successful, high-quality foster homes.

3.10 Although there is less robust evidence on defining good residential care than

foster care, the characteristics of good residential care are similar and include descriptions of the same type of parenting style. The PDG believed this type of approach to parenting in both settings is most likely to contribute to the ability of children and young people to develop healthy attachments and become more resilient.

3.11 Foster and residential carers also have an important role in helping looked-

after young people make the transition to adulthood, in the same way that many do for their own children. High-quality foster and residential care will prepare young people properly for leaving care. However, the PDG noted that young people with complex needs face particular problems in the transition from care to independence and considered that all residential homes should have a culture, organisation and regulations that help staff to equip young people with the skills to support their move into adulthood.

3.12 The PDG heard evidence that placements with family and friends last longer

and score higher on a measure of wellbeing than some other types of placements despite the children and young people having the same level of difficulties as those in other care settings. The same evidence reported a number of benefits to being placed with family or friends, including high levels of commitment shown to children and young people despite increasingly

challenging behaviour, and good placement stability when care is provided by grandparents. However, the PDG heard that despite the benefits of care by family and friends there is evidence that these carers face greater strain as they receive less support from children's services than foster carers.

Siblings

3.13 The PDG heard that a large number (up to 80%) of looked-after children and

young people who have a brother or sister also in care are living separately from them. Thorough assessment is required if siblings are to be separated. The PDG took the view that placements that enable siblings to live together or close by or which allow them to attend the same school are likely to be

beneficial. However, it was noted that this is not always the case and there may be situations where it is preferable to separate siblings.

Diversity

3.14 The PDG recognised that achieving and maintaining a sense of security may

be more difficult for children and young people from black, minority ethnic and multiple heritage backgrounds, and for unaccompanied asylum seekers. These groups may face racism and isolation which can additionally challenge their ability to develop resilience and high self-esteem. The PDG noted that all looked-after children and young people need to develop resilience and high self esteem, and that the care plan needs to reflect the individual needs for each child or young person.

3.15 Data from Department for Children, Schools and Families (2009a) show that

27% of the care population are children and young people from black and minority ethnic backgrounds. The proportion of different ethnic groups has remained similar since 2005, and at 31 March 2009 there were 3700 unaccompanied children seeking asylum in care – an increase of 200 from 2008. There is wide diversity of ethnicity and cultural experience within and among these groups of children and young people, and the PDG considered that it is poor practice and unhelpful to use broad categories such as white, black, mixed race, Asian and African.

3.16 Looked-after children and young people who are also unaccompanied asylum seekers have additional and different complex needs following their dislocation from family, community and home. They may also have experienced or

witnessed extreme violence, abuse and rape. Their physical and emotional health needs will require specialist interventions. Professionals need to be alert to these circumstances and ensure support is provided that is sensitive to their needs.

Health assessments, records and information

3.17 The PDG recognised the importance of collecting and recording

comprehensive, factual and non-judgemental information about looked-after children and young people. Professionals who rely on incomplete records can make decisions that adversely affect the child or young person.

3.18 Equally important is ensuring that health information held on looked-after

babies, children and young people is accurate, kept up-to-date and transferred at the right time. The PDG recognised that health history may not be

incorporated into the initial healthcare assessment, plans may not be updated and recommendations may not be followed through. In addition, records may be misplaced when the child or young person is placed outside their local area, or when children are admitted to care, discharged and re-admitted again some time later.

3.19 The loss of personal health information has significant implications for the

immediate and future health and wellbeing of looked-after children and young people. The birth family's health history may take on an additional importance when young adults begin to plan their own families. Recommendations in this guidance reflect these concerns.

In document Looked-after children and young people (Page 74-77)