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http://aaf.sagepub.com/content/36/2/4The online version of this article can be found at:

DOI: 10.1177/030857591203600202

2012 36: 4Adoption & FosteringRoger Norgate, Amy Warhurst, Cara Osborne, Maria Traill and Carol Hayden

ChildrenSocial Workers' Perspectives on the Placement Instability of Looked after

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4 ADOPTION & FOSTERINGVOLUME 36 NUMBER 2 2012

Introduction

The Care Matters White Paper (DfES,

2007) emphasised a need for stability in

the placement of looked after children

(LAC). The significance of stability is

typically understood in relation to

attachment theory (Bowlby, 1969).

Indeed, a child experiencing multipleplacement moves may develop attach-

ment difficulties and thus become more

inclined to develop constructs that

impair their relationships with others

(Munro and Hardy, 2006). It is perhaps

not altogether surprising then that young

people who have undergone multiple

placement moves do not adjust as well to

adult life as their peers (Biehal, 1995).

Until recently (2010) placementinstability was monitored by a perform-

ance indicator (NI 62): The percentage

of children looked after at 31 March

with three or more placements during

the year (DCLG, 2008). This indicator

is used as a reference point in the currentstudy. The target for local authorities

was that less than 16 per cent of LAC

should fall within this category (DCLG,

2008). Although the national indicator

has been withdrawn, data on the number

of children with three or more placement

moves are still captured and reported,

and the national data indicate a general

decline from 14.8 per cent in 2003 to

12.7 per cent in 2011 (DCSF, 2009; DfE2011a). By 2007/08, 94.6 per cent of

local authorities achieved the target of

less than 16 per cent within this cate-

gory; however, there was wide variation,

with percentages for individual author-

ities ranging from 4.7 per cent to 18.9

per cent.

It needs to be acknowledged that the

likelihood of breaching the index is not

uniform across all children. Age is aninfluential factor in determining the

likelihood of a child experiencing

multiple placement moves. Ward et al

(2006) found that over a quarter of

babies in care experience three changes

of placement before their first birthday.

Similarly, in 2004/05, 36 per cent of

children experiencing three or more

placements were under the age of four

years (DfES, 2006). However, the most

at-risk age group is 11- to 15-year-olds,with approximately 70 per cent of

placements breaking down for children

in this age group (Rowe et al, 1989;

Ward and Skuse, 2001; Wilson et al,

2004). In addition, many studies have

shown that the older the child is at the

start of their placement, the more at risk

that placement is of breaking down (eg

Berridge and Cleaver, 1987; Rowe et al,

1989; Fratter et al, 1991). The length oftime a child has been in care is a further

variable, with moves more likely in the

first year (Sinclair et al, 2004). As these

variables are not differentiated in the NI

Social workers perspectives on the

placement instability of looked after

children

Looked after children (LAC) often experience multipleplacements although different rates of placement instab-

ility apply across different local authorities. The aim of this

research by Roger Norgate,Amy Warhurst, Carol

Hayden, Cara Osborne and Maria Traill was to exam-

ine social workers views on factors influencing placement

instability. The research focused on a local authority with

higher than average rates of placement changes. Eight

groups of social workers across the area were identified

and members from each team (N = 71) completed a

questionnaire and participated in group interviews. Themain themes emerging from staff responses were a diffi-

culty accessing mental health services, lack of placement

options and limited foster placements, and over-hasty

placement decisions due to strict time restrictions on

emergency placements. Additionally, childrens challeng-

ing behaviours and foster carers unwillingness to

manage, or inexperience in managing, such behaviour

was identified as a contributory factor. The need to offer

more support to foster carers, with a view to improving

recruitment and retention, was identified as a key aspect

in reducing the need for placement moves.

Roger Norgate is

Consultant

Educational

Psychologist and

Amy Warhurst, Cara

Osborne and Maria

Traill are Psychology

Research

Associates,Research and

Evaluation Unit,

Hampshire County

Council, UK

Carol Hayden is

Professor in Applied

Social Research,

University of

Portsmouth, UK

Key words:

placement instability,

social workers views,

placement options,

support for foster

carers

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ADOPTION & FOSTERINGVOLUME 36 NUMBER 2 2012 5

62 data, caution needs to be exercised

when making comparisons between

local authorities.

This issue aside, it is also important to

note that number of placements is not

necessarily an index of negative out-

comes. Kelly and Hodson (2008) make

the point that a single residential place-

ment may disguise numerous changes ofstaff. On the other hand, a change of

placement might be a positive outcome

if the child is adopted or moves to be

closer to their birth family. Performance

indicators can also distort practice.

Skuse and Ward (2003) found some

young people had not been permitted to

change placements despite requests to

do so, and the Social Services Inspect-

orate (SSI, 2002) identified carers whoperceived support being offered to

sustain placements they did not think

were in the childs best interest.

In order to understand the drivers

around placement instability, categorisa-

tion into planned and unplanned moves

has been made. However, such categor-

isation is problematic as perceptions

about the need for a change may differ.

