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  1. 1. National Centre for Excellence in Residential Child Care Conference Proceedings Issue 21 – Spring 2006. ISSN 1357 7085 Editorial The new National Centre for In this issue Excellence in Residential Child Care Residential child care – a positive placement option 2 Sir William Utting, in his closing remarks to Review of the purpose and future the October 2004 Children’s Residential shape of residential care for children Network Conference, Residential Child Care and young people in Wales 3 2004: Progress through good practice, Risk assessment and management endorsed the longstanding proposal to set with young people – principles and up a National Centre for Residential Child practice 4 Care in England. Assessment of need – a modern day practical approach 5 I regard the establishment of such a centre Education of looked after children – as the single most positive step that can theory to practice in Buckinghamshire 6 now be taken for residential child care. I trust that next year’s conference will hear Education of Looked After Children - that the funds for the first three years have Short Course GCSE project 7 been secured and that the centre is about A time of change 8 to be launched. Healthy Care in the residential setting 9 In his keynote speech to the 2005 Bristol’s Collaborative Service 10 conference, Residential Child Care 2005: Policy, practice, outcomes, Bruce Clark, Integration, measurement and Divisional Head of the Looked After underpinning academia 11 Children Division in the Department for schools; and forging new partnerships Personal Communication Passports 12 Education and Skills (DfES), announced between care providers and commissioners. Service provision to unaccompanied funding of £731,000 (until March 2008) for The work plan of NCERCC addresses these asylum-seeking children 13 such a National Centre for Excellence in issues and further feedback on the plan Looked after children and Residential Child Care (NCERCC) to be hosted and priorities will be sought in spring 2006 interactive IT 14 by the National Children’s Bureau (NCB). via Children’s Residential Network (CRN) Referring to the challenges to be overcome regional meetings and other events. Getting the best from complaints – in achieving improved outcomes for young the children’s view 14 people in residential care, and the significant NCERCC will have a programme board to Fit for purpose? Professional work already in process to meet those steer its work and its membership will reflect education, training and qualifications challenges, he said: the need for close partnership working for residential child care. 15 between providers, practitioners, policy- The Children’s Workforce … there is much going on to address the makers and young people. Development Council and challenges we face in residential care – but Residential Child Care Staff 17 there is a great deal that needs to be done It is only by such a partnership that the Children in Public Care Unit update 20 to ensure that all children who are living in government, NCERCC, Commission for Social children’s homes and residential special Care Inspection (CSCI), local authorities, schools, both now and in the future, providers and young people can realistically experience a high standard of care. The aim to deliver measurable improved government, the national centre, the outcomes for children in residential care. inspectorate, local authorities and providers Sheryl Burton, Director of Social Inclusion at all have key roles to play in this. NCB, who will be managing the The CRN annual conferences have development of the centre, welcomed the demonstrated some of the renewed focus The areas of work which will be priorities DfES announcement and commitment to and energy that already exist. Abridged for NCERCC are the most urgent facing the centre: articles from the latest annual conference residential child care: measurable form the content of this newsletter and improvements in outcomes for children in Residential child care is a critical illustrate the creativity, complexity and residential care; significant increases in the component of the children’s services breadth of the work going on. Working level and quality of training of staff in provision for vulnerable children and young together we can build on existing good residential children’s settings; significant people. We hope this national centre will practice and make significant improvements improvement in the level of compliance give renewed focus and energy to improving in the life chances of vulnerable children with the National Minimum Standards outcomes for those children living in and young people looked after in children’s for children’s homes and residential residential care in England. homes and residential special schools.
  2. 2. National Centre For Excellence in Residential Child Care Conference Proceedings Issue 21 – Spring 2006 Residential child care – a positive placement option Summary of the keynote speech to the 2005 conference by Bruce Clark, Divisional Head of the Looked After Children Division in the Department for Education and Skills The government is committed to residential authorities to ensure that the use of which will enable us to ensure that the child care as a positive placement option high cost placements can be fully justified. Children’s Homes National Minimum for looked after children – children in care. Each local authority must Standards and Residential Special There is no doubt that good quality ensure they have timely access to a range Schools National Minimum Standards residential care helps looked after children of placement options, including residential are more closely linked to securing the find stability and achieve better outcomes. care. Children with multiple, complex and right outcomes for children, while And for such children, residential care will challenging needs need to be able to reducing bureaucracy by ensuring that continue to be their placement of choice. gain access to the therapeutic and inspection activity concentrates on rehabilitative services that are provided these outcomes, rather than Significant recent landmarks and by specialist children’s homes and monitoring compliance with processes. developments for looked after children residential special schools. ■ Funding of £731,000 (until March 2008) include: for a National Centre for Excellence in ■ An expectation made clear in the White We have worked closely with local Residential Child Care to be hosted by Paper, Higher Standards and Better authorities to support the development of the National Children’s Bureau. Schools for All, that the new School more effective commissioning strategies at Improvement Partners will hold schools local and regional level. Strategic As a result of this government action, we to account for how well they support approaches to commissioning will secure expect to see: looked after children, and for improving improved value for money and ensure that ■ improved quality in children’s homes and their educational outcomes. placements are better matched to the needs residential special schools ■ New regulations giving looked after of the child – and will, across time, free up ■ better value for money children top priority in school significant resources to redirect into wider ■ above all, better outcomes for looked admissions, thus strengthening the children’s services, including family after children who depend on children’s existing code of practice. support/early intervention/preventive homes and residential special schools for ■ A new duty on local authorities to services, thus reducing the need for high- their care. promote the educational achievement of cost placements in the longer term. looked after children. In conclusion, there is much going on to ■ The creation through the Adoption and Specific DfES action to address these address the challenges we face in residential Children Act 2002 of Independent challenges includes: care – but there is a great deal that needs Reviewing Officers, who are pivotal in ■ A study of the children’s homes market, to be done to ensure that all children who ensuring that individual residential which will provide evidence about the are living in children’s homes and