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“Returning home from care” – an analysis of the NSPCC research on rehabilitation of looked after children

The NSPCC have published their research into outcomes for looked after children who are rehabilitated to the care of their parents. The report can be found here: –

http://www.nspcc.org.uk/Inform/resourcesforprofessionals/lookedafterchildren/returning-home-from-care_wdf88986.pdf

Their big headline figure is that over 70% of the children in that situation they surveyed said that they weren’t ready to go home.

That initially made me blink, and wonder why the children had said that to the NSPCC but hadn’t said it to their Guardians, but then I realised that the pool of children concerned were probably the older children who were going home from s20 care rather than care proceedings.

There are still some startling figures in the report, however. In 2011, 90,000 children were looked after in England. 39% returned home (about 10,000 children, compared to the 3,050 who were adopted) Of the children who return home, between a third and a half come back into local authority care because the rehab breaks down, and around half suffer further abuse at home.

The NSPCC suggest that variance in Local Authority practice plays more of a part in whether a child is rehabilitated and whether that rehabilitation is successful than the child’s needs.

The report is quite critical of whether the family Courts have skewed the protection of children as against parental rights and article 6 too much in favour of parents.

“For children on care orders, family courts play a central role in assessing whether a child should return home. Their involvement can lead to improved planning and service provision26. However, courts have been shown to favour parents’ rights over those of the child27,28. Interviewees told the NSPCC that courts often instructed reunification, even when it was not in the best interests of the child, with decision making tipped in favour of the parents rather than the child.”

The tiny footnote there is referring to the Farmer research published in 2011, which is also worth a read.

The NSPCC recommendation in this regard is :-

Action must be taken to ensure that court decisions are always based on the child’s best interests. The new Family Justice Service must ensure that members of the judiciary specialising in family law receive training in child development and the implications of returning home from care. Information made available to the courts must enable members of the judiciary to receive better feedback on the outcome of their decisions.

To an extent, this strikes a chord with the Justice Ryder modernisation campaign, with its suggestion that the Family justice system should commission and take notice of some agreed research, rather than operating in a vacuum. I have to say, that for many years, my default reaction to seeing research quoted in a social work report is to reach for the red pen (or now, the ‘strikethrough’ button) as I know how unpopular it can be with the bench or judiciary to have a lot of research spouted to them -it tends to be either a statement of the bleeding obvious, in which case, why bother, or something which supports a proposition which is controversial (such as – the odds are that this child you’re thinking of sending home is 50-50 to suffer abuse at home as a result, or having five sessions of contact with a parent per week isn’t actually good for a baby) in which case nobody trusts it.

But you know, if all of the time and money we spend in trying to reach the right outcomes for children is resulting in half of the children we send home after that exhaustive process being abused, then we might want to recalibrate.

(of course, from the other side of the coin,  there’s something of a paucity of research as to the number of children who get long-term fostered or adopted when the Court and professionals were wrong and they could  successfully have gone home – that’s probably a harder piece of research to work out – probably working on the parents who go onto have another child and successfully care for that later child)

It is a bit hard to totally trust research commissioned by the NSPCC – I’m not questioning their integrity in the slightest, but when it comes down to working out where they stand on the “Keep children safe at all costs” versus “keep families together at all costs” spectrum (or the Cleveland-Haringey axis, if one is being unkind) it doesn’t take long to spot that they come with an agenda.

(Not necessarily a bad agenda – I wouldn’t claim to be precisely on the fulcrum of that particular see-saw myself – but it makes it harder to rely on their research as probative. It’s like seeing a report from Benson and Hedges about passive smoking – you sort of suspect there’s a starting point there)

 I liked this quote from a senior social work manager, though :- “Support is crucial. [But] we have to take a pragmatic approach as often the support that has been suggested by the courts or experts is simply not available.”

 Very true – an awful lot of expert reports which recommend that the door to rehab is not shut do so in complete absence of context about just how feasible it is that the parents GP will commission six months of therapy for them, and that that can start without delay.