Planned moves would include moving achild to a more appropriate placement

(eg to adoptive parents). Such moves

tend to be particularly common for

younger children. Ward and Skuse

(2001) found that planned transition

accounted for 54 per cent of all such

moves, compared with 66 per cent of

moves for children under the age of one.

While these moves have been made in

the interest of the child, it still begs the

question of whether they could havebeen avoided. In contrast, unplanned

moves tend to be crisis driven. Munro

and Hardy (2006) illustrate the issue with

reference to the provision being unable

to cope with the childs behaviour or

changes in the carers circumstances.

There are a range of factors making

placement breakdown more likely.

Planned moves can often be a function

of limited initial placement options(Kelly and Hodson, 2008).Fostering for

the Future (SSI, 2002) found that just

over 70 per cent of local authorities had

difficulties in finding suitable matches

between foster carers and childrens

needs. Similarly, Sinclair (2005)

reported that in approximately 50 per

cent of cases, social workers claimed

that they had little or no choice over

which foster carer to place a child with.

The net implication is that foster carers

may be persuaded to take children they

are not suited to or committed to taking(Minty, 1999).

It has been known for some time that

foster carers are also being asked to

support children with complex needs,

without being given appropriate training

and support (Hayden et al, 1999).

Without good support there is a tend-

ency for foster carers to leave the care

system, further limiting placement

options. Chamberlain et al(1992) foundthat support is more likely to be avail-

able to long-term foster carers and is

more frequently at hand in times of

crisis, rather than forming part of a

planned programme. However, some

studies suggest that merely training

foster carers has limited impact upon

their capacity to manage behaviour

(Pithouse et al, 2003). Sinclair (2005)

suggests that support is most effectivewhen it is tailored to a carers situation,

includes regular contact and training,

and responds rapidly to emergencies.

Speed of response seems particularly

important (Farmer et al, 2005). Foster

carers also value responsive out-of-hours

services, respite breaks, contact with

other foster carers and the perception of

being part of a team. Macdonald and

Turner (2005) reviewed the effectiveness

of training foster carers in cognitivebehavioural therapy (CBT) approaches.

Such approaches have face validity but

the relationship with outcomes for

children is not established, nor is there

compelling evidence of an association

with placement stability (Sinclair, 2005).

In line with this, a recent randomised

control trial involving adoptive parents

found that while those parents who

received training reported greatersatisfaction with parenting, and showed

an improvement in their parenting skills,

there was no impact on their childrens

problems (Rushton et al, 2010). Turner



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et al(2005) concluded that training

needs to form part of a wider pattern of

support, which integrates other services

and involves interventions specifically

designed to address individual needs.

There is also some empirical evidence

to support the use of the Multi-

Dimensional Treatment Foster-Care

model (MDTFC) (Chamberlain, 2003;Westermark et al, 2011), although this is

equivocal, with research suggesting that

the model is effective only in the short

term (Biehal et al, 2011). This model

can be adapted for use with any child

between the ages of three and 18 years.

The aim of the model is to provide LAC

with a structured and therapeutic, con-

sistent and positively reinforcing

environment within their care setting.They are offered mentoring and encour-

agement, boundaries and sanctions,

monitoring and supervision, and there is

an emphasis on creating positive rela-

tionships and avoiding negative peer

relationships. Foster carers are trained in

delivery of the model and are supported

by programme supervisors and thera-

pists, as well as working alongside the

birth parents, schools and other com-munity settings (eg youth centres, etc).

Linking these themes, Held (2005)

found that the most effective local

authorities offered professional develop-

ment for carers together with dedicated

teams involving multi-agency support,

including input from education, health

and Child and Adolescent Mental Health

Services (CAMHS) which were

available 24/7. It also seems important

to provide support to the children incare. Several studies have found better

stability outcomes associated with

individualised, therapeutic care packages

(Holland et al, 2005). Such provision

tends to be costly, but there is growing

evidence for the need for this to be

addressed (eg DfES, 2006; Munro and

Hardy, 2006).

When considering placement instab-

ility it seems important to give properconsideration to the views of those

involved with these issues on a daily

basis.

Holland et al(2005) conducted a

survey of the factors UK social workers

felt affected placement instability. Three

main themes emerged:

1.A lack of experienced social workers

Problems in the recruitment and reten-

tion of social workers is also well

documented elsewhere (DoH, 2002).

Most local authorities mentioned highlevels of vacancies within teams and in

many cases this has been exacerbated by

high staff turnover. The implication is

that some LAC do not have an allocated

social worker or experience regular

changes of social workers. In Ward and

Skuses (2001) study, over a two-year

period one child had seven social

workers, while ten per cent had three or

more. Thus, children may have no onewith an overview of their long-term

welfare. Nevertheless, good social work

constitutes an important factor in the

quality of care planning that underpins

placement stability (SSI, 2002).