residential placements meet the identified needs potential for improvements in children’s special schools, both now and in the future, of children. homes, and how such changes might experience a high standard of care. The best be achieved. government, the national centre, the The main challenges we face in residential ■ A review of the Children’s Social inspectorate, local authorities and providers care are: Services National Minimum Standards, all have key roles to play in this. Cost increases The overall cost of residential care has risen from £717m to £856m (almost 20 per cent) in the two years from 2001/02 to 2003/04, although the number of children placed in the residential sector has remained roughly static. There is concern that some children’s homes overcharge for placements – and the issue of ‘excess profits’ has in recent months also been highlighted. In addition, there is concern about fee increases in the residential special schools sector. Quality Evidence from inspection makes clear that the quality of care provided by children’s homes and residential special schools is variable. It is clear that a number of children’s homes and residential special schools provide very high quality care while others provide care which does not meet all, or even most, of the National Minimum Standards. Commissioning skills of local authorities There is further scope for improved 2 commissioning on the part of local
  3. 3. National Centre For Excellence in Residential Child Care Conference Proceedings Issue 21 – Spring 2006 Review of the purpose and future shape of residential care for children and young people in Wales Roger Clough, Emeritus Professor of Social Care and Research and Independent Researcher and Consultant (Eskrigge Social Research), described the findings of this study commissioned by the Welsh Assembly Government. Undertaken with Roger Bullock and Adrian Ward, in collaboration with a simultaneous review of fostering services, by Matthew Colton, Andrew Pithouse, Sue Roberts and Harriet Ward, the findings have wider relevance for residential and fostering services in England. The Welsh Assembly Government (WAG) Understanding children’s needs – our do this we need: commissioned a review to consider ‘the categorisation for the review: ■ a range of residential provision with purpose and future shape of residential care ■ children with relatively simple or clear differentiation in terms of level services for children in Wales, with the aim straightforward needs and type of need of establishing a cogent theoretical basis and ■ children or families with deep rooted, ■ residential care as a key component in a strategic direction for the development of an complex or chronic needs wider system effective, quality service’. ■ children with extensive, complex and ■ three types of facility (mainstream, enduring needs compounded by very residential treatment homes, high The ‘shape’ of residential care has changed difficult behaviour. support units) in recent years: ■ investment in residential staff and ■ it is used less Towards a national strategy in Wales managers to produce a positive care ■ there are fewer children in it The Welsh Assembly should develop a culture ■ there is a growth in very small homes national strategy for services for children in ■ each home to be led by an expert ■ there have been failures in meeting the need and looked after children with the residential manager with vision, mental health and educational needs of following aims: commitment and leadership qualities. children ■ to set out the current placement of ■ there are difficulties in assessing children in diagrammatic form It is easy to despair of doing anything outcomes ■ to reduce the number of looked after worthwhile, but quality of daily life does ■ out-of-county placements are a problem children by 10 per cent matter and much of what happens in daily (cost, monitoring, contact and so on) ■ to examine current resources and living is within the control of the home. ■ there are increasing numbers of children compare with predicted demands with complex needs ■ WAG and local authorities should The two research reports summarised above are ■ residential staff feel undervalued determine what services they want – Review of the Purpose and Future Shape of ■ there are concerns of staff about the and be in a position to ensure provision Fostering and Residential Care Services for management of allegations of abuse. of those services Children in Wales: What Works in Practice. ■ a child’s placement must not be What Works in Residential Care is also being Good practice in residential homes dependent solely on making use of what published in print format by NCERCC based There is solid evidence from research on other organisations provide at NCB. what makes a positive difference in ■ each local authority should show how it Reviews of the research evidence, Stage Two residential care, such as: would provide services for a mix of Report, are available from: ■ the leadership of a home children and share resources across local www.childrenfirst.wales.gov.uk/content/ ■ high quality of the relationship between authority boundaries placement/foster-res-care-review-e.pdf carer and child is vital ■ reward those local authorities that ■ the congruity of objectives between develop specialist services for children www.childrenfirst.wales.gov.uk/content/ staff, the home manager, external with the highest levels of need with placement/foster-res-care-review-stage-2-e.pdf management and wider social systems mechanisms to: ■ the establishment of appropriate cultures – prioritise risk within the homes. – set out eligibility for services – ensure provision matches the needs Planning children’s services of the child How do you create systems that will – identify a single process leading to a promote and support the best practice? continuum of interventions The first step is to understand the child – – develop services for children with not to search for a placement. Assessment greater degrees of disturbance. is the key. The assembly should review the systems Too frequently social workers try various that best support corporate parenting. options, starting with less specialist foster care rather than choosing the placement Services are inter-related – change in one option suggested by a clear assessment of will affect others. Foster and residential needs and services. In planning residential care must link with each other and with services there must be: other services for example, health and ■ clarity as to what the intervention on education. behalf of the state is designed to achieve ■ a continuum of services for children in High quality residential homes need The overriding aim is to create a positive ■ differentiation between children. environment for residential child care. To 3
  4. 4. National Centre For Excellence in Residential Child Care Conference Proceedings Issue 21 – Spring 2006 Risk assessment and management with young people – principles and practice Paul Mitchell and Bev Stowell, FACTS (Forensic Adolescent Consultation and Treatment Service, Manchester), described some of the underlying principles of risk assessment and management Risk assessment and management A dynamic process proportionality. Necessity means making a strategies have become increasingly Risk is something that changes over time in decision that is justified in protecting the important in many domains of child care response to environmental conditions. safety of the young person or others against over the last two decades. Developing Therefore risk assessment and management an anticipated risk. Proportionality means protocols and practice guidelines has been need to be a continuing process rather than that the intervention used is proportional seen as the way forward in ensuring that a one-off procedure. Risk needs to be re- (and not excessive) to the level of risk posed. children in contact with the care system assessed and the management strategies However, what is justifiable in a one-off and receive a high quality and safe service. reviewed on a regular basis and also in unanticipated situation would not necessarily However, despite the numerous enquiries response to unanticipated changes in be justifiable as an ongoing strategy for and reports that