Tuesday 29 Jun 2010 @ 07:58
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In Loco Parentis

The hidden costs of delay and indecision in the care system.


Looked after children who have a poor quality of care – characterised by delay and instability – can cost children’s services up to £32,755 per child each year more than a positive care experience a report by Demos has found.
 
With the current care population in England and Wales close to 61,000 the potential emotional and financial savings that could be made if the care system was more proactive are considerable, shows the report In Loco Parentis funded by children’s charity Barnardo’s.
 
The report draws upon research with looked after children, care leavers and foster carers as well as case studies of good practice, to set out recommendations to de-stigmatise care as a source of family support and ‘taper’ the edges of the system so that care is not used as an all-or nothing intervention.
 
Key factors that made a positive difference to a child’s life were:
•     Early intervention where appropriate and steps to minimise delay between the decision to take a child into care and securing a long-term care placement
•     Fewer, high quality, stable placements that are planned with a focus on stability
•     Supported transition to adulthood for young people leaving the care system
 
It is the delays in removing the most vulnerable children from birth families at an earlier stage that show an association with poor mental health and behaviour. This early damage to a child significantly reduces their chances of being adopted or securing a long-term foster placement.
 
In Loco Parentis includes two hypothetical journeys of ‘Child A’ and ‘Child B’, where Child A experiences a positive care journey and Child B experiences a poor care journey – to identify how the care system could be improved.
 
A stable experience of the care system over 14 years – where the child enters early, has fewer family placements and stays for longer – can cost £354,053 to children’s services. An unstable experience over 7 years – where the child enters the care system later and experiences multiple moves between foster carers and has poor mental health - can cost £393,579, a difference of £41,526.
 
Looked after children who leave care early, at age 16, tend to do less well in education, employment and health than those who leave care later. The report also considered the costs associated with adult outcomes after care:
 
Child A - who leaves care at 18 with good mental health and strong relationships, then goes on to university and finds a job - could cost the state £20,119 between age 16 and age 30. This is compared to the £111,923 that Child B, who leaves care aged 16.5, with poor mental health and no qualifications could cost the state between age 16 and age 30.
 
Demos recommends that the care leaving age should be raised to 18, with a ‘right to remain’ in placements until 21 and a ‘right to return’ to care up to the age of 24. Around 6,000 looked after children leave care for good every year. The average age for a young adult to leave home is 24. Children in care leave much earlier:
•     21 per cent leave aged 16
•     17 per cent leave aged 17
•     61 percent leave aged 18
 
Julia Margo, Acting Director of Demos said:
“Because we don’t trust the care system, we don’t use it as the effective parallel parent that it could be.”
 
In Loco Parentis recommends:
·    The care system must be de-stigmatised and viewed as a positive form of family support - The state should be recognised as being capable of acting as a “parallel parent” for children and families who need such ongoing support.
 
·    The Department for Education needs to strengthen care planning guidance to ensure there are fewer failed family reunifications - Repeated efforts to reunite children with their birth parents have a negative impact on a child’s mental health and chances for stability in the future.
 
·    Foster carers should receive mental health training - Foster carers look after children’s wellbeing at the ‘front line’ and more training on child development, mental health and psychological wellbeing is needed to equip them to support particularly vulnerable children. Children in residential care should receive support from on-site mental health workers.
 
·    Local authorities need to make respite support and placement support workers available to foster carers on request - Investing in providing short breaks for foster carers caring for children with challenging needs to reduce the likelihood of placement breakdown, particularly in the early stages of a placement.
 
Celia Hannon, one of the authors of the report said:
 
“Government must urgently address the factors that affect a child’s experience of being in care. That means focusing more on working with families at an earlier stage and minimising the instability resulting from indecision and lengthy processes.”
 
The report stresses that the pre-care experiences of children need to be taken into account when considering the effectiveness of the care system – studies show that 72 per cent of children aged from 5 to15 enter the care system with behavioural or emotional problems. To believe that the care system causes such problems is a common misconception, which only serves to undermine public confidence.
 
Martin Narey, Chief Executive of Barnardo’s said:
“Many believe that care is always second best to the care provided by parents. Contrary to popular belief, and for all its inadequacies, care does make things better and can and does create stable, nurturing environments for children.
 