2.Recruitment, retention and training of

foster carers

A common concern was the need to

retain foster carers and to develop theskills they have. Many local authorities

have experienced difficulties in the

recruitment of carers because of the

competition presented by independent

fostering agencies (IFAs). These

typically provide better rates of pay and

more attractive packages of support.

3.Access to support

Reflecting the behavioural, social and

emotional difficulties of this population,access to services such as CAMHS has

been seen to be a difficulty in many

local authorities. The length of time

waiting to be seen has been particularly

problematic (Vostanis, 2005). School

exclusion was the second most

frequently cited problem in this section,

with the cumbersome nature of the

procedures whereby children can access

special provision being a significantfeature.

These three themes are interrelated. The

shortage of experienced social workers



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may affect the quality of care planning

and social workers ability to support

carers effectively. The recruitment and

retention of foster carers impacts on the

range of placement options and the

ability to match need to placement,

making them more prone to fail. The

lack of appropriate support structures

can cause placements to break down, aswell as increasing the potential for carers

to leave the care system, thus reducing

placement options further.

While the findings of Holland et al

(2005) explained difficulties in place-

ment stability as perceived by senior

managers from across the UK, their

study utilised telephone interviews and

focused on innovative practices to

address the issue. The current study,however, used face-to-face meetings

with both managers and non-managerial

social workers to probe more deeply the

reasons behind placement moves in a

county that had a high NI 62 percentage.

Therefore, the current study aims to give

a more in-depth consideration of the

factors resulting in placement moves in a

high-incidence English county.

Methodology

This study was undertaken in a large

shire county which has high rates of

placement instability. The local authority

has consistently been above the national

average by some four percentage points

in respect to the NI 62 criterion. More-

over, over the past five years, while the

national figures have declined from 14.8

per cent to 12.7 per cent, the data for this

local authority have remained relativelystable (ranging from 15.8% to 17.4%).

The study was practical rather than

academic, in that it set out to inform the

development of the service in the case

study local authority and sought to gen-

erate hypotheses for the latter trend as

perceived by social workers. It developed

the themes of interviews undertaken by

Holland et al(2005) to elicit the views of

social workers, but adapted them toinclude non-managerial as well as man-

agerial staff. We acknowledge that the

data constitute the subjective views of

those engaged in the system: there is no

claim to a more fundamental validity.

The data were collected in a series of

eight meetings with social workers. The

format of each meeting was similar.

Social workers were initially asked to

complete a questionnaire, which con-

sisted of rating scales and sentence-

completion questions. The group

discussions that followed yielded aricher picture of what some of the

questionnaire responses meant. Team

managers were interviewed separately,

following each meeting.

The views of the Children in Care

team, Family Placement Social Workers

(FPSW), Children in Need team,

Reception and Assessment team and the

Intensive Support Service were sampled.

Where there was more than one team inan area, the one with the highest number

of children breaching the indicator

(NI 62) between August 2009 and

February 2010 was selected. The number

of individuals present during each

meeting ranged from five to 14. In total,

71 social work team members completed

the questionnaire (66 social workers and

five team managers).

The meetings formed an adjunct toregular team meetings. The aims of the

project were explained, confidentiality

issues addressed and permission

obtained to record the conversation, so

that direct quotes could be reported. The

questionnaire consisted of 32 statements

relating to factors identified in the

literature, such as the experience level of

social workers, access to mental health

support, and the number and range of

placement options available (eg Haydenet al, 1999; DoH, 2002; SSI, 2002;

Sinclair, 2005; Vostanis, 2005; Holland

et al, 2005; Kelly and Hodson, 2008).

Participants were asked to indicate the

extent to which they agreed that the

factor might reduce placement stability,

based on their experience over the past

12 months. The questionnaire also asked

more general questions about the

reasons underpinning the last unplannedand planned move on their caseload, and

what might have been done to prevent

them.

Following the questionnaire, an open



6/16


discussion took place, which covered

factors perceived to influence placement

stability and what was most needed in

order to reduce placement instability.

Interviews with managers adopted a

similar structure. Following the meet-

ings, a summary of each discussion wasproduced, along with key quotations,

rather than transcribing recordings

verbatim. This was shared with teams to

clarify and confirm responses. A them-

atic analysis was then conducted to

identify themes emerging from the data

overall.