have been published circumstances. This is particularly true when managing risk. over the last two decades there continue working with young people who are subject to be failures in the service we provide to to rapid changes in mood and behaviour as Planning, documentation and young people. well as maturational processes. information sharing Planning is important in anticipating likely Risk assessment and management is a large Structured but flexible challenges and making appropriate plans and complex subject that clearly cannot be The process should be standardised and for their management. It is particularly comprehensively addressed in such a short consistent, but permit scope for individual important to look at precipitating factors article. However, we will try to address judgments when circumstances change that may indicate circumstances where risk some of the underlying principles that rapidly or in an unanticipated way. Good is likely to increase. This process should were covered during the presentation at risk assessment tools are a major aid in also include the development of the conference. making decisions about risk and how to contingency plans. manage it. They are usually based on a Two sides of the same coin large amount of previous evidence and Documentation is crucial to the process Risk assessment and risk management are enable staff to think about risk in a and should include detailed accounts of two sides of the same coin. It is pointless structured way that is consistent across the serious incidents and near misses using to establish and implement a risk staff group. However, no risk assessment clear, simple and non-emotive language. assessment process if no consideration has tool can factor in every possible situation Documentation enables future risk been given to how any subsequently and, therefore, such tools need to be seen assessment to be more realistic and also identified risk will be managed. It is as assisting staff in making judgments serves as a justification for staff equally pointless to develop protocols for about risk rather than replacing them. interventions. It also helps to build the case managing the risk in the absence of a risk- for more or different resources. assessment process. Both aspects need to The risk assessment process is not about be addressed if the overall strategy is to be making categorical or absolute predictions of Information sharing, both within the team effective. How will you know if your risk risk. It is about making consistent, coherent and between agencies involved in care, is management strategies are effective if you and defensible decisions. Sometimes crucial. It assists staff in making day-to- cannot assess and then re-assess risk using information is unavailable or inaccurate, or day decisions about risk management and a standardised process? circumstances change in a way that had not also helps to build up a broader picture been previously anticipated. Risk assessment regarding how risk may vary over time or cannot be about the in particular circumstances. avoidance of all risk, it is about risk reduction and Organisational responsibility minimisation. As risk assessment and management is a dynamic process it needs to be supported Use the available within organisations by ongoing guidelines programmes of staff training, support and Interventions for managing supervision. This process should include risk need to be informed by reviewing practice standards in the light of the legal framework and changes in legislation or guidelines and guidelines or standards laid also as a result of serious incidents or near down by professional bodies. misses (i.e. what lessons can be learned). This includes the common Training and support for staff should also law duty of care as well as take into consideration the psychological child-care legislation and effect on staff of being involved in serious associated guidelines. When incidents. The risk assessment and decisions are made to management process needs to be intervene in a way that may incorporated into organisational culture at be against the child’s wishes all levels in order to anticipate and meet or what would usually be challenges rather than having to react to considered their rights, staff them after the event. need to be able to justify such decisions on the basis For more information please contact Paul of both necessity and Mitchell (paul.mitchell@bstmht.nhs.uk). 4
  5. 5. National Centre For Excellence in Residential Child Care Conference Proceedings Issue 21 – Spring 2006 Assessment of need – a modern practical approach Helen Jones, Throughcare Social Worker, and Mark Digby, Senior Residential Care Worker, Pine Lodge Assessment Centre, The Caldecott Foundation, described the development of an effective assessment tool to meet the needs of their staff and young people Historically, The Caldecott Foundation has (CSCI) standards and easily provides evidence We developed our own assessment tool, been known for its use of a psychodynamic of effective working. We are referring to initially to focus on young people’s framework for understanding children. This Standards 2 and 3 of the Children’s Homes readiness for a transition into a substitute approach requires the practitioner to have National Minimum Standards in particular. family. However, the tool proved useful in the ability to think analytically and to gaining an understanding of where a interpret behaviour. It requires years of Standard 2. Placement plans young person was and outlined the training and experience if it is not to be ■ Outcome – Children have their needs outstanding work for a young person. It misused or the behaviour of young people assessed effectively and comprehensively, has proved popular with social workers in misinterpreted. In today’s world, as Gilligan and written placement plans outline how providing evidence for continued funding (2001) states: ‘a one-size-fits-all approach these needs are met and are to the out-of-county panel. rarely works’ and working with a transient, implemented. Children in the home are young and often inexperienced staffing appropriately placed there. The strengths of this assessment tool are population, it is difficult to maintain the that it: level of understanding required to work ■ Standard 2.1 – The placement plan for solely with psychodynamic principles. each child sets out clearly the assessed ■ is based broadly on seven dimensions needs of the child, the objectives of the from the Department for Health’s (DH) Good assessment ensures that the staff and placement, how these are met by the Framework for Assessment of Children young people have a clear focus for the registered person on a day-to-day basis, and Families in Need work they are being asked to do together. the contribution to be made by staff of ■ involves young people throughout the Assessment without planning causes drift; the home, and how the effectiveness of process, enabling them to be actively and intervention without assessment or the placement is to be assessed in relation involved in planning their treatment planning means a lack of focus. It is only to each major element of the plan ■ encourages communication between with all three elements in place that children and adults and different parts of effective change is possible. Breaking the Standard 3. Reviews the organisation assessment process down allows a range of ■ Outcome – Children’s needs and ■ provides a framework for action planning alternative ways of thinking and development are reviewed regularly in to ensure focus for measurable outcomes. interventions to be used to best meet the the light of their care and progress at young person’s need. the home. The strengths and need assessments can in turn identify the need for other assessments. Having carried out our own organisational ■ Standard 3.1 – The registered person For example assessment tools might include: ‘need assessment’ we identified that we contributes effectively to each child’s ■ Assessing and Promoting Resilience in needed a user-friendly but informative placement plan review and the looked Vulnerable Children (Daniel and Wassell) approach to assessing the needs of our after child’s review, and ensures that the ■ Independent Living Skills Assessment children and