Introduction 

In the summer of 2016 the government announced a national ‘stocktake’ of fostering in England. The aim of the stocktake is to reach a better understanding of the current system and where improvement can be made. The evidence review was commissioned to inform the stocktake by bringing together quantitative and qualitative research to contribute to an overview of the fostering system. The review provides:

1. A brief high-level description of the fostering system;
2. A review of what works and where improvements could be made to improve outcomes for children;
3. A review of the quality of the evidence and identifying gaps in the evidence base.

The evidence review was undertaken by a rapid review of published literature supported by interviews with key individuals in the sector.

Discussion of whether too few or too many children are being taken into care was out of scope for the review.

This is a comprehensive review of fostering providing a wealth of valuable and interesting information about fostering. This briefing will only provide some highlights from the review and recommends that anyone with an interest in this area should read the whole review or those sections of most relevance to their role.

It is an excellent piece of work with messages for practice in children’s social work, fostering, commissioning, understanding performance and outcomes and leadership of all the relevant services.

The review is available at:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/629383/The_fostering_system_in_England_Evidence_review.pdf

Contents of the Review

The review report has sections on:

1. Background to the review;
2. Methodology and reporting;
3. Issues ad challenges facing the contemporary fostering system;
4. Types of foster care placements;
5. Securing the stock of placements;
6. Recruiting, retaining and supporting the foster care workforce;
7. Foster care placements: How they are made, kept stable and supported;
8. The experiences of foster carers and their families;
9. Birth families of children in foster care and reunification;
10. The experiences of children and young people in foster care;
11. Outcomes for children and young people in foster care.

The appendices cover the literature search method, foster care in the United States. The report is very extensively referenced – 46 pages of references – providing a valuable resources for anyone wanting to explore the research literature for fostering and children in care.

Each chapter from 3 to 11 except 4, which provides a description of types of foster care placements, includes key findings and reflections which helps provide summaries throughout the report.

The briefing will provide a summary of some of the key points from sections 3 to 12.  The briefing uses the word children to mean 0 to 18 year olds.

Section 3: Issues and Challenges

This section sets out the issues and challenges facing the contemporary fostering system.  It notes the contribution of previous government initiatives over the last twenty years. These included the Quality Protects initiative, Children (Leaving Care) Act 2000, Adoption and Children Act 2002, Choice Protects, introduction of National Minimum Standards for Fostering, Care Matters: a Time for Change 2007 which was legislated for in the Children and Young People Act 2008 and included the ‘sufficiency duty’ on local authorities and Staying Put in 2014. Revised Children Act 1989 Guidance and Regulations Volume 2: Care Planning, Placement and Case Review which sets out the guidance on planning for permanence.  Since 2008 and the financial crisis there is evidence local authorities have protected spending in this area.

The review notes the dynamic nature of the concept of permanence and of the population of looked after children with a declining proportion under five years of age, escalating numbers of special guardianship orders. It describes the widely reported view that greater numbers of children have more complex needs but that current data do not allow this to be interrogated or substantiated.

Independent Fostering Agencies (IFA) have become accepted and necessary partners of local authorities providing about a third of placements, a wider range of placement options and a spread of locations. The report identifies the need for more accurate comparisons of costs between IFAs and local authorities’ own services.  It sets out information on numbers of IFAs and numbers of children placed with IFAs. There is also discussion about the emergence of a number of very large IFAs. Informants in all sectors saw local authority cuts as an aggravating factor in their relationship between IFAs and local authorities.

Section 4: Types of Foster Care Placements

This section provides a very helpful summary of the types of foster care placements including regulatory requirements and guidance for the different placement types and research on the roles different types of placement play. This is a very useful resource for anyone wanting to refresh their knowledge of the diversity of fostering or for those new to working in fostering.

Section 5: Securing the Stock of Placements

This section deals with the demand for placements and the placement capacity that exists.   Section 9 of the Children and Young Persons Act 2008 placed a general duty on local authorities to ensure sufficient accommodation that is appropriate to the needs of the children they look after.  The review identifies that many authorities have a great deal of difficulty in fulfilling this duty.

The actual capacity of the system is unknown with guesstimates made on the basis of figures drawn from Ofsted data and surveys such as those by The Fostering Network.  The report presents the complexity of identifying capacity. There were 83,175 approved fostering places in England at 31 March 2016, a 3% increase on the previous year but some of this increase is accounted for by the rise in the number of approved ‘family and friends’ placements. Ofsted reports a 23% vacancy level at 31 March 2016. The Fostering Network estimates a shortfall of 7,600 carers. Local authorities report difficulties finding placements and the local picture varies substantially across England.  The difficulty of understanding capacity in relation to need is illustrated by the complex needs of children meaning they require to be the only child in placement. This will mean a carer who may be approved for three placements only able to care for one child.