Results

Not everyone answered every question

on the questionnaire and consequentlythe number of responses varied and is

shown wherever data are reported. The

ratings ranged from 1 (strongly disagree)

to 4 (strongly agree), hence the higher

Table 1

Facors associaed #ih placemen insabili$ (1 = srongl$ disagree o 4 = srongl$ agree)

Factor Mean rating Nmber

(ot of 4) responding

Lack of quickly accessible mental health services 3.47 66

Lack of choice of placements available 3.46 71

Limited choice of foster placements 3.36 70

Children/young people who present offending behaviour during an episode of care 3.36 69

Children/young people who are excluded from school during an episode of care 3.32 69

Lack of a specific type of placement 3.32 57

Children/young people who have attendance problems at school during an episode of care 3.31 68

Difficulties in recruiting foster carers 3.28 68

Limited choice of residential placements 3.24 50

The mix of children/young people in residential homes 3.24 46

Lack of full-time educational provision 3.24 67

Number of different types of placement available (eg residential, foster, etc) 3.23 66

Children/young people who have mental health problems 3.22 69

Limited availability of respite care for residential care 3.00 40

Inadequate services for foster care 2.89 61

Limited availability of respite care for foster care 2.87 62

Inadequate support of residential staff 2.83 30

Difficulties in retaining foster carers 2.82 62

Children/young people who change their educational placement during an episode of care 2.81 63

Inadequate training of foster carers 2.80 65

The location of residential homes 2.79 52

Inadequate training of residential staff 2.76 29

Difficulties in recruiting residential staff 2.73 30

Inadequate out-of-hours services for residential care 2.73 41

Difficulties in retaining residential staff 2.71 28

Inadequate support of foster carers 2.70 66

Quality of placements available 2.66 68

Quality of care planning 2.43 68

Emphasis on returning children to their birth parents 2.35 66

Quality of assessment 2.29 68

Vacancies in your social work team 2.21 66

Lack of experienced social workers in your team 1.87 67



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the score the more strongly the factor

was thought to be associated with place-

ment instability. The highest mean rating

(3.47) was given to lack of quickly

accessible mental health services, fol-

lowed by lack of choice of placements

available, offending behaviour (law-

breaking behaviour) and exclusion from

school (see Table 1). These themes alsoarose in the group discussion and

quotations have been included here to

provide some depth to the analysis.

Children presenting behavioural

challenges were perceived to place an

enormous strain on carers, yet it often

took too long to gain therapeutic

support. Children could also be excluded

from services because their placement

was deemed unstable. Even onceCAMHS were involved, they were

perceived to provide inadequate

feedback about what they were doing, to

the extent that carers frequently felt

excluded. It was thought that carers

should be given an insight into why the

child was reacting in these ways, as well

as strategies they could use. The

treatment-fostering model was raised in

this respect; it was thought that alterna-tives to CAMHS might be needed, as a

key issue was the speed of response:

I would like to see the use of extra thera-

peutic and intensive support to carers

and children to help maintain difficult

placements, where behaviour is partic-

ularly challenging, and for this to be

available quickly and before the crisis is

reached.

Some felt that children should be offered

an assessment on entering care, the logic

being that they were likely to experience

difficulties solely as a result of reasons

relating to them coming into care. It was

also felt that this would provide an

opportunity to brief the carer on what

they might expect, as well as strategies

as to how they might respond.

While it was acknowledged that thereis a need to match placement to needs,

the reality was that there is pressure to

make a placement and this often

compromised the ability to make a

suitable match. Social workers described

how their knowledge of the foster carers

might suggest that they are not ideal or

that the placement will probably not last,

but the lack of any alternative demands

that the placement go ahead:

Theres no matching taking place, you

just find a carer.

Weve got a pool of carers which is too

small . . . youre left with whoevers

left . . . they might have skills with seven-

year-old children who are emotionally

abused, and youve got a 14-year-old

who is a drug user, absconder . . . so

from the start, youve got ill-equipped

carers, with a child theyre probably not

going to be able to manage.

Poor matching then demanded the

expenditure of social work time to

support the placement, thus reducing the

time available elsewhere. As indicated

earlier, foster carers who had a bad

experience might ultimately leave the

system, thus further reducing the pool

available. It was also clear that the

number of carers available did not

equate with the number of children whocould be placed. Additionally, social

workers highlighted the fact that some

children were particularly challenging to

place. Individual primary-aged children

(510 years of age) were considered the

easiest group to place, while those over

the age of 12 years tended to be the most

difficult. Additionally, the placement

together of siblings was particularly

problematic:The team has a board upstairs with a list

of carers that are available at the

moment, but we could have someone

phone up and not one of those carers

would meet the criteria for the needs of

that child.

Even where the placement breaks down

or is considered inappropriate, social

workers acknowledged that it could taketime to change that placement. Conse-

quently, carers often have to retain the

child for longer than they want. In some

cases, this had led to the carer



8/16


demanding that the child be moved. It

was perceived that a crisis point often

needed to be reached before the situation

was taken seriously enough for action to

be taken:

Ive currently got two that have ended

unexpectedly, but weve still got to keep

them going because we havent got

alternatives.

Social workers were also asked the

reason behind the last unplanned move

on their caseload. Thirty-nine responded,with some giving more than one reason.

The responses were categorised, and the

frequency of each noted (see Table 2).