young people. We needed to child participates as far as is feasible in (adapted from Lewisham Leaving Care use language that could be understood by the review process. They ensure that the Team) young people, families, social workers and agreed outcomes of the review are ■ Working with Children with Sexual our staff. Our approach needed to be reflected as necessary in the day-to-day Behaviour Problems: Child sexual grounded in research-based practice that care plan of the child, as provided for in behaviour checklist (Dr Toni Cavanagh meets Commission for Social Care Inspection the placement plan. Johnson Ph.D.) ■ Initial assessment of sexually aggressive behaviour (AIM and G-Map) ■ SAVRY – Structured Assessment of Violence Risk in Youth (Borum, Bartel and Forth). In particular, we have found introducing the concept of resilience to staff has helped them to think about children and young people in a positive way. Daniel and Wassell’s work, mentioned above, not only provides a framework for assessment, but also provides practical suggestions for work to be carried out. For inexperienced staff this provides some comfort and increases confidence in developing their skills with the children. This approach to assessment has been used, alongside the DH Framework for Assessment for Children and Families in Need, as a framework for the work carried out in our assessment centre. 5
  6. 6. National Centre For Excellence in Residential Child Care Conference Proceedings Issue 21 – Spring 2006 Education of looked after children – theory to practice in Buckinghamshire In September 2005 the Education of Children in Public Care Team (ECPC) was presented with Buckinghamshire County Council’s Achieving Top Performance – Overall Winner award. Here’s how they did it… From the 120 teams or individuals identified by these wide ranging staff The first appointments to the team were a nominated, ECPC was judged to be the groups as the team most effective at social worker and a teacher, each with team that best demonstrated all eight core partnership working on behalf of children. nearly 25 years experience of working at council values: At every external inspection since the team the front line in Buckinghamshire. Due to ■ works in partnership both internally and was established (Ofsted, SSI, Audit the proven success of their work, this has externally Commission) they have been identified as now expanded to be four part-time ■ adaptable and flexible to change an area of strength. teachers and two social workers. ■ focuses on customer need ■ member-led Factors in our success They work closely with schools, pupil ■ values and empowers its employees High profile referral units, specialist nurses, admissions, ■ committed to performance management Sally Morgan, who was appointed to set up educational psychologists, as well as ■ innovative in its approach and lead the ECPC Team, was for the exclusions and reintegration, SEN, and ■ business like in its operation. previous four years a senior development leaving care teams, Connexions and officer at the National Children’s Bureau volunteer organisations. While it was gratifying to receive this (NCB), on a Department of Health funded recognition from the council leader, the project promoting the education of LAC, Good tracking and monitoring chief executive and Olympic gold medallist, and subsequently running an NCB national Key priorities for the team were to identify Duncan Goodhew, the real satisfaction for network on LAC for local authorities. In this a designated teacher in every school in the team members is knowing that they are role she had built up a sound knowledge of county, and to set up systems for indeed helping the children in the theory of improving educational monitoring the educational progress and Buckinghamshire’s care to achieve more outcomes for looked after children, and needs of every looked after child. each year. was keen to make it happen in practice. ECPC has established an extensive Prior to the establishment of the ECPC It was important to liaise from the start database, which includes the: school, social Team the educational experiences and with Cabinet members, heads of services, worker, care status, any special needs, outcomes for young people in and school leaders, to ensure they realised attendance and attainment for each looked Buckinghamshire’s care were not good, the potential issues for LAC and would after child. While they make use of the with only 33 per cent of care leavers (year actively support this drive to improve central social care and education databases, ending March 2002) achieving any GCSE outcomes. they find it essential to maintain their own grades. By the year ending March 2005 this for this purpose, since they receive new had risen to 66 per cent achieving that The team leader is line-managed at a information from schools and social level, and this was part of a sustained and sufficiently senior level to keep the role workers on a daily basis. substantial improvement over the high profile. intervening years. Supporting the child Multi-agency team As well as the strategic and training Improved examination results are not of The team is joint funded by education and function of the team, the other essential course the only indicator of success. social care budgets (originally from strand of activity is to support individual Equally indicative is that at five recent Standards Fund and Quality Protects grants children in the most appropriate manner. Every Child Matters workshops across the but now base budget). This may be by: county, ECPC was the team most often ■ advising individual schools, social workers, carers and young people ■ ensuring every looked after child has a Personal Education Plan and it is implemented ■ acting as advocate for the young person ■ setting up education case conferences where there is a need ■ providing direct support/tuition for the child in the classroom to address short- term learning gaps or the danger of exclusion ■ setting up short-term flexible educational packages (including tuition) where there is a gap in school placements for whatever reason. An additional resource for every looked after child and their carer since autumn 2005 has been a Book Bags Scheme, whereby 1,000 good quality educational 6
  7. 7. National Centre For Excellence in Residential Child Care Conference Proceedings Issue 21 – Spring 2006 books donated by the listeners to the local team is therefore supported as it tries to most complex behavioural needs radio station Mix96, are loaned out. keep moving things forward for young ■ replicating this model of support for people. other needy children. Strategic and operational partnership Janice Moloughney has been team leader Current challenges For more information contact Sally Morgan, since 2003, with Sally line managing her The Children’s Residential Network Development and Liaison Manager, Special (as part of a broader remit). They have Conference has provided a chance for Educational Services, Buckinghamshire County worked together for five years now, and delegates to share ideas on addressing the Council (tel: 01296 382051 or email agree that a key to success is the division latest challenges including: smorgan@buckscc.gov.uk). of labour they have established. Janice ■ raising achievement levels in higher likes to keep close to the front line, in grade GCSEs and A levels constant contact with her team members, ■ tracking and reporting on participation headteachers, social workers and young in cultural and leisure activities people. Sally, meanwhile, ensures that the ■ supporting, equally, the looked after education of looked after children remains children of other authorities high on the agenda strategically, and the ■ lack of placements for children with the Education of Looked After Children - Short Course GCSE project Mike Evans, Service Manager, Social Care and Health, and Jane Millward, Team Leader, Social Care and Health explained how the Short Course GCSE project was developed in Leicester A familiar picture confronted Leicester been given in a Girls to Go club. Practical The future will hopefully see extension of local authority regarding the education of learning is also offered in courses such as the programme to other groups, a wider their looked after children: low Managing your Own Home. There have range of courses with the publication of expectations, underachievement, the also been new supports brought in, such course materials for others to follow. complexities of mainstream education, as peer mentoring. exclusion. The challenge was to develop ways that would support young people Success has been observable: 22 successful who were unlikely to achieve in students; 100 per cent GCSE pass rate A-E; For further information please contact Mike mainstream provision. 