Social care – Do care homes remain a last resort?

An expert has suggested that councils may be capping their care places for cost reasons. Janaki Mahadevan investigates. Residential care homes accommodate some of the most vulnerable young people in the country.

Often specialising in taking extremely traumatised children, in many cases residential settings offer therapeutic services that other placements may not.

But figures recently released in the House of Commons Library showing the number of children placed in residential care in each local authority has prompted a leading care expert to question local policies of allocating residential care places.

Jonathan Stanley, manager of the National Centre for Excellence in Residential Child Care, says local authorities that appeared to have the same number of children in residential care each year may be capping places, rather than being led by the needs of the children.

Last resort

Natasha Finlayson, chief executive of The Who Cares Trust?, says residential care should not be seen as a last resort.

“The assumption that being in a nuclear family setting is best for the child is not always the case. Some have had a terrible experience in a family,” she explains. “We also still have significant problems with outcomes for looked-after children, and with three-quarters of them in foster care, it clearly isn’t consistently providing the right answer.”

According to Finlayson, some social workers are under pressure to make decisions based on budgetary considerations. But the recent focus on alternatives to foster care is starting to turn things around, she says.

The latest report by the Children, Schools and Family Select Committee was welcomed by care campaigners for providing a spotlight on residential care. It states: “The potential of the residential sector to offer high-quality, stable placements for a minority of young people is too often dismissed.”

But how far-reaching is this message, and is it managing to turn around entrenched attitudes within local authorities? At Reading Borough Council, which figures show has had 20 children in residential care every year from 2004 to 2008, foster placements are preferred.

A spokesman for the authority says: “Our belief is that children thrive best in family-based placements, and we only seek residential care if it is not possible to find a family that can meet their needs.”

Oldham, which has had 45 children in residential care every year from 2003 to 2008, also puts family placements first.

Councillor Kay Knox, cabinet member for children, says: “We do not have a cap on the number of residential care placements but we aim to use these only where we are unable to meet the needs of children in a family setting.”

Careful consideration

While residential care is getting more airtime, particularly in Channel 4’s recent Britain’s Lost Children season, the issue of cost and provision of specialised care places requires more careful consideration, according to John Kemmis, chief executive of charity Voice. “Local authorities see children’s homes as a last resort largely because of cost,” he says. “But they must pay for quality, not just for what is cheaper.

“Commissioning managers are not expert enough to know what the needs are of the children in their locality. They are people who oversee services commissioned by local authorities and are not children’s services professionals.”

THE COST OF CARE

£126,256 – Average cost of a children’s home place per year in 2007/08

£25,428 – Average cost of a foster care place per year in 2007/08

16 – Number of councils with little or no change in the number of children in residential care over at least the past three years to 2008

Source: UK National Statistics, House of Commons Library

CHILDREN’S HOMES – WHY THEY CAN BE A SOUND INVESTMENT

Alistair Gardiner, director of practice at independent care provider Perpetual Care, runs children’s homes in Lancashire. He has also been service manager for two local authorities. He says he can see the issue of placing young people in residential care from both sides of the fence.

“Residential placement is the most expensive option, and local authorities will look at the cheaper option first, so fostering would be the first port of call. But for many young people, their experience of family life has been so traumatic that a family placement may not be suitable.

“We don’t want residential care to become a dumping ground; the matching process should be as important as it is in foster care. Children’s homes also have to expel the idea of being a dumping ground, by not taking every child regardless of whether they are going to be able to meet their needs or not. It is not unusual for children to have had multiple placement breakdowns before they come to residential care.

“It will be looked at as a negative that the child was too difficult for each placement, so they had to go to residential care. What they don’t look at is that a family may not be the most appropriate setting for that child at that time. And instead of considering residential care, first the child has to go through sometimes seven or eight placements, and the cost for that child goes up.

“We have this term ‘unfosterable’, but that is the wrong way of looking at it. We know there are children that at some point of their life may not be able to live with a family, but children’s homes may be able to provide the initial stability they need.”