“We must urgently adopt a more pro-active and positive use of care, one where care is used earlier and more effectively so it becomes a means of real cost avoidance. For many children care does work. Yet there is still considerable room for improvement, and more importantly, this improvement is eminently attainable.”
 
ENDS
 
Notes to editors
 
Child A experiences a positive journey through care, has secure attachment relationships, and stability in housing and school arrangements. This is intended to reflect the 5-10 per cent of children in care who experience long-term, stable placements and supported transitions.
 
Key characteristics of Child A’s journey:
·        Enters care aged 3
·        Swift care proceedings to obtain a care order
·        Short-term foster care placement for one year
·        Long-term foster care placement for 14 years
·        Leaves care aged 18 with good mental health and good qualifications
 
Child B experiences a poor journey through the care system, might enter care with poor mental health, move placements several times, exacerbating their emotional and behaviourial difficulties, and leave the care system earlier. This is intended to reflect the 5-10 per cent of children who experience the worst care journeys characterised by instability, disruption and abrupt exits.
 
Key characteristics of Child B’s journey:
·        Enters care aged 11
·        Emergency foster care placement (1 week)
·        Short-term foster care placement (12 months)
·        Reunified with family (6 months)
·        Emergency foster care placement (1 week)
·        Short-term foster care placement (6 months)
·        Reunified with family (6 months)
·        Re-enters care and legal processes are undertaken to obtain a care order
·        Three foster care placements over 12 months
·        Placement with agency foster carer (12 months)
·        Short-term residential placement (11 months)
·        Exits care aged 16.5 years old and lives in independent accommodation until 18
·        Has poor mental health and no qualifications
 
Whilst children entering care have very different intrinsic needs – such as disabilities – or may only need care later in life, both of which affect how much their care journey will cost, Demos created two journeys currently experienced by around 5-10 per cent of the care population at each extreme of very positive experience to very poor experience.
 
In Loco Parentis was researched and written by Celia Hannon, Louise Bazalgette and Claudia Wood. The research took place over 12 months and included quantitative analysis, expert interviews, international scoping, domestic case studies and focus groups.
 
Due to a lack of longitudinal data, Demos was unable to establish a causal link between different types of care journey and outcomes. Instead, we drew on a number of small scale academic studies which showed a correlation between particular factors in care and outcomes related to mental health and educational attainment.
 
As such, the costed care journeys created for this report do not attempt to prove that certain care journeys causecertain outcomes, but rather they are designed to illustrate the costs associated with two experiences at each end of the spectrum. A stable and positive care journey is associated with, but may not cause, better mental health, leaving later from care, and improved academic attainment. A poor and unstable care journey is associated with, but may not cause, poorer mental health, educational attainment and earlier exit from care.
 
On leaving care, we also drew on national data to estimate the likelihood of unemployment and low income based on educational qualifications, but again, we have no evidence to prove that a poor care journey causes unemployment and other negative adult outcomes, just that these two factors have been associated in several academic studies.
 
The report shows that overall a good care experience can cost far less, both in terms of possible improved outcomes in later life but also in terms of immediate cost savings in administration and staffing overheads.

Specifically in comparing two extreme care journeys the report found that annual costs to children’s departments could be up to twice as much for an unstable care journey depending on the length of stay in care. In addition, poor outcomes associated with what happens on leaving care for looked after children who have had unstable care experiences could result in costs to the state being up to 5 times more between leaving care and age 30.
 
 
Demos is an independent think tank focused on power and politics. We develop and spread ideas to give people more power over their own lives. Our vision is of a democracy of powerful citizens with an equal stake in society.
 
This research was supported by Barnardo’s. Barnardo’s works with more than 100,000 children, young people and their families in 415 specialised projects in communities across the UK. They believe in the potential in every child and young person, no matter who they are, what they have done or what they have been through. We will support them, stand up for them and bring out the best in each and every child. Every year Barnardo’s helps thousands of children turn their lives around. But they cannot do it without you. Visit www.barnardos.org.uk to find out how you can get involved and show you believe in children.
 
The authors are available for interview. For media enquiries, please contact:
 
Beatrice Karol Burks, Press and Communications Officer
020 7367 6325
079 29474938
 
This research was supported by Barnardo’s.

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