Nearly three-quarters of the responses

(72%, 28 of 39) cited the childs behav-

iour as key to the breakdown of the

placement. Issues included: absconding,

non-school attendance, drug misuse,

mental health issues and sexualised

behaviour. Additionally, some cited

placement mismatch issues (23%, 9 of39), in that the behaviour presented was

too extreme for the foster carers to

manage; hence the figure for behaviour

was in fact higher than the 72 per cent

quoted. In some cases (9%, 3 of 34) the

foster placement broke down for reasons

unrelated to the child (eg foster carers

illness, carers marital breakdown).

The placement of children who exhib-

ited more extreme levels of behavioural,emotional or social difficulties was

perceived to be particularly difficult.

There was also a perception that children

coming into care were exhibiting more

complex needs than they had in the past.

Some foster carers were perceived to be

unwilling to take children with even

minor difficulties, let alone those with

more significant needs. In summary,

there was a mismatch between what

foster carers were prepared to accept and

the type of children coming into care,

which may have implications forrecruitment arrangements:

The children that were bringing into the

care system are often very damaged,

very difficult, quite hard to care for

children, and require a lot of skills . . .

This myth out there that you might look

after a nice little child whose mummys

gone into hospital type of scenario is not

todays fostering.

Education provision was said to have an

important bearing on placement instab-

ility in a number of respects. Those not

attending school were perceived to be

more at risk of placement breakdown as

carers came under pressure to make

contingency arrangements. Permanent

exclusion from school presented part-

icular difficulties. Once excluded, itcould take a long time before any

arrangements were made for the childs

education and their time in alternative

educational provision was often inade-

quate. Consequently, there was an

expectation that the child stay at home

under the supervision of the foster carer

for much of this time. It was felt that this

placed additional burdens on the carer,

and the need to supervise the child

during the day often conflicted withwork commitments. Currently, services

to support either children or foster carers

under such circumstances were

perceived to be inadequate. Some home

tutoring arrangements exist but these are

often overstretched. Some children had

been offered an e-learning programme.

While this might ensure some contin-

uation of their education, it can generate

friction between the carer and child andraises fundamental questions about the

role of foster care. Such arrangements

were also dependent on the foster carer

not having to work and being willing to

Table 2

Facors in he las !nplanned mo"e (39 cases)

Factors in the last nplanned mo!e Freqenc#

Behaviour of the child 28

Mismatch between need and placement 9

Failure of foster care placement 4

Birth parents aggression to foster carer 1

Childs request to move to a different town 1

Child scratched by foster carers child 1

Total 44*

* More than one reason given in some cases



9/16


have the child at home during the school

day. Where such arrangements did work,

a combination of ad hoc day-care

arrangements had to be made:

Its the lack of educational input once

theyve been permanently excluded from

school. This child was permanently

excluded in September, were now in

November, and still nothing, absolutely

nothing. He went to another centre,

absconded once, and they said he was

too high a risk, you have to have him

back home . . . they said they might be

able to offer him three hours a week.

Social workers were further prompted to

suggest how the last unplanned move ontheir caseload might have been preven-

ted. The results are shown in Table 3. As

might be anticipated, the most common

response was that better support could

have been provided to the foster carer

when the difficulties first occurred

(38%, 15 of 39). As discussed earlier,

suggestions as to what this might look

like included having more easily

accessible therapeutic support, betteraccess to educational provision, more

social worker availability enabling

quicker intervention should difficulties

arise and better initial information

sharing about the childs needs.

The second most common response

was that there could have been better

initial matching of the child to the

placement (31%, 12 of 39) and, in two

cases, that this might have beenfacilitated by a better initial assessment

of the childs needs. In some cases,

social workers were unable to suggest

anything that would have helped. This

was typically linked to the perception

that the childs behaviour was set on a

course of self-destruction that would

have been difficult to avert.

Social workers were also asked for the

reasons for the lastplannedmove on

their caseload. The results are categor-ised in Table 4. Nearly half (48%, 16 of

33) of these moves appeared to represent

positive changes in the childs life:

either a return to parents (8 cases),

moving to a placement that could pro-

vide for him/her on a long-term basis

(3), being placed for adoption (3),

moving to be closer to their birth family

(1) or moving from secure accommo-

dation to an intensive foster placement(1). Transition to an adult placement also

featured in three cases.

The remaining factors were similar to

those given for unplanned moves and

Table 3

Pre"ening he las !nplanned mo"e (39 cases)

What "old ha!e pre!ented the last Freqenc#

nplanned mo!e

Support to foster carer 15

Better initial matching of child to placement 12

Nothing 7

Better training of foster carer 4

Better initial assessment of child 2

Foster carer being more motivated to work 2

through the problems.