79 per cent improvement in local Evans (mike.evans@leicester.gov.uk) or authority A-C targets. jane.millward@leicester.gov.uk With just £50,000 to devote to the project, partnership working was essential between social care, education, the youth offending service and Connexions. The pilot ran from January to July 2004 with six students and two GCSE courses, Art and ICT, and this expanded from September 2004 to July 2005 to 23 students pursuing six courses (GCSE and GNVQ Art, ICT, OCR National Health and Social Care and Preparing for Work). The meeting of individual needs was identified as a key factor for success. Specific needs for all students were identified with a risk assessment directing the work towards their strengths. Students were taught one-to-one in a well- resourced environment that contributes to the message ‘this is a place with a purpose’ and this sense of purpose underpins all relationships and activity. Students were given choice as to their focus, a contract was made and a consistent yet flexible approach employed with a view to ensuring achievement. Positive feedback is a regular feature of the scheme. Along with organic developments such as a coursework club, additional services have started responding to further needs that have been identified, including a post-16 club and outreach programmes. Specific support for young women has 7
  8. 8. National Centre For Excellence in Residential Child Care Conference Proceedings Issue 21 – Spring 2006 A time of change Catherine Dalton, Director of the Castlecare Group, described how Castlecare set about improving educational outcomes for the children in their children’s homes The pace of change in health and social ■ appointed a researcher to ascertain after children. We believe they should have care is rapid and affects us all. We all, at educational needs the opportunity to develop knowledge times, need to be reminded that the main ■ contracting with a private education about citizenship and their role in their purpose of agencies concerned with health company communities. Our education programme and social care is to ensure the best ■ setting up Education Action (see below). reflects that belief. possible quality of life for the people who use these services. Finding a route through The way forward for Castlecare was to set In August 2004, the DfES advised us we the maze of changing service structures up our own education company, Education could no longer register all of our children and maintaining the fundamental belief Action. We employed qualified teachers in through our school in Shropshire, and that that the welfare of the child is paramount each of our regions with a lead or head to continue with our education programme can be challenging to say the least. teacher in each region to oversee teaching we needed to register our homes as and assure quality. Individual education independent schools. We would in fact be The Children Act 2004 placed a new duty on plans were linked to schedules of work and in breach of the Education Act 2002 if we local authorities to promote the educational lesson plans and children had educational continued as we were. However, the success achievement of looked after children. assessments, which meant we could of Education Action was astonishing, Regulations are in place to prevent children evidence their academic achievements. children were achieving academically and placed away from home having their we had more children in school and college educational needs left to chance, and the We registered our school in Shropshire and, than ever before. This was a powerful framework of the five national outcomes after consultation with the Department for motivator and helped us make the decision from Every Child Matters demands we adopt Education and Skills (DfES), registered all of to move forward with the registration. an approach focused on outcomes. our children and teachers through the school. This meant children in our homes in As an organisation we debated our ethics I would like to share with you Castlecare’s Kent, for instance, would be taught by and values in relation to children’s homes journey in its endeavour to promote the their own teachers in their homes – but be becoming registered schools but we have educational achievements of children registered at the school in Shropshire. gone ahead and have recently experienced placed in our care. The journey has been at Effectively the homes were being treated our first round of Ofsted inspections. times frustrating and confusing. The routes like small satellite units. (Scary, if you are a teacher or a residential we have taken are as follows: worker.) Feedback from our staff has been ■ approaching local education authority Like all good health and social care workers fairly philosophical: ‘Children’s homes have schools we had dilemmas, one being the issue of always been learning environments – this ■ contracting within the private integration and social inclusion. We believe just formalises what we have always done!’ education sector looked after children need and should be ■ funded two teacher posts within encouraged to develop relationships in the I would like to share some statistics with mainstream community, not just with other looked you that help to explain why the journey Castlecare has taken has been worthwhile. ASDAN Awards are linked to the National Curriculum and give children the ability and confidence to move forward and achieve. Enjoy and achieve is after all one of the five national outcomes of Every Child Matters. ■ Three children have received the Gold Award And more than: ■ 100 children have received the Bronze ASDAN Award ■ 30 children have received the Silver Challenge Award ■ 20 children have received the Silver Award. ■ 30 children are participating in the Life Skills Award, in mainstream school or Castlecare education centres. Twenty-five of our children are currently attending mainstream school or college and within Education Action 15 children are working towards GCSEs. We are all working towards successful and meaningful outcomes for our children and I feel we have to recognise that good outcomes can often rely on long chains of events. 8
  9. 9. National Centre For Excellence in Residential Child Care Conference Proceedings Issue 21 – Spring 2006 Healthy Care in the residential setting How can Healthy Care partnerships improve outcomes for looked after children? Helen Chambers writes… The Healthy Care Programme developed by including mental health, food and activity, ■ carers were unaware of the importance National Children’s Bureau (NCB) and sexual health and substance misuse, as of promoting leisure and creative arts funded by the Department for Education well as on play and creative arts and and play opportunities and Skills (DfES), aims to create an leisure with looked after children and ■ links to community groups and environment of care that provides the young people. activities were not established. support and opportunities necessary for a looked after child to learn life skills, and The role of carers in promoting health and The partnership decided that the culture gain confidence and self-esteem that will well-being is crucial to improving of the residential homes needed to lead to improved physical and emotional outcomes for looked after children’s change, and that required: health and well-being. The programme has health and well-being, and has developed ■ action planning to improve carers’ proved to be a highly successful way of as a distinct area of practice within many practice and build on current good ensuring that Promoting the Health of partnerships. NCB worked with local practice Looked After Children (Department of partnerships to devise a Carers Health ■ joint