Agenda item

The Cabinet Member introduced the report and officers discussed the contents in greater detail.

Challenge:

What is the total number of care leavers? Is this about average compared with other authorities? What additional support can be given to these children?

I'm not sure, but can clarify after the meeting (Action: Charlotte Drury), but what I will say is that we do have good outcomes. Our care leavers tend to fall into two distinct groups young people whose abuse trauma and transition through care has not been as reparative as one would hope and a lot of work is done with them in terms of training and support and access to education and later life education.  In regard to the number of children who are actually in education in long-term education employment apprenticeships or in universities, we do quite well in relation to our colleagues in Gwent, although we don't have as many care leavers as some of the big authorities.

The most recent children's commissioner report 2021-22 suggests that there is insufficient provision for children with complex needs, which by nature, also has the potential to negatively impact the young people leaving the care system.  I found that a little bit concerning. Has that improved since 2021-22?

If we're talking about the provision of care, when we say complex needs, invariably we're talking of children with significant mental health problems, children with disability or children who have experienced high levels of trauma, whose therapeutic needs and reparative needs are very high, sometimes with difficult behaviours.  We’re in a difficult place and in fact, that position has got worse, in terms of destabilization of the market, not knowing what the future holds and how the eliminate agenda   will progress. Monmouthshire has plans to create their own residential units so that we can take more control and more oversight over the outcomes for young people , but it is a nationwide problem.   We have been heavily reliant on independent agencies which is a specific problem in Monmouthshire problem, but in terms of the difficulty of placing children in foster placements generally, we share the same challenge as the rest of Wales and the UK, which is that we don’t have enough foster carers and recruiting them is becoming more challenging.  and the ‘eliminate agenda’ hasn’t assisted us in this respect. We struggle to find placements for sibling groups, who maybe don't have complex or challenging needs and for younger children, partly due to having an older demographic, with a lot of foster carers retiring and also we don't have younger people coming into the fostering arena because they cannot afford to live here.  In some communities in the valleys, foster caring may support people’s income, if people have a spare toom and thinning they have good parenting skills and like children, but we don’t have the same motives here and that is why we have a greater reliance on independent fostering. Independent fostering agencies are now choosing to take English children over Welsh children, because of the ‘eliminate agenda’ and the risk of losing the placement within the next few years. Welsh Government have a clear position that they will seek to remove profit from children's care by 2027 and when they talk about eliminating profit, what they're talking about is the profit made by private providers, such as private residential homes in Wales and also independent fostering agencies. By 2026 it will be illegal to place a child in an independent residential provision, so there are funds to support the local authorities to create their own residential units and work in cooperation, particularly for the care of children and young people with very complex needs, because an authority like Monmouthshire might only have one or two children in that category.

What are we doing creatively to recruit foster carers?

We are trying to create an environment where every single member of staff becomes a fostering recruitment officer, and as elected members, you have the opportunity to have those conversations with people and encourage them to come and have a conversation with us, as we can look at ways of making it possible. We have explored opportunities to convert annexes to enable a young person to remain within the family until such point they are ready to transition to independence. We have bought bunk beds, looked at converting attics, supported foster carers to move to bigger properties and doing everything we can think of to encourage appropriate people to foster.  We are sensitive in how we have those conversations and encourage people to have conversations with us, without giving the indication that anybody can foster. The Corporate Parenting Strategy sits alongside a Fostering Strategy and a Foster Care Recruitment Strategy, which has broadened some of those barriers of age, employment, accommodation etcetera, so that we can help resolve the barriers. That recognised, there is between two and three hundred pounds a week difference in financial support received via a local authority foster placement and one via an agency.  There are plans nationally to regulate the terms and conditions and scales of pay for foster care, but in the meantime, we have to look at different ways via our fostering strategy to make up the difference and one of those things is our base therapeutic support, which you don’t receive via an independent agency.

What is provided in terms of training about nutrition, given it’s fundamental in supporting cognitive behaviour as well as physical wellness and how do you support families who have nutritional problems?  Also, what sort of checks and balances are undertaken with your foster carers whether prospective, newly engaged or experienced, to ensure they are truly being supported and do you feel that you have the systems in place?