The first bit of this next quote is blindingly obvious, the second part much less so.

Poor parenting, drug or alcohol misuse, domestic violence, and parental mental health problems, all increase the chance of harm when the child returns home. Farmer et al found that 78 per cent of substance-misusing parents abused or neglected their children after they returned from care, compared to 29 per cent of parents without substance misuse problems29

 

78% of rehabs involving substance-misusing parents result in further abuse or neglect. Being a maths guy, that suggests to me that rehab to parents who misuse substances is more likely than not to result in the child being abused or neglected if rehabilitated to their care. (of course, what you argue in any individual case is that for this particular parent, these are the factors that mean the Court can be confident that they are one of the 22% who won’t abuse their child; but that context of how prevalent the risks are to that subject-group remains important.)

 The challenge of rehab to a substance-misusing parent is significant – on the one hand, if you can resolve the drug problems there’s often a good parent underneath, but on the other it is so easy to be over-optimistic about an upward curve on a graph of peaks and troughs being a sign of a genuine change – being too close to the graph to see the pattern as being anything other than up, up and up)

From a bit more of a parental perspective, I think this is probably a valid and fair criticism of LA support.

Where support is provided it is often removed after a short period of time, before a problem has been sustainably addressed. Alongside resource constraints, support can be removed due to a belief that parents need to be able to shoulder their responsibilities and not become dependent on services33. Support is often discontinued once a child returns home without any assessment of whether the families’ problems have diminished. This results in further instability and an increased risk of harm to the child. Parents also report concerns about the short-term nature of interventions designed to support them.

Some more recommendations – all of which make sense to me

Decisions about whether a child should return home must always be led by what is in their best interests.   [Of course, it already is, it is just that what one body thinks is in the child’s best interests isn’t necessarily the same as what another body thinks]

Support for children and their families prior to and following reunification must improve. 

 The government should ensure there is sufficient support for parents who abuse drugs and alcohol, who are victims of domestic violence, who have mental health difficulties or who have other issues which could affect their ability to parent effectively when their child returns from care. Local services must be incentivised to provide sufficient support for these parents. 

 Local authorities must ensure that the support provided to children and families matches the needs identified in a child’s risk assessment. This information should be used to inform local commissioning and investment decisions. •

Local authorities must ensure that foster carers and residential care workers are involved in the process of a child returning home from care and are supported to help the child prepare for a return home, where that is in their best interests. 

 Guidance on designated teachers for looked after children should be revised to include children who return home from care, even if they cease to be looked after on their return. The support provided by the school can play an effective part in successful returns home.

The very last bit of the report sets out a new method of classifying risk, which the NSPCC are working with 8 local authorities on. To my cynical eye, it looks somewhat simplistic given how complex the variables are in child protection cases, but it’s not bad as a benchmarking exercise. I’m not sure I’d place quite as much weight on them as the child’s wish to return home being an element that allows you to consider the risk is lower. (It seems to be about a third of the factors in weighing the risk, which appears to my untrained eye to be far, far, far, far, too high)

Classifying the risk of reunification – a tool to support decision making about children returning home from care, adapted from Safeguarding Babies and Very Young Children from Abuse and Neglect (Ward, Brown and Westlake, 2012) 

 Severe risk

 • Risk factors apparent and not being addressed, no protective factors apparent.

 • No evidence of parental capacity to change and ambivalence or opposition to return home by child or parent.

High risk

 • Risk factors apparent, and not being addressed. At least one protective factor apparent.

• No or limited evidence of parental capacity to change and ambivalence or opposition to return home by child or parent.

Medium risk

• Risk factors apparent or not all risk factors addressed. At least one protective factor apparent.

 • Evidence of parental capacity to sustain change. Parents and child both want return home to take place. 

 Low risk

 • No risk factors apparent, or previous risk factors fully addressed, and protective factors apparent.

• Evidence of parental capacity to sustain change. Parents and child both want return home to take place.

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About suesspiciousminds

Law geek, local authority care hack, fascinated by words and quirky information; deeply committed to cheesecake and beer.

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