'We have already achieved better outcomes for some of our young people, and we think this could save us around £4.2m a year.' Martin Gray, Director of Children's Services at Stockton Council.
Stockton’s work with IMPOWER aims to improve the life chances of children in care by strengthening the links between children’s needs, the outcomes being pursued, and the financial resources available. Personally, I approach this issue from two areas of experience. From working alongside children’s services departments, I see first-hand the challenges that fostering and adoption teams face in finding the right support. In addition, as a foster carer of over six years and someone who is active in fostering circles, I regularly hear from carers about the challenge of accessing the support their children need.
The inadequacy of language
As foster carers, we are often called to take children with ‘challenging behaviour’ which could mean anything from defiance (eg throwing TV remotes) to the deep impact of developmental trauma where every interaction is hard for all involved. It will become apparent over time what this ‘challenging behaviour’ entails and if the initial description is accurate. Yet descriptions like this don’t explain the root of the behaviour, which is what the whole team around the children actually want to be working on, in order to bring some kind of healing. There is often a promise of ‘support’, but it can be very difficult to actually secure either therapeutic or practical support so that the child can begin to thrive.
Indeed, the word ‘support’ is often over-used and ill-defined. I hear this all the time from carers. They know they need support but are not always sure what it should look like; and when they get the support that is on offer, it can feel like it doesn’t do what they hoped or in some cases can even make things worse.
Getting the right support for both child and carer can prove difficult because we often have to rely on subjective judgements in seeking it. These judgements are formed in placement planning meetings, Looked After Children reviews and other forums by numerous professionals who all have different ways of expressing their views. Two sets of paperwork that appear to use similar words actually might be describing two children with markedly different therapeutic needs. The language we use is often inadequate.
Given that what is written down does not always tell the whole story, it’s no wonder that budget holders, who want to know how best to spend their limited resources and must rely on just these kinds of reports, might not be able to commission the right intervention.
This subjectivity also raises another question: how are improvements or regressions tracked in a meaningful way? We are used to tracking progress in the field of education as it sits within a framework of testing and measuring performance. But if a child is receiving specialist support, how is their progress being followed, and how is it being fed into the wider framing of their life?
It is also worth noting that development and improvement rarely progress in a linear way. Sometimes progress in one area is accompanied by regression in another. This complex picture is only reflected on infrequently, and even then it is easy for the nuance of the changes and developments to be masked in a few lines of description on a report.
Are we serving our children well with this blurry picture?
The Valuing Care approach
We know that a huge amount of money is spent on providing placements for children, often with Independent Fostering Agencies (IFAs) for children with more complex needs. But do teams know that this money is making the difference in children’s lives that it is supposed to? Does a child still need a therapeutic placement four years on, or have the therapeutic needs morphed? How are cases reviewed?
From my observation in Stockton, Valuing Care aims to provide a more consistent framework for undertaking needs analysis for Looked After Children to better inform their care and support planning. It works by identifying the needs and the strengths of the child across a number of domains. It is an approach that seems to lend itself to being used at regular intervals. Language is shifted from being the main tool of recording need to the descriptor that accompanies a suite of numerical measures, enriching the assessment of need.
The beauty of the Valuing Care approach is that it gives a common language that can be used across agencies to both describe and monitor changes in a child’s needs and strengths. This is much like a holistic Strengths and Difficulties Questionnaire (SDQs – which as carers we seem to have to fill in all the time for different teams), with full descriptors of these needs that can paint a rich picture of the child. In quantifying the level of need in a common framework it should also help in decision-making across the board. It allows for mapping the changing needs of an individual child, as well as equipping heads of service with an eagle-eye view of the changing needs across cohorts and the services that need to be commissioned to meet them.
A vision of the future?
For the many local authorities I come across which are constantly seeking value for money and doing more with less, Valuing Care seems to be a powerful approach. Directors of Children’s Services could use the data and the methodology to hold IFAs and residential providers to account for children’s development and progress, and to avoid being overcharged for interventions that are no longer necessary or didn’t work in the first place.
If well integrated, this approach could assist new professionals who starting to work with a child, by making the recording of that child’s strengths and needs easier, allowing them to see past changes and ultimately support them better. Whilst nobody wants the professionals around the child to change regularly, it happens and the turmoil this can create in the child’s life requires us to do all we can to lessen its impact.
As a foster carer, I could immediately see the impact this could have in care planning. This could help at the point of matching to see how the needs and strengths of a child would likely fit with your own skills and capabilities. At reviews this could be an incredibly helpful tool to measure progress and inform the Independent Reviewing Officer (IRO). I can see too, if carefully done, how it could be used to demonstrate to the child how much they have grown, helping them see their own development, challenges, strengths and successes clearly and be a cause of celebration.