This is the third and last paper written by Nancy Hazel from the booklet, Free to be Myself: the development of teenage fostering” edited by Nancy Hazel and Andrew Fenyo. In this paper she specifically refers to the way ISP started.
Expansion of teenage fostering (1993)
The studies described in the previous chapter demonstrated that foster family placement for teenagers is a worthwhile alternative to residential care. This chapter describes how other research has documented the growth and development of specialist foster care in North America and the United Kingdom. Recently, government policy and new legislation, particularly in the UK and Germany, have led to changed attitudes and promoted new ways of working, especially by recognising the importance of natural parents and the need for after-care.
Research into the growth and development of specialist foster care North America
There have been four surveys of specialist foster care in North America during the 1980s. The most recent was by Hudson, Nutter and Galaway (1990). Hudson replicated the survey he had reported in 1989 and produced information on 293 programmes operating in North America during the Autumn of 1989. His criteria were that:
- the programme was defined as ‘specialist’ or ‘treatment’;
- payments were made above the normal rate;
- training and support was provided;
- a formal goal was to provide for clients who would otherwise be retained in a non-family setting;
- care is provided in a family residence; and
- the specialist foster carer is a member of the service/treatment team.
He found that the vast majority of the programmes were administered as private not-for-profit agencies which were relatively new (with approximately half established in the past five years) and operated as small and medium sized agencies (one-third were publicly run). Most of the foster parents were paid by day of service provided, although a substantial number were also paid on a monthly, salaried basis. Approximately half the programmes paid a standard rate to their foster parents, the remaining half paid differential rates according to behaviours manifested by clients, ages of clients, degree of disability and so on. Sometimes the length of service and qualification of the carers were taken into account. (This is never the case in the UK.) Almost all the programmes required both pre-service and in-service training, although the number of hours varied tremendously. Approximately two-thirds of the programmes required their treatment parents to participate in support group meetings and approximately half of those required monthly support group meetings, with smaller proportions requiring twice monthly meetings and weekly meetings. Almost all of the programmes used treatment plans or service agreements, although the number of weeks covered by these differed amongst the programmes. Approximately half used agreements covering five weeks to three months, another quarter covering 13 weeks to six months and a smaller proportion covering four weeks or less. (Agreements in the UK are usually considerably longer.) Treatment approaches used in the programmes covered every conceivable type. Less than one-tenth of the programmes noted that research had been completed on their programme.
Almost all these programmes were comparatively small, although often situated within a larger organisation. Eighty-seven per cent noted that a maximum caseload calculated on the number of clients was set for their social workers. About half set this maximum at no more than 10. The two main differences from the UK are the preponderance of private schemes and the short time-span of the written agreements.
The United Kingdom
In the UK, Shaw and Hipgrave have undertaken two surveys and Lowe one. In their first survey, Shaw and Hipgrave (1983) sent out 99 questionnaires to local authority social service departments in England and Wales, excluding the London boroughs. They received 67 replies. Of the agencies responding, 74% had special schemes of some kind, although only 48 were analysed. Of these 48, four had respite/relief schemes only. Excluding these authorities, of the remaining 45 schemes provided by 44 agencies, 42 provided for ‘disturbed’ adolescents. Four schemes had existed for seven years, three for six years, 10 for five years, 10 for four years, four for three years and 10 for up to one year. Twenty three had two to 13 placements and 18 between three and 11 placements. Six agencies had 8 placements. Numbers placed ranged from 1 to 72. Written contracts were used in 86% of the schemes. Ninety-two percent had support groups for the foster carers. In 1989, Shaw and Hipgrave reported a follow-up survey. In this second study, they sent a questionnaire to all the local authorities in the UK. A quarter of the agencies who responded did not have an identifiable specialist scheme, although about half of these were planning to start one. Although two had closed their specialist schemes, the general trend was towards specialisation. An important finding was that since their earlier survey in 1983, specialist fostering now has a much wider remit. It is no longer seen as an alternative to residential care, and has moved away from specific categorisation. At the same time, schemes have differentiated into groupings such as emergency, remand and assessment, teenage mothers and babies, respite care and so on. The authors comment that these are specialist objectives rather than schemes. Time limits are still in use, but have become more flexible and the majority of programmes use some form of written agreement. It is now general practice that the area social worker should work with the child and his/her family and that there should be a specialist social worker with responsibility for the foster carers. The authors comment specifically on the considerable impact which the specialist programmes have had on other areas of policy, and on practice in mainstream fostering.
