Adoption: Threats And Divisions As Gove Loses Patience

We’ve known for some time now that as far as working with children in care are concerned, adoption is the government’s absolute priority. A series of announcements over the past 15 months or so have focused on different aspects of the process. Last week came the latest and potentially most radical, where failing authorities could be stripped of their powers, which would be handed to the voluntary or private sector. There’s £150m purely for adoption, new resources but it’s not new money because it comes from cash previously earmarked for early intervention. Michael Gove just got serious.

The new money for adoption is £150m previously earmarked for early intervention, an area where Surestart and other preventative initiatives that aim to keep families together have already been decimated. A few days before this announcement, Eric Pickles stated he wanted to cut resources available for troubled families. The agenda could not be more stark – prevention and keeping families together is less important than adoption. With devastating irony, this most ideological of decisions uses money specifically set aside for evidence-based initiatives.

Politicians and practitioners agree that the shortage of adoptive carers has to be robustly addressed but surely not at the expense of other children in need. The government’s attempt to say that one sector in need is more important than another smacks of the way their divisive language around the welfare and employment debate tries to set working people against the unemployed, the rest against the “shirkers and skivers”. Child care is a continuum, with support for keeping families together at one end and adoption at the other. They may appear to be poles apart but in fact they are part of the same whole, far more closely related than is convenient for the governement to acknowledge.

Evidence shows that large numbers of children come in and out of care. In foster care, for example, providers have noticed that the rise in placements due to the higher numbers of children coming into care has been accompanied by an increase in the number of short-term placments, where children then return home. It is easy to forget that the original intention of section 20 of the Children Act where children and young people can be accommodated with the agreement of their parents was designed to maintain the ties between children and their families rather than close the door, and that families could use accommodation as a service, a week or two’s respite while they sort out problems with the help of their social worker so that the child can return to where they belong, in a safe, caring home. The Act became law in 1991 but sounds like ancient history. I may as well be writing in Sanskrit for all the sense those last few sentences make in 2013.

On a personal level, as someone who has worked across the whole spectrum but more recently in fostering and adoption, I feel dirty, as if I’m using money that’s been pinched from a child’s piggy bank. This is how awful this low, underhand and cold-blooded financial conjuring makes me feel.

The decision encapsulates all that is wrong in that dark, dank place where politics meets planning for children’s services. These are themes I’ve written about before. Prevention leads to better services and saves money in the long run whether it’s children in care, health and safety or gritting the roads before forecast snow falls. Yet for the government, any government not just this one, there’s little reason to invest in the long-term because another administration will reap the benefit, be it another government or perish the thought, another lot of politicians from another party. Yet we will know the success of our work with children in care only when they are well into adulthood, and anyway, even then people change as they grow older.

Adotpion czar Martin Narey, now Sir Martin, said this week that if even half the children on the waiting list are adopted, that would produce huge savings. He’s right of course, and he’s right to say that children should not have to languish in care with only the hope of a family to hang on to. Where I fundamentally disagree is that one element of the continuum should be prioritised at the expense of another. The twin goals of long-term savings and better choices for children and families for children in need of help from the state could be achieved by investment in early intervention as well as in adoption, not instead of. Also, even if the adoption backlog were cleared, there are others coming through the system in greater numbers than ever before. They too will need placements and the resources to find them. Further, adoption is not the only route to permanence. Evidence demonstrates the value of long-term fostering for many children and for their carers who receive support throughout the placement. These placements cost money but the children are worth it.

I am delighted that the government has made the welfare of children in care a priority, the first to do so in recent memory. However, it’s hard to escape the conclusion that for this long-term, complex issue they are seeking a quick win, the headline and the soundbite that goes with it.

More irony: government proposals in the pipeline won’t grab the headlines but are far more interesting and relevent for me as a practitioner because they directly address many of the problems in the existing system. Most important is the review of the court process that maintains a steadfast focus on the needs of the child within a clear timetable and minimises drift. Support for adopters will increase, with a look at personal budgets so they can decide what their family needs and how to sort out any problems. The purpose of the new national Adoption Gateway is to make it easier for prospective adopters to find out more. Changes in the inter-agency fee place the voluntary sector on the same level as authorties, thus widening the pool of adopters. Finally, there will be more organised gatherings of prospective adopters and children, sometimes called adoption parties. This is a direct result of an evidence-based study by the British Association for Adoption and Fostering that was properly researched, funded by the voluntary sector and fully evaluated. Taken together, these initiatives will do nothing but good. I fully support them. Evidence not ideology.