training of foster carer mentors Health 2002a) is implemented, and the Promotion Training Programme, now and managers to cascade good practice five national outcomes for children are available within the family of Healthy ■ work with managers and LAC nurses to delivered (HM Treasury 2003). The Care document resources from NCB. provide support and supervision programme has benefits that go much Experience shows that where carers are ■ increasing the aspirations of carers wider than physical health and is intended supported, trained and resourced to ■ close partnership working with health to improve the well-being of carers, as deliver the training, it enhances their care ■ young people to be included in Healthy well as children and young people. practice, improves self-confidence and Care Programme development in a demonstrates the relevance and benefit of sustained structure The multi-agency Healthy Care the training for developing the looked ■ senior management and partnership partnerships programme encourages the after children’s workforce. support for cultural change promotion and protection of health and ■ evaluation and celebration. well-being and improves wider life It is clear that while all professionals play chances through improved health a vital role in promoting health and well- Healthy Care plans to work with the new outcomes. It provides a national standard being, it is the carer who has day-to-day Children’s Residential Network and for improving the health and well-being affect on the environment. For some national centre (NCERCC) to develop more of looked after children (LAC), against children and young people creative and work to improve outcomes for young which local Healthy Care partnerships can playful work at home, school or in their people in residential settings. audit their work, with the participation of wider community can provide a vital looked after children and their carers. stepping stone to improved education For more information on Healthy Care, Work at local level focuses on four key outcomes, improved mental and emotional contact Helen Chambers, Principal Officer, areas for action: policy, partnerships, health, and self-confidence, as well as Promoting Health and Well Being, Children’s participation, and improved practice, to help to build and sustain a supportive Development Department, NCB (email: ensure that the six entitlements for looked relationship with their carers. hchambers@ncb.org.uk). after children set out in the National Healthy Care Standard are met. An example of the Healthy Care Programme in action A significant element of Healthy Care has Derbyshire Healthy Care partnership been the creative participation of looked audited its residential services in its five after children at a local level, leading to units by the development of the Well-being ■ consultation with young people age Creativity and Play Project, at the request 10–17 in a local sports centre of young people, to improve their access ■ adapting audit tools to young people’s to play, arts and leisure provision. needs and entitlements ■ consultation with residential carers and Developing a healthier environment foster carers ‘Children live in a healthy environment ■ audit and action planning with and their health needs are identified and residential centre staff and managers. services are provided to meet them, and their good health is promoted’ (DoH The close working between the looked 2002b). after children's nurse and head of residential services was vital to success. The Healthy Care Programme Handbook (NCB 2005) gives local and regional areas Issues raised during consultations guidance on setting up multi-agency included: partnerships and on carrying out the service ■ a large variance in practice across five audit against the National Healthy Care residential units and foster care Standard, including the views of children, ■ young people often lacked awareness young people and their carers, which is the of their rights starting point for healthy care. ■ the LAC nurse was highly regarded by the most vulnerable young people Healthy Care Briefings (NCB 2005a) have ■ there was little awareness of the carers’ been produced. These identify research role in promoting health and and best practice on public health issues achievement 9
  10. 10. National Centre For Excellence in Residential Child Care Conference Proceedings Issue 21 – Spring 2006 Bristol’s Collaborative Service Bristol’s Collaborative Service (BCS) is a locally based, multi-professional project providing ‘wraparound’ support in community and residential settings. Patsy Burrows, Project Manager at BCS writes… BCS works with children and young people The Residential Team is supported by a multi- Young people and families identify aged five to 16, with complex needs and professional community team consisting of: outcomes that would represent beneficial challenging behaviour, who are unlikely to ■ one social worker change to them. Outcomes and the impact be maintained in existing educational and ■ one youth worker of the project also relate to the Every Child care provisions without additional support, ■ two teachers Matters outcomes. and who are at risk of being placed out ■ CPN of authority. ■ one family therapist Challenges and benefits ■ one psychologist What has worked for us? The project is a partnership between Bristol ■ one psychiatric consultant. ■ shared understanding Social Services and Health; Bristol Education ■ consistent approach and Lifelong Learning; and Bristol North The community team also supports a ■ clear systems and joint-working Primary Care Trust and Bristol South and further six children and young people in arrangements (e.g. for assessment) West Primary Care Trusts. community settings (at home, in foster care ■ clear communication or in other residential placements). ■ tight referral criteria and maintenance BCS came out of a research project of the agreed project capacity commissioned by the partner agencies that The project’s work ■ supervision/appraisal/practitioner aimed to demonstrate the impact of being Admission to BCS is via a multi-agency support placed out of the local authority area on referral panel, which is made up of ■ training and team development young people and their families. representatives from education, health and ■ team as a resource (transfer of skills and social services. We carry out holistic experience within team) assessments and deliver individually ■ trust tailored intervention packages that ■ co-location with Children Looked After ‘wraparound’ the young person, their Nurses Team and Thinking Allowed family and carers. (CAMHS Service for Looked After Children) The assessment, planning and review ■ clear project management and processes are coordinated by lead accountability structures. professionals (the case coordinator in the community team, and the keyworker in the What have been the challenges? residential team). ■ vision: resource-led service versus needs-led service Our approach is grounded in the findings ■ identity: moving away from a social from research that demonstrates that the services project with education and young people we work with are likely to health ‘bolted on’ Aims of the project find it difficult to transfer learning from ■ getting consent to share information The aims of the project are to improve one environment to another. The ■ recruitment and retention of staff outcomes and increase life chances for opportunities for learning and skills ■ commissioning clinical input children and young people by: development therefore, come to them. ■ recruitment of specialist foster carers ■ enabling children and young people Young people in our care experience: ■ problems of case closure and with high levels of need and challenging ■ a therapeutic environment consequent ‘silting up’ of the service. behaviour to grow up with fewer ■ a structured behaviour management emotional, behavioural and educational programme to address each child’s For more information please contact Patsy difficulties individual needs Burrows, Project Manager (Acting), BCS (Tel: ■ enabling children and young people to ■ educational input 0117 914 5442, Fax: 0117 914 5452 or email: stay in stable living and educational ■ structured activities patsy_burrows@bristol-city.gov.uk). situations, and not be dislocated from ■ therapeutic input their local communities ■ work with their birth family. ■ reducing the number of joint-funded out of authority placements, and The aim is for the young people placed in ensuring more effective use of our residential unit to move on to BCS placement budgets specialist foster placements, which will ■ increasing the level of expertise of staff provide consistency and a continuity of and carers across all agencies, in working care. The first young person moved into the with children and young people with residential unit in June 2004 and six young complex needs and challenging behaviour. people have been placed since then. BCS provides a purpose-built residential Outcomes unit for four young people age 10–14, and In demonstrating the outcomes for young is staffed by: people, it is important to recognise the ■ one unit manager distance travelled and the soft targets ■ two assistant unit managers achieved. Outcomes relate to the aims of ■ seven residential childcare workers the project, and progress and outcomes are ■ one administration assistant measured using assessment tools that are ■ one domestic. repeated at three, six, nine and 12 months. 10