Fewer changes of social workers (less turmoil) 1

Better planning of parental contact arrangements 1

Better relationship between social workers 1

Provision of respite care 1

Total 46*


Table 4

Facors in he las planned mo"e (33 cases)

Factor Freqenc#

Return home 8

Age transition to adult placement 3

Placed for adoption 3

Foster carer ceased providing 3

Move to long-term placement 3

Behaviour 2

Breakdown of relationship 2

Foster carer served notice 2

Poor initial matching 2

Complex needs 1

Lack of foster care placements 1

Child request closer to birth family 1

Part of plan 1

Poor initial contract 1

Move from secure to intensive foster care 1

Temporary placement prior to long-term 1

Total 35*


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primarily related to the behaviourbecoming too difficult for the foster

carer to manage, the main difference

being that the foster carer served notice

that a change was needed. In some

cases, the foster carer had concluded that

this role was not for them, and they left

the system. Again, social workers were

prompted to suggest how that planned

move might have been avoided. The

results are shown in Table 5.Reflecting the reasons for the change,

many social workers (13) actively

welcomed the change of placement as a

positive development. Many also

suggested that nothing could have been

done to prevent the move (11). By way

of example, in some cases the court

decided the child should return home. In

some cases, a lack of support for the

foster carer (4) or therapeutic support for

the child (3) was felt to have contributedto the placement change.

Mos imporan change req!ired

Social workers were also asked what

they perceived to be the most important

change needed to reduce placement

instability; the results are shown in

Table 6.

The three most common categories

support for foster carers, more place-ment options and foster carer training

constituted 57 per cent (52 of 92) of all

the points made. In particular, social

workers felt that there should be better

support for foster carers as they came

under pressure from behaviour exhibited

by the child in their care. This was

closely followed by acknowledgements

that there was an insufficient pool of

foster carers, which compromised social

workers ability to match the childs

needs to the placement at the outset.

Interlinked with this, social workersrecognised the need to enhance the skills

of foster carers, who were often being

asked to manage difficult issues with

little prior experience.

Themes from gro!p disc!ssions

The discussions also identified a number

of other issues; most significant among

them were the following.

Emergency placements

There was discussion about emergency

placements being too short (typically

24 hours). Examples were given of

children being placed as an emergency

for one night, being brought back first

thing in the morning and subsequently

having a series of placements. It was

suggested that consideration might be

given to extending the length of anemergency placement, so that the next

placement could be based on a better

consideration of what was required:

[It happens] probably once a fortnight,

but one child could be sat in the office

every day waiting for a different bed

each night for an entire week.

Quantity of social workers

The number of social workers wasthought to be inadequate and com-

pounded by administrative demands.

This implied the work tended to be crisis

driven rather than preventative. Social

workers were said to need smaller

caseloads in order to get to know the

foster carers, so they could offer support

and strategies prior to crises arising.

New foster carers were particularly

needy and required more support:

Hopping from one crisis to another . . .

we are chasing our tails and its not

really to the benefit of anyone.

Table 5

A"oiding he las planned mo"e (35 cases)

Factor Freqenc#

Move was in childs best interest (welcomed) 13

Nothing 11

Support to foster carer 4

Availability of long-term placement 3

CAMHS/therapeutic support for the child 3

Better matching of need to placement 2

Change to classification of foster carer 1

Provision of respite care 1

Total 38*




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Withholding information

A frequent charge from FPSWs was that

social workers often withheld informa-

tion when referring a child for placement.

Comments ranged from inaccuracies to

misrepresentation. It was acknowledged

that social workers may not know the

child sufficiently well to provide the

information or did not have the time to

trawl through the file to obtain it. In

respect to misrepresentation, one obvi-

ous reason was that it could jeopardise

the placement:

Its a dilemma because youve got a

foster carer who wants to know every-

thing and has the right to know every-

thing about a child, but . . . if we tell

them everything they might then choose

not to take the child.

There were also tensions in describingbehaviour in such a way that might

distort its importance or stigmatise the

child. However, by misrepresenting the

childs behavioural needs, the ability to

match placement to need and offer foster

carers the support they require is com-

promised. FPSWs felt they had a respon-

sibility to provide the carer with as much

information as possible to avoid unex-

pected issues arising. Reflecting the lack

of placement options, the counter-view

was that the information did not have

any obvious impact on placement

decisions.

Independent Fostering Agencies (IFA)

placements

While an IFA placement was possible

under some circumstances, there was

perceived to be pressure to place child-

ren locally even if it did not represent a

reasonable match with the childs needs.

The financial drivers were acknow-

ledged but there were doubts about the

wisdom of not using more suitable IFAplaces.

The perceived attractions of IFA

carers were that they offered further

placement options and better quality of

Table 6

Changes needed o red!ce placemen insabili$ (54 cases)

Factor Freqenc#

Support for foster carers 20

More placement options a bigger pool of foster carers to facilitate matching 17

Foster carer training 15

Therapeutic support for the child 8

More social workers 6

Better quality foster carers more motivated to address the difficulties 5

Better links and communication between social work teams 3

More residential provision, particularly for older children 3

Respite arrangements for foster carers 3

Better initial placement information 2

Tighter database monitoring 2

Better payment arrangements for foster carers 2

Improvement in long-term planning 1

Educational support 1

Consistency of management within placement 1

FPSWs being better valued 1

Foster carers being better valued 1

Less turmoil in social workers 1

Total 92*




12/16


training and support, which also

extended to therapeutic support. The

point was also made that as they were

essentially professional carers

(whereas local authority carers were not

perceived in this way, in the main),

expectations regarding care delivery

could be made more explicit. Relating to

an earlier point, it followed that theinformation provided could be more

comprehensive because there was

confidence that the structures were in

place to support the carer and child:

Some of them [IFAs] even have

therapeutic support, whereas in-house

were expected to go to CAMHS

[greeted by laughter from others in the

room] which takes forever.