Lowe (1990) concentrated on the specialist fostering of teenagers. He sent a questionnaire to 132 local authorities in the UK. Voluntary agencies and independent fostering agencies were also approached. There were 119 replies, 108 from local authorities (99 separate authorities). Sixty-four of these said they had a special scheme for fostering teenagers (62 authorities). The 99 authorities represent 75% of the total number of local authorities in the UK. Thirteen schemes were set up between 1976 and 1980, 24 in 1981-1985, 21 in 1986-1990 (six not known). This survey confirms the Shaw and Hipgrave findings that the objectives of the schemes have widened and that time limits have become more flexible. As in North America, most of the programmes are small, over half having less than 20 families. New programmes are being set up, but a few of the old-established programmes have been integrated into the general fostering system. Lowe’s survey covers many of the same points as Hudson’s. He found that only about half of the programmes indicated that any monitoring takes place. Most programmes provided training for the foster carers, and support groups were a central feature. The ratio of staff to carers appeared to change in relation to the size of the scheme, with a ratio of one fostering officer to four carers in schemes with up to five carers, rising to 1:12 in schemes with over 40 carers. Only 7% of the programmes considered the carers as equal members of the management group. Fifty-two per cent said they were “consulted occasionally”. Very few programmes considered their objective to be ‘treatment’. Like Shaw and Hipgrave, Lowe comments on the considerable impact which the specialist programmes have had on general fostering practice. Perhaps the most striking finding of the survey is the extreme variability of provision: nine agencies placed 70% of their teenagers in foster care, but about 45% placed virtually all adolescents in residential care. Perhaps the most worrying finding is the lack of after-care: 67% replied that they had no structured after-care programme. This is an area where foster carers can help enormously, but need some financial support as the number of ‘returners’ increases. This lack of provision is particularly disturbing in view of the large number of teenagers who spend their last period in care in a residential establishment and have no local roots or acceptable family in the community to help them when they leave.
Development from the mid-80s to 1992
From the mid-80s to 1992, significant changes have taken place in the use of family placements both for adolescents and for younger hard-to-place children, as well as for other groups such as homeless young people over 18 and old and handicapped adults. In the UK during this period, provisions for maintaining young offenders in the community have greatly improved, and the number placed in custodial institutions has declined. As a consequence, the proportion of young offenders referred for family placement has lessened, and the proportions of emotionally disturbed young people has increased. The latter are probably more difficult to help.
In North America, the expansion of specialist fostering seems to be rapidly gaining momentum (Hudson, Nutter and Galaway, 1990), and is underpinned by a growing professional cohesion. This is demonstrated by the establishment in 1987 of an annual North American conference on treatment foster care which is very well attended. At the second conference, the North American Foster Family Based Treatment Association was set up and an international semiannual journal, Community Alternatives: International Journal of Family Care, is published by Human Service Associates in St. Paul, Minnesota. In 1990, a book was also published (Galaway et al, 1990). International courses on specialist foster care were held in Dubrovnik (1989) and Budapest (1991); it is planned for this series to continue.
In West Germany (before reunification), there had been some expansion, but little overall change except for rather more emphasis on the systemic approach (Blüml et al, 1989). Reunification has brought with it the vast problem of creating a new social work service in the eastern provinces. Other countries now planning to develop specialist fostering include Austria and Spain. In the UK, as Lowe (1990) has shown, expansion continues. This period, however, has also seen a totally new development in the setting up of independent placement agencies run by the foster carers. As the Kent Family Placement Service was run down and finally merged into the general fostering service, dissatisfaction grew among the experienced specialist foster carers.