The quality of forward planning for sufficiency is not well developed with, it appears, little attempt by local authorities to model what future needs may be. While there are many framework contracts in place which should assist with understanding need and developing forward planning a great deal of commissioning happens outside the frameworks. The report identifies that there is concern that the split of commissioning and delivery functions in local authorities means that those commissioning placements do not have the expertise to judge quality or are able to take full account of the needs of the child or young person. The review found it was not clear how local authorities judged the quality of placements.

This uncertainty in understanding need for foster carers is reflected in the absence of an agreed approach to calculating costs of placements which means comparing local authority and IFA placement costs is difficult.

Section 6: Recruiting, Retaining and Supporting the Foster Care Workforce

This section summarises the review findings on the recruitment, retention and support of foster carers. The chapter provides valuable detail from a wealth of studies of all aspects of the recruitment, retention and role of foster carers from recent decades. It recognises the centrality of sufficient recruitment of foster carers to ensuring children have the placements they need. The quality of carers and the availability of the right match is key in helping children in care have stable placements.

The report finds that it is increasingly difficult for local authorities and to some extent IFAs to balance the profile of foster carers and of the children and young people needing care. There is a need to recruit carers with a wider skill set.

Financial reward plays a role in recruitment and retention of foster carers but other factors are important in recruiting and retaining foster carers i.e. support, training, recognition.

The report describes the importance of foster carers being recognised for the expertise they have about the children they care for and for the importance of their commitment to children in their motivation to foster. When this is recognised they are more likely to be content and continue in their role.  Linked to this is the importance of foster carers successfully negotiating their role as ‘quasi employed’ individuals as well as parents and carers. When this is done successfully they are less likely to be subject to stress and role conflict.

Improved cooperation and coordination are important between all those involved in developing strategic regional recruitment strategies which need to be based on current and reliable needs analyses. The importance of agencies responding to enquires in a timely and appropriate manner is commented on. An interesting finding on assessment of carers is that there is no evidence from the literature that the use of tools designed to support the assessment of potential foster carers is linked with better placement outcomes.

Support plays an important role in retaining foster carers as does training in a more general way.    Social media are of growing importance in recruiting foster carers while the review found that media driven strategies are expensive and do not necessarily help agencies target the specific groups they need to reach.

Section 7: Foster Care Placements: How they are made, kept stable and supported

This section contains some key findings for social work practice and for improving outcomes for children in foster care. It provides a very full review of the evidence on these topics which is worth reading in full.

Positively the review found placement stability is linked with strong monitoring, case planning, placement choice and multi-agency support. Studies have found a link between high quality social work conducted by experienced and confident social workers and placement stability. Studies also emphasise the importance of the relationship between the child and carer and the networks/support available to the carer. Stability is also associated with good support and training for foster carers.  Of concern are findings that there is little evidence of the extent to which social workers take account of relevant factors to achieve the best match when identifying potential placements. Little is known about current matching practice given the shortage of placements and high turnover of social workers. There is also little evidence of the extent to which social workers involve children in decisions about placement while it is widely agreed they should be involved.

The evidence considered confirmed that poorly matched placements are more likely to break down and this is because of lack of placement options and rushed decisions. The review found placement breakdown is more likely where foster carers are provided with insufficient, inaccurate and out of date information on children. Foster carers’ understanding of an individual child/young person’s behaviours, perceptions and understanding has an impact on the relationship between the child and carer and on the stability and security of the placement. The review found that while some research points to the behaviour of the child as the most usual reason for ending a foster placement other studies emphasise that breakdowns were more closely associated with a combination of the quality of the placement and the match.

Section 8: The Experiences of Foster Carers and their Families

This section draws on research about foster carers and their families from their perspectives. As well as studies, many of which are small scale it draws heavily on The State of the Nation’s Foster Care reports from The Fostering Network. The section has interesting and important detail on the impact of caring on foster carers and their families. It covers their experience as foster carers and of working with other professionals, in particular social workers.

The findings reflect that fostering is enormously rewarding and challenging for families but can be very stressful. Factors that protect families from stress and strain include the rewards of fostering, higher parenting efficacy, high quality social work support and matching procedures that asses the foster family and child and do not place the child where the carer feels unsure about accepting the placement. Good quality support is consistently found to be essential to foster carers. The report notes the risk of experience of stigma and social isolation for foster carers, especially if the children they care for have behavioural problems.

To do their job well foster carers need enough information about children prior to placement and be involved in decision making and planning for the children they care for. They want to be trusted and involved as valued members of the team.