Both nutritional training and support for foster carers and families fall under our preventative services. In terms of the foster care support, all foster carers have to attend skills and foster training and part of that is around the children's emotional and physical well-being, so that would include things like nutrition and if we had specific concerns about individual foster carers, they would be provided with specific support and training in order to ensure that the children in their care were receiving the right kind of environment to enable them to flourish, and that includes our ‘connected persons carers’ as well (these are family members who come forward to foster children within their family network). There may be some health concern, but foster children receive annual health checks and there is an annual review process which is reported back to the panel every three years for a foster carer to renew their status, so there is a wide range of general support as well as tailored specific support and there is a training  development framework that applies to all of our foster carers, with core modules that all foster carers have to complete and a Pioneer program where foster carers can put themselves forward to mentor and support other foster carers on specific issues where they have specialist expertise. Monmouthshire has very good placement stability compared to other areas in Gwent.  The Base service is also a small support service of a clinical psychologists and therapists, and they are currently establishing a young people's group to help inform the development of the service and that group is currently working on a therapeutic garden, in collaboration with the local community, to determine the location of the Base building. We are focussing on understanding where we need to input, to support the foster carer to provide the best care to enable the child to thrive and flourish, so that our care leavers can contribute as productive healthy connected members of the community.

We have benefitted from some of the media advertisements on foster caring, which was really positive. However, taking a child into care isn’t always a case of taking a them out of risk, it can be a case of taking a child out of one risk and placing them in another set of risks and that’s one of the reasons why we are so keen on promoting special guardianship orders and kinship placements, because even the most perfect foster carer may not be as resilient as the grandmother, the uncle or aunt and when we are dealing with very traumatised children with difficult behaviours who may be communicating their distress in very challenging ways, sometimes a foster carer may need to prioritise the other children in their care, whereas the family members may  be more able and willing to support these young people, so making sure that we have the right support around those kinship carers is critical. We’ve had huge success in converting kinship orders to special guardianship orders. Sometimes the family members may not be perfect, but if the child is happier and they are able to support them, often it’s abetter place for the children to be with people who love them.  The Families Together project is a shared project with Barnardos, which supports children to continue to live with their families.

Do you have strategies to cope with the eliminate agenda, given the pressure on the system?

The Gwent heads of service are working with Welsh Government on this very issue  also the ‘All Wales’ heads of service and directors are also heavily involved in discussions on this.  Feedback has been given on the need for a strong element of support as the system changes and if independent providers of foster carers were to exit the system, we would need to fill the gap, but it is an ongoing issue we are negotiating upon. We have an independent reviewing officer who's extremely skilled and experienced whose job it is to sit outside operational services and to review the care plans at statutory times throughout the year to ensure that all partners (health, education, psychology, children's services) are doing their utmost for the benefit of the children in our care.

We've had money from Welsh Government for the Eliminate agenda to support children to go to a foster home via the local authority, and often we are presented with a situation where we have a child we know nothing about or the family they have come from and we need to provide them with accommodation which we haven’t got, so it's about developing services such as those provided by our ‘family time’ team, to support children in their own home, while the assessments are done.  We have our ‘MIST service’, which manages very complex crisis-driven young people and we've been able to divert some of that team from their longer-term work to help us manage crisis. The development of the ‘going home staying home’ team will enable us to support children and families in crisis, right at the beginning, whilst we begin to understand the issues, because placing children with complete strangers is also traumatising. We hope to recruit to this team in order to bolster the services that we already have developed in children's services, so we can ensure we can manage crisis and keep children home safely.   

How does the work you do link with education and any support they offer?

The link with education should be strengthened by the recent recruitment of a vulnerable children's lead in education, education recognising that there is variation in school's ability to meet the needs of some of their more vulnerable pupils.  Whilst every school has a designate designated lead for children who are looked after, certain schools are better at doing that than others, so there is work to do in supporting schools in developing more therapeutic approaches for trauma and emotional. There are also ‘complex care panels’ where children's services, education, CAMHS (Child and Adolescent Mental Health Services, MIST and health have joint duty to look at the ‘Brighter Futures Strategy’ in terms of education for looked after children in particular and to make sure their needs are met, so a lot of our complex children will go through that panel, in order to be able to make sure that difficult aren't unnecessarily excluded. The new vulnerable children's lead will also sit on that panel to ensure education is a priority for our looked after children. We also have a key relationship between children services and the pupil referral service to support the needs of children who looked after within that service.

How do you match children with foster carers ad what is the success rate?  As a percentage, how many children have to face the unsettling process of having to start again?