Discussion

This article adopted and adapted the

approach used by Holland et al(2005),

including non-managerial social worker

views in addition to manager perspec-

tives, and being conducted in a high-

incidence local authority to allow greater

consideration of factors leading to

placement moves. It was reassuring thatearlier research was replicated here but

also disquieting that many of the issues

appear long standing and resistant to

change.

In a survey for the Department of

Health, Meltzer et al(2003) found that

young people in the care system were

four to five times more likely to have

some form of mental disorder than the

general population. It is perhaps

unsurprising, therefore, that the maindriver for unplanned changes of place-

ments was perceived to be the behaviour

of the children concerned. It is perhaps

even more telling that although this

factor was not mentioned as a broad

category within the items on the initial

questionnaire given to social workers,

many freely mentioned this when asked

open-ended questions about the factors

linked to the last unplanned move ontheir caseload. It would perhaps be

prudent to include behaviour within

the initial questionnaire items in any

future research, as this may alter the list

of leading factors resulting in placement

instability. It is important to note,

however, that the questionnaire did ask

specific questions about mental health

problems, offending behaviours and

exclusions from school, but these will

not have covered all behavioural

difficulties faced by carers.

Childrens behavioural difficultiestypically placed enormous strains on

foster carers and their families. As

Holland and colleagues (2005) found, it

was felt that there needed to be much

better access to CAMHS and related

services to support both children and

carers. This difficulty has been identi-

fied elsewhere (Williams et al, 2001),

the length of waiting time being a major

irritant. Delay merely increases the riskof placement breakdown and the child

incurring further damage because of the

changes to family and school placements

and associated relationships. As Held

(2005) suggests, multi-agency support

(education, health and CAMHS) avail-

able 24 hours per day and throughout the

year is required. Indeed, multi-systemic

therapy, a community intervention for

young people incorporating a partner-ship between various social, education,

and mental health services (DfE,

2011b), has a broad evidence base

supporting its effectiveness in reducing

the risk of out-of-home care or custody

(eg Littell et al, 2005; Welsh and

Farrington, 2006). It was particularly

worrying to note that in this local

authority context children are still being

caught in the bind of being excluded

from support merely because theirplacement is viewed as unstable (see

Vostanis, 2005 for similar findings). The

difficulty with this is that the problems,

which contribute to the instability, may

never come to be addressed. Financial

restrictions within local authorities also

make it more likely that support services

established within social care are more

prone to being cut as services become

reduced to their statutory functions.The current study also suggests that

exclusion from school is perceived to be

a significant threat to placement, part-

icularly where carers work full time.



13/16


Alternative educational provision can

still take an inordinate amount of time to

organise and the arrangements that are

made are often inadequate to the needs

of carers. Part of the issue appears to be

that exclusion is used by schools to

place pressure on parents/carers to help

ensure the appropriate behaviour of

children, irrespective of how illogicalthis position might be under these

circumstances. This issue again high-

lights the need for joined-up planning by

the corporate parent.

A more structural problem, also

reflected in the main three factors identi-

fied by Holland et al(2005), was inade-

quacies in the placements available (also

SSI, 2002 and Sinclair, 2005). This

meant that matching needs to the skillsof the available carers was an unattain-

able aspiration, with there being little

real choice over the placement of a child,

thus making it more likely to fail. Re-

cruiting more foster carers could yield a

wider range of placement options, and

providing them with better packages of

support might help to develop skills and

retain them longer. However, there are

also issues over the quality of existingcarers, with some viewed as unprepared

for the type of children coming into

care. Thus, quality of carers is as import-

ant as quantity. It was also perceived that

an IFA offered more placement options

and better support to carers, and was

much clearer in its expectations of them.

Unless this is a feature of the grass

being greener the other side of the

fence, it begs the question of why such

features cannot be replicated locally,especially given that they are ultimately

funded by the same source. An addi-

tional issue in relation to placements was

the suggestion of more relaxed time-

scales when children are placed in an

emergency, in order to avoid placement

breakdown due to overhasty decision-

making about the next placement.

One of Holland and colleagues

(2005) main themes a reduction ofcaseloads was also reflected here.

Teams felt that there should be more

social workers within the local authority

and less demands on reports and paper-

work. With smaller caseloads, they

indicated they would have more time to

work proactively to avoid placement

breakdowns occurring, rather than pri-

marily reacting when a crisis had been

reached and it was increasingly too late

to intervene.