In 1987, two of these experienced foster carers set up their own independent programme – the Integrated Support Project. As directors, they employed their own foster carers, qualified social workers, teachers and therapists. They offered not only a family placement but also developed their own education unit for those children unable to cope with normal schooling, and offered therapy services. An individualised package was devised for each child and offered at a set price to social service departments. They are now well-established and their morale is high, with a strong sense of group identity. They have commissioned an independent evaluation from John Fitzgerald, Director of the Bridge Child Care Consultancy Service. This evaluation is based not on breakdown rates of completed placements, but on an analysis of process. The results will be available in 1993.
In 1988 and 1989, other independent groups with foster parents as directors started up. One of these, Pro-Teen, which normally places children over 12 years of age, as an example of the way an independent agency can develop and consolidate innovative ways of working. Some local authority social service departments have declined to place children with these organisations on the grounds that they are too expensive (although probably no more than the equivalent residential placement) and that their value is unknown, but not all local authorities hold this view. There seems to be a certain lack of logic in the opposition to independent agencies as children in care have been placed in private residential care, which may be very expensive. In addition, in the wider context of community care, buying-in private services was commended by Sir Roy Griffiths (Griffiths, 1988) to widen consumer choice, stimulate innovation and encourage efficiency.
Finally – also in Kent – a small voluntary agency, Rented Accommodation for Teenagers (RAFT), is extending the same method of family placement to homeless young people aged 16 to 20, either ‘off the streets’ or on the point of leaving care (Graham, Hazel, Richards and Waddell, 1992). The family placement is used as a staging post for sorting out problems prior to independent living or a return home and, for those who need to move on but cannot return home, RAFT provides a shared house or small flats as a second stage. RAFT appeared able to recruit without undue difficulty the same kind of capable and enthusiastic families as those who responded to the challenge of teenage fostering, but encountered difficulties in the management of a placement programme which was situated in a centre for youth work. The model (family placement followed by supervised housing) seems to suit the needs of the very young homeless.
A number of similar programmes appear to be starting in other areas. One of the most recent (January 1991) is the Young Offenders Community Support Scheme, run by Hampshire (UK) Probation Service in conjunction with National Children’s Homes and the Home Office (Field, 1992). It aims to prevent young people aged 17 to 21 from entering custody by placing them with families. Both the families and the young offenders receive substantial support. After a successful start, the weakness of this programme has been shown to be the lack of follow-on accommodation, which was not planned at the beginning and which is difficult to provide, so that young people leaving their family placement may face acute housing problems.
During the period under review, the idea of fostering as paid work has become widespread in the UK. Both local authorities and voluntary organisations have experimented with different ways of combining in one system short-term foster care leading to a return home, long or medium-term substitute homes for younger children and ‘professional’ or ‘treatment’ fostering for adolescents – not to mention remand fostering, respite care and so on. One county, Warwickshire, experimented with managing with no residential care, except for five retained places. Their experiences have been described with great openness (Cliffe, 1991), but the result was not wholly successful. The experiment began from a base of very little residential care, but did not attempt to recruit more foster carers or to re-organise a somewhat traditional fostering system. The only professional foster carers were employed for placements lasting four weeks or less. Despite a considerable degree of success, children and young people in placement were moved more often than was described and had little choice of foster home. The foster carers had not been trained to work in teams*, so that many of the disruptions did not lead to planned, constructive transfers.
Teenage foster care in the UK has continued to expand and develop. The quality of the service offered by local authorities and voluntary bodies is difficult to assess and is certainly variable. The quality of service offered by the new independents appears to range from excellent to probably very poor. As no system of registration or inspection for these agencies is in place, this new development is not without danger, especially in view of the rapid increase in the number of these programmes. However, profound changes in practice are gradually taking shape as a consequence of the new children’s legislation. Regulation of the new independent agencies is likely to be one of these changes.