Every now and again any system in any organisation needs a good kick up the backsidebut in my experience, threats are far less effective than committed, considered leadership that understands a problem and sets goals for change. The government has quickly tired of what it sees as intransigence in the sector. Last week we heard that councils who do not respond will find adoption services removed entirely from them and placed in the hands of the voluntary and private sector. The appearence of the private sector is noteworthy. This requires a legislative change as private companies are not able by law to become adoption agencies.

Once more we are seeing divisions rather than partnership. The voluntary sector wants to work alongside local authority partners. Legions of dedicated, able local authority social workers want to find more adopters, not to be excluded from the whole process. We have to work closely with communities to find more adopters, for example more black adopters, rather than becoming ever more distant. Change must be accomplished by working with the sector not against it.

That Old Chestnut

[Guest post by Sharon Levisohn]

Mother came home from hospital on Friday, having been in over Christmas and New Year. She has advanced COPD (emphysema) and had a respiratory virus that resulted in pneumonia.

However, her lengthy stay was not due to her illness – a week of steroids and antibiotics settled that insofar as it could be – but the inability to plan a discharge to meet her ongoing needs. The hospital wanted to send her home with three (local authority funded) home care visits plus daily district nurse calls. The social worker could not authorise the home care package without it “going to panel” and of course there would be no more panel meetings until January 7th. Then the hospital suggested a nursing home placement but, despite full-time oxygen dependency and limited mobility, my mother did not meet the criteria for a funded admission. Next they suggested a short admission to a cottage hospital. That was rejected as they thought, frankly, that the journey would kill her. Plan D was to be discharged home with the support of the (health-funded) Re-enablement Team; however, she was not open to this as her condition was too far progressed for rehabilitation. All this time, Mother was in an acute bed – one of those infamous bed-blockers – on a ward with confirmed Norovirus, while the family and I rode the Waltzer of uncertainty and conflicting updates, always aware that she might just give up the long battle with COPD.

What is the point of this personal anecdote of woe over the festive period? I suppose it is not a unique case; even on the ward there were several other patients unwillingly playing the Cherchez La Femme game of discharge co-ordination. How many patients and families in how many hospitals were going through similar experiences? What vexed me – and as a former nurse I am not criticising the frontline ward staff – was that the hospital did not seem to know what qualifying factors were applied to the various options – one might have assumed that they had confirmed Mother’s eligibility before informing her and the family only to dash their hopes. The other bugbear is the responsibility for funding. Surely, if a risk assessment has shown that a frail elderly terminally ill patient has been assessed as needing input from various agencies in order to be at home with the people and dogs and personal touches she loves, which give her a little quality of life, and if we believe that it is better for the elderly to live at home so far as is possible, surely then the funding needs to be provided? Or shall we simply abandon that principle as practically unviable?

Rotherham: Truth and Politics

The only time I read my local paper is at the Indian takeaway. Whilst waiting for my korahi chicken yesterday evening, I disinterestedly flicked through the familiar mix of parking problems, noisy neighbours and oversubscribed schools. I nearly skipped the article buried on page 11 about a man who died after an error from his GP, because I was pondering whether to order a popadom. Then I stopped and read it: it was my GP.

Our doctor is kind, caring and hard-working. He treats people as individuals and always makes time for them. On this occasion, the surgery computer system did not indicate that the prescriptions for the drugs his elderly patient required for a heart condition had stopped after the man was released from hospital. Several months on, he relapsed and sadly died. The coroner praised the doctor for his honesty. I can’t recall the actual verdict but the death could have been prevented.

Today’s Daily Telegraph didn’t lead with an avoidable death or for that matter any death. The case of foster carers who allegedly had children in their care removed from them because they were UKIP members has run on all media. It’s been top of 5Live news all day, for example. You would expect Nigel Farage to have an opinion but Michael Gove has swiftly weighed in too. As I write, Milliband is being quoted. Cue outrage at social work.

If UKIP membership is the only reason why these children were moved, I don’t agree with it. They should have stayed where they were. The council said on the news this morning that the children were going to move on anyway. This may be the case. However, the original Telegraph report says the boy was moved the following day and his two sisters soon after. If this is accurate, it does not sound like a planned move to me.

I qualify my remarks with ‘if accurate’ for a couple of reasons. Firstly, the report does not appear to have any corroboration from other sources. They may exist but it’s based heavily on the carers’ account. I thought journalists cross-checked, especially on a headline story, but this is different.