As reflected in the details documented

in the methodology section, the socialworkers in this local authority are

segregated into teams with discrete

functions. Inevitably, there are pros and

cons with all arrangements and by

sampling views within the discrete

teams some tensions were revealed.

Withholding information about children

seeking a placement was a case in point.

While there are always dilemmas in

providing sufficient information withoutstigmatising the child or alienating the

carer, some of the points revealed a lack

of appreciation of the reality within

which colleagues worked. Arrangements

to enable social work teams to be more

conscious of the role and pressures

facing colleagues might be a useful way

of improving inter-team collaborations.

Suggestions for improvements

deriving from this study included:

having more foster carers, whichwould yield a wider range of placement

options;

ensuring better-quality foster carers,both through the initial selection and the

training provided;

providing carers with the quality andquantity of support thought to be

provided by IFAs;

developing approaches along the linesof the MDTFC model to provide a better

quality of support to children with more

challenging behaviours;

reviewing the decision-making aroundIFAs with the view to streamlining

arrangements where possible;

having a more relaxed timescale when

children are placed on an emergency

basis, to avoid placement breakdown due

to overhasty decision-making about the

next placement;



14/16


agreeing to, and keeping to, short-term deadlines for placements which are

not emergencies, but which are known to

be inappropriate, albeit unavoidable, in

order to avoid carers having to retain a

child for longer than they want, which

could ultimately lead to an unplanned

breakdown and the need for an emer-

gency placement move;

exploring arrangements to enablesocial work teams to be more conscious

of the role and pressures facing

colleagues in other teams;

developing more comprehensiveprovision or arrangements for children

excluded from school.

Taken together, these points indicate anintense need for training foster carers so

that they are enabled to care for a wider

variety of children, both in terms of age

ranges and in terms of childrens needs

and presenting behaviours, or alterna-

tively, recruiting foster carers special-

ising in particular ages or behaviours.

Perhaps the setting up and running of

foster carer-led support networks and

telephone helplines, supervised byspecialist social workers, might help to

ease the pressure on overstretched social

worker teams, while still providing a

relatively inexpensive level of support

that can be used by carers before a crisis

point is reached. Further, for children

presenting with more severe behavioural

problems, including offending behav-

iours, having specialist foster carers

trained in the use of MDTFC, or similar,

might help to reduce offending behav-

iours in the short term and give CAMHS

time to intervene and address any under-

lying problems, before the child can then

be placed within a more generalised

foster care setting. This could help to

bridge the perceived gap between what

could be expected of in-house foster

carers and IFA placements, thus poten-

tially reducing the need to look at IFA

placements.Where IFA placements are required,

more clarity about the criteria needing to

be met before applications for these can

be made, and the budget available for

these placements, could be more widely

distributed to social workers to increase

shared understanding about the pro-

cesses involved. It may also be prudent

for more senior managers to meet

regularly with social work teams to

discuss the difficulties social workers

face and to jointly problem-solve.

In terms of provisions for childrenexcluded from school, local authorities

need to work more closely with educa-

tional outreach centres and pupil referral

units, to find workable solutions for

challenging behaviours and ways to

safely educate children in non-

mainstream settings. It is beyond the

scope of this article to investigate the

methods that may be available for this.

Additionally, extending the amount oftime able to be spent in emergency

placements, while simultaneously

ensuring that any subsequent placements

that are less than satisfactorily matched

have definite time limits, would enable

better matching of placements immedi-

ately after an emergency-based place-

ment, and a reduction in the level of

anxiety and tension that builds up for all

concerned. The consequence of thesechanges would theoretically be a

reduction in the number of crisis-point

placement breakdowns.

Enabling different social work teams

to meet regularly for the sharing of best

practice, and to arrange shadowing

opportunities for colleagues and shared

training days, would enhance their

understanding of each others roles in

supporting LAC and their strengths and

limitations, as well as the pressuresfaced by each.

Summary

Concerns about placement instability in

foster care have been around for a long

time, and many of the factors influen-

cing instability are still present today.

The current study found that the main

driver for unplanned placement moves

centred around the behaviour of thechildren concerned, and the difficulties

in accessing mental health services

support and adequate educational pro-

vision further exacerbate the situation.



15/16


An insufficient number of foster carers

able to handle a wide range of children

has resulted in the local authority being

forced to accept inadequate or unsuitable

placements, and a large caseload per

social worker reduces their ability to

support carers until a crisis point is

reached. Several suggestions for

improvement included increased supportand training opportunities for carers,

better communication and joint problem-

solving between senior management and

social workers, increased emergency

placement access and a revision of

timescales in place for placements that

are not suitably matched and an increase

in inter-team communication. However,

further research would be needed to test

the practicalities of these suggestions.Additionally, future research could

examine the perspectives of other

stakeholders, such as parents, carers and

children, to see if different or additional

themes emerge from their experiences of

the care system.

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Adoption & Fostering 2012 Norgate 4 18

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