Finally, this chapter notes the impact of allegations against foster carers and their families. These can be long lasting and include emotional and financial impacts as well as impacts on health and relationships.

Section 9: Birth Families of Children in Foster Care and Reunification

This section covers research on birth families and their relationships and contact with children in foster care. It also looks at the management of relationships with birth families from the perspectives of foster carers and social workers. It provides an overview of research about reunification home to birth families. This is a very broad range of topics and this section provides an excellent review of the available research and identifies the gaps in that research.

A key finding is that a consistent relationship with a social worker who treats birth families with respect and who is open and honest is extremely important to birth families. The research identifies the sense of loss and grief of birth families and their feelings of powerlessness within the social care system. The research suggests there can be tensions for social workers in supporting birth parents while addressing the concerns that led to their children being taken into care. For reunification access to support services, especially those that address substance misuse and mental health problems, is especially important.

For many children living in foster care contact with birth parents, siblings and wider families is a high priority. However, this can bring difficulties and there is a need to ensure it is safe, well planned and has a clear purpose.  Good quality contact supports reunification, placement stability and positive child wellbeing. Placement of siblings together in foster care may improve the likelihood of positive outcomes.

Successful returns home are linked to good quality planning, assessment, case management, support for children and parents and preparation before and monitoring post return.

Section 10: The Experiences of Children and Young People in Foster Care

This section looks at the experiences of children and young people who live in foster care. It makes the obvious but critical point that children are experts in their own experiences and their views are fundamental to considering the ways in which the foster care system should develop. The section provides an excellent summary of recent work capturing children’s views with some telling quotes from the children who contributed to the research. For example “I feel safe, I am cared for e.g. fed, washed, clean clothes, clean bedding, listened to, not pushed away, doing things with my foster family, having fun, being loved and wanted.”

It has sections on the views of specific groups of children such as unaccompanied asylum seeking children, black and minority ethnic children, lesbian, gay and bisexual children, children with disabilities and younger children.

Amongst the key findings are that children value foster carers who offer love, respect and acceptance as part of the family and who will ‘go the extra mile’. The research with children shows the central importance of a trusting relationship with an adult which may be a foster carer but may be a social worker, teacher or other professional. Children like flexible and responsive services that respect their views and help them participate.

Children frequently cite lack of continuity of social workers as a problem. Children want better communication and more information including about placements prior to moving to them. They have a strong desire to be involved in decision making.  Being given choices and feeling listened to are very important, including about placements.

Section 11: Outcomes for Children and Young People in Foster Care

This section reviews the research on outcomes for children in foster care. Much of the research on outcomes does not differentiate between children in different types of placement. As with the other sections it provides an excellent overview of the research on both general and more specific factors that affect outcomes for children in care.

Many children move between different placement types over their time in care. The report therefore sometimes considers looked after children as a broad group but wherever possible it highlights work that focuses on foster care.

The review notes that research is increasingly moving away from broad comparisons between looked after children and all non-looked after children to consider differences in outcomes between distinct groups within the care system and, for example, children on the edge of care.

The review finds there is evidence that quality foster care can be a protective factor which can support and enable children to achieve positive outcomes. Children who enter care early and stay in care for long periods, particularly in foster and kinship care do better than other groups including those identified as being in need but who are not in care. Relationships are central to good outcomes.  Warm sensitive care giving makes a huge difference.

The review identified that it is important to bear in mind that many children will defy generalities and that the idea of providing individualistic care to children should be a key tenet of the system.  Children in care are not a homogenous group.

Placement instability is one factor most often linked to poor outcomes. However, stability is not of itself enough as children in stable placements that do not meet their needs can benefit by moving to a placement that does.

Section 12: Conclusions

The review starts this section with the conclusions of a knowledge review on fostering for Social Care Institute for Excellence (SCIE) in 2004 which sets out what is positive about fostering. The review finds the conclusions as valid today as they were in 2004. These conclusions reflect the key findings highlighted throughout this briefing about the positive role fostering can play in making a difference for children in care.  For the review, this raises the question of the extent to which what is known is used.

The review identifies the biggest current challenge as how to recruit and retain enough high-quality foster carers.

It also identifies what it calls three ‘wicked’ issues – wicked and hard to resolve problems. These are:

1. Whether as reported in interviews and the studies examined children coming into care have increasingly complex problems;
2. The quality of social work support offered to children in foster care and to their carers;
3. The need to review the issues that facilitate and challenge outsourcing of fostering services.

Finally, the review notes what is missing from the research including good quality evidence to inform the commissioning of services and very little attempt to provide the quality of detail on which to judge success or value for money. This gap would be helped by the development of appropriate and consistent measures of placement outcomes.