I don't have the statistics to hand but can provide that after the meeting (Action: Charlotte Drury), but in terms of placement stability, we perform well and the base service assists with that. I would like us to be even better, but because we don't have enough foster carers, it is a challenge. Every decision involves risk and we are so careful. Placement matching is essential and is not imply a case of matching children with foster carers, but also with the other children who may be in placement, so that adds an additional layer of complexity.  We are making 80% conversion rate form enquiry to approval, which we would like to be better, but people pull out for valid reasons. We speak to their children, we speak to their employers, and we have been audited and they were very confident in our assessment process. Our foster carers are amazing, flexible and work with us, but there are times when the fit just isn’t right and sometimes children expose other children in the placement to two levels of risks that can't be managed and there have been occasions where we've had to exit foster carers from the service, because their own priorities have changed. We work very hard to get it as right as we can with the resources that we have and to support that match as much as we're able to and we are doing we are doing pretty well across the region.  The link between the operational teams, crisis management teams and the fostering service is crucial, because we need to build support around families to manage risk in the community or mitigate risk in the community and having the information on children is vital in order to be able to match well and make sure that they're in the best possible placement.  Sometimes the support has to transition across to the foster carer, in order to be able to hold a situation whilst we learn more about children, so it’s very complex.

I notice in the report you refer to issues accessing dental care?

This is a national problem and foster children are not prioritised over any others, so getting a child registered at a dentist is extremely difficult, so it remains on our agenda. (Action: The Public Services Scrutiny Committee to highlight when discussing dentistry services with Aneurin Bevan University Health Board).

How important are developing life stories for young people and what emphasis are you putting in training staff on this?

Developing life story work for looked after children is quite a challenge if we're being honest. It’s important for all children but life story work for children who are going forward for adoption has always taken the priority. We work with South East Wales Adoption Society, who have a lead worker for life story work, and she has developed a life story format which starts as soon as a child comes into the system whether that's at birth or whether that comes children coming into the foster care system.  Life story work is quite a demand on social workers, who are already struggling with the day-to-day job, so to do life story work is very challenging. We have foster support workers and we've just employed a new support worker whose job will be to do the life story work and to support other people to do the life story work from the moment the child arrives. It’s now a responsibility for our early health assessment team as well as social workers and education and health to contribute to this, but it’s always children who are to be adopted have taken priority, because they are going into a new life with a new family, so how we manage life story work for all of our fostered children is a real conundrum, because you can do it for the children coming in, but we can't forget children who've been in our system a very long time and there are children who are exiting our system as care leavers who still don't really understand their past. I’d like to think that we are preparing in this new way, because we have had a five year children plan towards the eliminate agenda and financial pressures means that it's now a two-year children's plan, which is very much about preparing young people to have support networks, to have lifelong opportunities. So we are starting much earlier now and have a lot of plans in place, but in terms of life storybooks for children age 9 who have been in our system for five years, it’s very difficult.

Do children leaving the care system have personal advisors?

We have excellent personal advisors in Monmouthshire and they sit on our corporate parenting group and we've just extended the hours of one of them so we've now got three full-time personal advisors to support our young people up to the age of 25. They can help support them to access their records, so we are very aware in social work, what might have been written in 2002 might would be very different to what would have been written today this can be traumatic reading records that are  written in the third person, talking about family and making very difficult comments, so it's a very difficult thing and we provide a great deal of support. We do have quite a lot of young people who want to know their history, but we have tried to engage those young people in their journey from the age of 14, so they are preparing to leave the system with some understanding.  I think this has been a gap in previous social work practice for various reasons and foster carers are very much encouraged to write a daily diary, writing to the child about whether they had a good or bad day, what they may have done that day or any difficulties they experienced and whether they had conversations with them about it. It’s accessible to the child and they can be part of it, so that when they leave care, they have their story.  Part of it is helping children understand why they are in care, because not all of our children do understand why they are in care and doing that in a way that is sensitive way, so as not to damage their self-esteem, bearing in mind that half of all children aged 16, 17, 18 will go home, it’s important that they understand the decisions that have been made in their best interests, but without leaving them with a shattered sense of self and how they fit with their community.

Chair’s Conclusion: 

Thank you for presenting this and answering our questions in detail. We feel the work you are doing is exceptional, despite the challenges and the committee is very satisfied with the progress.