The Children Act 1989 and Teenage Fostering
The Children Act 1989, which was implemented in October 1991, provides a single and consistent statement of the law about caring for, bringing up and protecting children. It brings together previous fragmented legislation and makes radical changes.
Changes affect both accommodation arranged by agreement between the social worker and the family or individual and compulsory care or supervision resulting from court proceedings. Voluntary arrangements are to be preferred wherever possible and this chapter will not consider the detailed changes to court procedures and orders resulting from the Act (Department of Health, 1991b).
The Act rests on the principle that children are generally best looked after within their own family, with both parents playing a full part and without resort to legal proceedings. The concept of ‘parental responsibility’ replaces the previous ‘rights and duties and authority’, and the Act places on local authorities the duty to ensure contact with parents whenever possible for children looked after by them away from home. So, like the recent German legislation, it is now the duty of the authority to support the upbringing of children by their parents as far as possible. The provision of day care is emphasised and regulated. Local authorities may arrange for others to provide services (such as foster care) on their behalf. In an attempt to reduce the stigma of entering care, the former terms are replaced by ‘providing accommodation’ and being ‘looked after’ by the local authority.
Both Acts insist on the importance of maintaining contact with the parents if the child is accommodated away from home, and of fully informing and consulting before all decisions both the parents and the child (age and ability permitting). Whenever possible, placements should be in the child’s home area. Given the emphasis on care in the community, at home or in foster care, it can be seen that the Act conforms fully to the original Swedish child care principles of normalisation, voluntariness, participation and localisation (Hazel, 1981).
If a local authority arranges for an agency, whether a voluntary organisation** or an independent agency, to place children in foster homes on its behalf, it must be satisfied as to the capacity of the organisation to discharge these duties, and must therefore check standards before placing any children. A voluntary body is defined in the Act as ‘a body (other than a local authority) whose activities are not carried on for profit’, but the Department of Health has not yet clarified whether an independent agency registered as a charity fits this definition. If it is, then before placing a child with an independent agency a local authority must be satisfied ‘as to the capacity of the voluntary organisation to discharge duties on their behalf’, which includes the wherewithal to properly approve foster families to care for children, who remain the legal responsibility of the placing authority.
The Act strengthens the requirements for this approval. Every approved family must be reviewed annually. There are no specific regulations as to persons considered suitable to manage such agencies.
Other dimensions of the kind of practice outlined in the preceding chapters have also now been given the force of law. All foster placements must now be based on written agreements, but there must now be two agreements: firstly, an agreement setting out the relationship between the foster carers and the agency, which does not need to be renewed for each placement; and secondly an agreement for each child placed in the family covering goals, tasks and duration, together with the relationship with parents and social workers as well as other relevant persons or organisations. The Act requires that every placement should be regularly reviewed and that, before the review, the placing agency must take into account the views of the young person, his/her parents and any other relevant people to attend. This is a slightly weaker section than the Kent method which required the presence of the adolescent and her/his family – if they could not attend the reason had to be recorded. Arrangements to provide for the young person’s religion, culture, education and health are to be included in the agreement. It is also the duty of the local authority to provide a written plan, both short and long-term, the latter including after-care. In the official guidelines to the Act, it is strongly recommended that foster carers should meet together in groups to help and support each other. The usual fostering limit for each foster family is set at three places, which may be exceeded only with special permission. Over this limit the family becomes subject to the regulations for children’s homes.
Certain changes specifically affect adolescents. After reaching the age of 16, they may now discharge themselves from the accommodation provided by the social services department (unless there is a court order to the contrary), or may choose to remain in their accommodation even if their parents object. This brings them into line with young people living at home, who may leave at 16 without parental consent. The Act emphasises the importance of after-care. Local authorities and voluntary organisations now have a duty to prepare young people for the time when they leave care. The Act lays upon local authorities a duty to advise and befriend adolescents and young adults who leave care at 16 years or older. The duty remains until the young person is 21 years of age and is subject to them asking for such help and the local authority considering that they need it.