  11. 11. National Centre For Excellence in Residential Child Care Conference Proceedings Issue 21 – Spring 2006 Integration, measurement and underpinning academia SACCS offers an integrated service in providing recovery for severely traumatised children and young people, who need, but are not yet ready to spend their lives in a family environment. Richard Rose, Managing Director, SACCS Training, and Patrick Tomlinson, Director SACCS (Practice Research and Development) write… Integration receive reassurance and support from her Each of these indicators is scored in At SACCS we provide containment and key carer. Jane’s behaviour, and actions in comparison to a healthy child of a similar safety for children: therapy were able to be interpreted and she age within the community. The assessment began to accept and move forward through helps us to: Containment of the child in the SACCS the recovery process. Towards the end of ■ identify where a child is in terms of programme allows children to test out their the placement, Jane had understood that development understanding of previous life experiences her sister had died, through circumstances ■ measure progress and outcomes for and enables them to reframe these as well that could not possibly have been her fault. children as their behaviours. As they test out new She was able to work through her grieving ■ evidence progress and outcomes behaviours and understanding they have process and to consider her previous consistently the opportunity to reflect and positively thinking and adopt a more healthy ■ work out plans within the context of alter their external and internal processing. perspective. This work is reliant on the achieving outcomes effectiveness of the integration and the ■ communicate about outcomes clearly relationship with Jane; without this Jane’s ■ evaluate our approaches – what works needs would possibly not have been and what doesn’t. identified, and her recovery not secured. Underpinning academia Measurement SACCS has continued to base its The young people and children placed at commitment to the children and young SACCS require the integrated process of the people placed by creating a training recovery programme; this means that each portfolio unique to residential child care of the three integrated services are services for all those employed within the interdependent to ensure that recovery is care provision. It is our belief that all our Safety through this process enables delivered. care workforce understands child children to consider their behaviour and development, attachment and other reflect with caring adults on the causes SACCS has introduced an assessment related topics; this enables them to put and effects as well as their own actions framework, which collates the progress of theory into practice. From January 2006, and reactions. each young person placed within the all our front line care staff (160 recovery programme. The assessment is individuals) will be undertaking a In SACCS children receive care through based on our unique SACCS Recovery Foundation Degree in Therapeutic Child therapeutic parenting, therapy through the Programme. By concentrating on the Care leading to a BA Honours Degree. This services of our in-house therapy teams, and outcomes of Every Child Matters, SACCS will academically underpin the excellent life story work through our in-house life has identified six indicators: practice that each of our children and story teams. All three services have close ■ learning young people requires. This course, communication and share all information ■ physical development presented by SACCS and the North East and professional assessments through ■ emotional development Wales Institute (University of Wales) will regular meetings, reports and plans. By ■ attachment provide this training externally to all child ensuring that all services consider the child, ■ identity care services online from January 2008. SACCS can identify, plan and deliver ■ social communication. services that provide recovery. The concept of integration can be explored by considering the case of a child – we shall refer to her as Jane. Jane arrived at SACCS with considerable confusion about her history; she felt that she was responsible for the death of her younger sister and that she should be punished. Through life story work, Jane’s history, her parents’ and grandparents’ stories, carers’ experiences, and the stories (and memories) of all those we identified who had been involved with her, helped create an information bank. This information was assessed and her story was shared with her key and support carers in SACCS, her therapist and, over a period of two years, with Jane, herself. Throughout the process, Jane was able to ask those questions she had been unable to voice and 11
  12. 12. National Centre For Excellence in Residential Child Care Conference Proceedings Issue 21 – Spring 2006 Personal Communication Passports Personal Communication Passports provide a practical and child-centred approach to passing on key information, rather than it being locked away in a cabinet in confidential records. Sally Millar and Stuart Aitken, Communication Aids for Language and Learning Centre (in collaboration with Sense Scotland), University of Edinburgh, write… Some communication difficulties in direct, honest, specific and detailed and – children may be easily identified because hopefully – fun. Passports are a special way they are accompanied by physical or of sorting information. They don’t contain sensory disabilities, or second language all the information about a child, but a learning issues, while others are more synthesis of key information to help people ‘invisible’ (for example, delayed or help the child to be the best they can be, disordered speech and language on a day-to-day basis. development, language comprehension difficulties, dyspraxia, dyslexia, and social The passport belongs to the child – not to interaction difficulties). All communication staff or the family (although they may help difficulties have a profound effect on the child to use it appropriately, and update learning and education, self-esteem and it). Passports are especially important at personal and social relationships. times of transition, when new people come Communication disabilities and their into the child’s life and information may not implications can easily be missed in be passed on. They are also helpful when children in disrupted circumstances. new or temporary staff or volunteers meet the child, helping them to quickly acquire Personal Communication Passports provide key information, or for introducing a child a practical and child-centred approach to to a new foster family. The process of passing on key information. A passport is a creating a passport can help in the assessing way of supporting a vulnerable young children and their needs (and in identifying person with communication difficulties gaps in assessment). across transitions, drawing together complex information (including the child’s Evaluation at Sense Scotland own views, as