The local authority is also empowered to give assistance in kind, or in exceptional circumstances, in cash. Assistance with education may continue until the end of the course even if the young person has reached the age of 21. In addition, the local authority is required to have a written policy on leaving care. The local authority, either the housing or social services departments, must provide accommodation for all 16 and 17-year-olds who are ‘in need’ and whose welfare would otherwise be seriously prejudiced.
These changes in after-care represent a cautious step forward, but the position in 1992 was still unsatisfactory. A high proportion of the young homeless consist of young people formerly in care; many young girls leaving care are pregnant, and most of these young people lack adequate educational qualifications. (Department of Health, 1991a). There is a desperate shortage of affordable housing. Young people 16 and 17 years of age are not entitled to social security payments, although they may be granted discretionary help – a difficult negotiation for a young person to undertake, and a cause of much hardship.
The theme which runs right through the new legislation is that of partnership – particularly between the local authority and the parents, but also between foster carers and social workers, and between the adolescent and the carers/helpers. Once again, this picks up a recurrent theme in the preceding chapters. However, although the rights of children and their parents have been strengthened in several ways, including a statutory complaints procedure, there still remains a great deal to be done if the principles of openness and equality are to be realised – and the provisions for after-care are still weak.
Legislation, regulations made by government departments, and practice in local authority social service departments and other agencies are not the only ways in which new concepts in placement are introduced. The National Foster Care Association has developed training for foster carers and social workers, and has commissioned research on foster care. As the following chapter shows, particular emphasis has been placed on the concept of partnership, on the needs of adolescents, and on after-care.
* In this book the work ‘team’ is preferred to ‘cluster’. A cluster is a group of similar things or people. It has no particular objective or sense of direction. A team, on the other hand, implies collaboration and purpose – ‘team spirit’ and ‘teamwork’. ** We use ‘voluntary organisation’ to denote an established charitable child welfare agency, and ‘independent’ for the newly developed agencies run by foster carers. Some, but not all, of the latter are registered charities.
-Blüml H. et al (1989) Changing Concepts of Social Work in Foster Family Care, Community Alternatives: International Journal of Family Care, Vol. 1, No. 1, pp. 23 – 24. -Cliffe D. with Berridge D. (1991) Closing Children’s Homes, National Children’s Bureau, London. -Department of Health (1991a) Patterns and Outcomes in Child Placement, HMSO, London -Department of Health (1991b) An Introduction to the Children Act 1989, HMSO, London. -Field S. (1992) Young Offender Community Support Scheme – Hampshire, England, Community Alternatives: International Journal of Family Care, Vol. 14, No. 2, pp 77 – 96.-Galaway B., Maglajlic D., Hudson J., Harman P. and McLagan J. (Eds) (1990) International Perspectives on Specialist Foster Family Care, Human Service Associates, St. Paul. -Graham J., Hazel N., Richards R. and Waddell J. (1992) Foster Family Care for Homeless Young People: The RAFT Program, Community Alternatives: International Journal of Family Care, Vol. 4, No. 2, pp 27 – 42. -Griffiths R. (1988) Community Care: Agenda for Action, HMSO, London. -Hazel N. (1981) A Bridge to Independence, Blackwell, Oxford. -Hudson J., Nutter R. and Galaway B. (1990) Specialist Foster Family-based Care: North American Developments, in Galaway B., Maglajlic D., Hudson J., Harmon P. and McLagan J. (Eds), International Perspectives on Specialist Foster Family Care (pp 17 – 24), Human Service Associates, St. Paul. -Lowe K. (1990) Teenagers in Foster Care: A Survey by the National Foster Care Association, NFCA, London. -Shaw M. and Hipgrave T. (1983) Specialist Fostering, Batsford, London -Shaw M, and Hipgrave T. (1989) Specialist Fostering 1988: A Follow-up Study, Adoption and Fostering, Vol. 13, No. 3.