much as possible) and At Sense Scotland, passports were found distilling it into a clear, positive and to be valuable in many service settings accessible format. This information helps including residential short breaks (respite); staff and conversation partners to get to holidays; summer activities; day activities know the child with communication and support. Residential care and support disabilities and to interact and respond staff are often young and inexperienced consistently in order to help the child make in specialist work with children with sense of events and to get the best out of communication difficulties and complex what communication abilities they do have. support needs and there is a comparatively high turnover of staff. A passport is a vital tool in inter-agency There are high demands on staff and little planning and working, and is an excellent time for staff training (once the way of implementing and recording mandatory sessions on moving and consultations with, and the participation assisting; epilepsy awareness and of, the young person. Passports aim to administration of medication; child support children with complex protection, first aid; and CALM are communication difficulties who cannot delivered). In an evaluation exercise, easily speak for themselves, by: passports scored more highly with parents ■ presenting them positively as and staff than traditional information individuals, not as a set of problems or collection and record keeping, on disabilities effectiveness, accuracy of information, ■ drawing together information from past and personalisation. It was agreed that and present, from many people who passports were the preferred method of know the child, and from different recording child information. contexts ■ describing the child’s most effective Passports should not be just a list of likes • I need lots of time to work out what my means of communication and dislikes, or a photo album of people eyes are seeing – one thing at a time ■ presenting information in an attractive and activities. They should include specific works best. easy to understand way information about communication, for • I see objects, but I can’t make sense of ■ describing the child’s most effective example, ‘How to tell when I’m showing pictures, photos or symbols. • You need to think very carefully about means of communication, so that others you what I like and dislike’, ‘How to help where I sit. I am distracted by lots of can be better communication partners. me make my own choices’. things, especially by people’s faces or by bright light (e.g. from the window). Passport booklets (or cards, folding pockets, Passports can show the details of how to • Please make sure that the background on or wall charts) present information about use a child’s communication system, as which you show me things is uncluttered the child in an accessible way that assumes opposed to just stating for example, ‘Jan and contrasts well. no prior knowledge and is simple, clear, uses a communication book’. With regard 12
  13. 13. National Centre For Excellence in Residential Child Care Conference Proceedings Issue 21 – Spring 2006 to vision, rather than having lots of recording those views so they are not lost. References information about visual acuity scores, They help by giving guidance to others Aitken, S and Millar, S (2004) Listening to visual field and contrast scores about, for example, the best way of asking Children 2004. Glasgow: Sense Scotland. documented in a report that staff questions, or giving information to help often do not understand, a passport can others understand how the child feels. A Millar, S and Aitken, S (2003) Personal record what you need to know to work template for a Consulting Passport is one Communication Passports: Guidelines for good with the child. of the resources to be found on Listening practice. Edinburgh: CALL Centre, University of to Children 2004 (Aitken and Millar 2004) Edinburgh. Passports and consulting and more information about Personal Passports can be very useful when seeking Communication Passports, including the views of a child with complex templates, and listening to children can be communication support needs, and in found at: www.callcentrescotland.org.uk Service provision to unaccompanied asylum-seeking children Marjorie L Reid, Registered Manager at a specialist children’s centre for unaccompanied asylum-seeking children aged between 12 and 17 in Hillingdon, described some of the challenges and priorities in working with these young people Charville Lane is purpose-built and set in During the first 72 hours the staff build a These are not to be taken for granted, as its own grounds in a quiet residential area. positive relationship with the young person, they are fundamental to unaccompanied The home plays a pivotal role in the ascertaining their needs, likes and dislikes. asylum-seeking children. It could be borough of Hillingdon, as it is eight miles They also dialogue with the Children’s argued that anyone can cook for these from Heathrow airport. The young people Asylum Intake Team and arrange a date to young people and a well-known proverb are admitted to the home on either a discuss plans and assessment. Should the states: ‘when in Rome do as the Romans planned or emergency basis. young person remain at Charville Lane then do’, but this is not always the case and a comprehensive assessment will be can be discriminatory. The only affinity or On admission, each young person will be completed by the link worker. We also need link that some young people have with received respectfully and sensitively, taking a bank of interpreters for meetings, or for their home or culture is food. I have into account the time of the admission and informing a young person of the basic found it necessary to have a cook who is whether the young person has an expectations of the home, and also for versatile in cooking culturally diverse understanding of the English language. The determining their likes and dislikes. foods, and will meet the challenges of staff on duty will ensure that basic needs ingredients and recipes they may not have are met in terms of clothing, skin and hair The needs of young asylum-seeking experience of. The young people care. The young person is given a room and children are complex and diverse and I take themselves have proved invaluable in assigned a link worker who will act as the into account the whole person as well as helping with recipes, ideas and feedback. focal point for them, addressing their needs the impact of immigration issues. Many of and compiling reports. the young people have experienced abuse, Religion can be an emotive subject, and trauma, loss and mental health concerns, as assumptions and stereotypical comments, I work with up to 14 young people, well as being separated from their families due to a lack of knowledge or ignorance, including two emergency placements, and and having to live in an alien country can have a profound affect on a young 27 staff who make up a diverse and multi- where the weather and food are different, person. We have approached this subject in cultural team. There are members of staff and – on occasions – a language they do team presentations to widen our who can speak a language the young not understand. knowledge base and have encouraged people are familiar with, or at least have an young people to discuss their religious understanding of their culture. This has The high priorities within the home are beliefs in a house-meeting forum. been indispensable to the home. education, food, culture and religion. We have found that young people often want to attend a place of worship similar to what they were used to at home. By being open to various religions the young people are able to appreciate religions of the world and accept the religions of others without being discriminatory. We ensure that we have calendars that inform us of the religious celebrations and festivals so that special preparation can be made for them. There are many issues that challenge the staff team, including over-identifying with a young person in terms of culture or language, and the young person’s fear of the unknown. The primary task is to respect and care for the young person irrespective of their history. 13