Secondly, it doesn’t chime with my experiences over the years. Judgments about the capabilities of  carers are never made on the basis of a single piece of information, unless of course it relates to a child protection matter or allegation, in which case prompt action must be taken to safeguard the child.

In this case, you would like to think that other evidence would have been considered, such as the history of the carers over their fostering career, the progress of the children in placement, any evidence that the actual behaviour of the carers had negatively impacted on the children (as  distinct from their membership of a political party) and the wishes and feelings of the children. Bear in mind that the Fostering Standards prohibit changes in children’s careplans without consultation unless there is a real and immediate need. If the local authority has other information, they could not possibly break confidentiality and share it publicly, which offers no protection to the storm of media outrage.

Some of the criticism is misinformed. Farage was calling for the immediate reinstatement of the carers but they are still approved carers, it’s just this placement that has ended. Also, he might think about considering the children’s needs first, which is the law after all.

However, what is most significant is why this is a story at all. My doctor will carry on practising, as he should. The competence of the medical profession has not been called into question because a man died. Yet in the case of the Rotherham foster carers, the ability of the entire social work profession has immediately become the issue. This is all the corroboration the Telegraph needed. We know social workers do this sort of thing, don’t we. Leaving aside the fact that as I have already suggested, any judgement is based on incomplete evidence, this is not about the actions of individual social workers or even the authority itself, it’s about how lousy our profession supposedly is in making these judgement.

The implication clearly is that social workers make snap judgments based on dogma and preconceived ideas. More than this, we are driven by political ideology. In much of the coverage, this deeply flawed and prejudiced perspective has not been significantly questioned. This must be the case – what other reason could there be? It shows how little the public still understand about what we do.

This may have been a carefully considered decision or something that was rushed. It could have been a wrong decision. If so, hold up our hands, but it does not prove one single thing about how social work as a whole assesses the needs of children.

You would think the minister, our minister, might at the very least inject a sense of perspective. Not so. “The wrong decision in the wrong way for the wrong reasons,” he said. I humbly suggest he cannot know that for certain. But there are bigger issues at play here and it suits him to use the profession for which he is responsible for other reasons.

Rotherham is holding a by-election. It’s Labour-held, therefore this decision is the responsibility of the Labour authority even though it would have been made by social workers, i.e. officials not politicians. The assumption that this is a political issue has not been called into question. No coincidence.

Also, the consultation period for government proposals to diminish the significance of culture and origin in decisions about adoption placements is coming to an end. This has been well-trailed over the past year – see some of my previous articles – as a way of removing what the government characterise as impediments to swifter adoption. It’s an important proposal that has considerable opposition as well as its proponents. Whichever position you take, it’s disturbing that a matter about the health and well-being of three little children and public confidence in social work becomes a chance for political points-scoring.  We might look back at this episode in future and ask if anyone truly cares.

What The BBC Can Learn From Social Work

One of the biggest problems faced by the social work profession is that everybody else thinks they know what we do, and most of them think they can do it too. Not the nasty bits like taking children away from their families, but knowing when a child is being neglected or abused. I’ve written about this before. It undermines our credibility as a profession and limits the effort people make to understand what we do because they believe they already know the answer.

I have the same relationship with the BBC. The reality is, I don’t know what’s really going on during this latest schmozzle (see how I’m avoiding the ‘c’ word there) but I’m firmly convinced that on the basis of having some contact with the corporation on virtually every day of my life thus far, I understand exactly what’s happening.

From Danny Baker to Jeremy Paxman via David Mellor, the message bellowed by anyone who has a microphone thrust in front of them is that the BBC have too many managers. The Newsnight contretemps (neatly sliding past the ‘f’ word) is full of poor practice but also raises issues that are pertinent to most organisations, about who takes decisions, how much senior managers know about any given topic, how much they need to know and how much power is delegated. Whatever is going on, those sorting out the mess would do well to pause and make considered choices about how to maintain the balance between the professional discretion that encourages creativity and the compliance that spends so much time ensuring things get done the right way, not enough gets done.

Despite Munro’s attempts to focus on practise, children’s social work remains in the grip of a risk averse culture. The waves from the so-called Baby Peter effect are slowly becoming ripples but their effects are still being felt. This manifests itself in a variety of ways. The most noticeable is the high level of care applications before the courts but it’s all around us. I’m writing this in my lunchbreak, seeking respite from a tender application for fostering provision. At this opening stage, the authority will base its decisions on just three pieces of information – the price, the training programme and the Risk Assessment Procedure. Nothing about the quality of service provided for children or outcomes. It’s a revealing insight that lays bare the authority’s current priorities and concerns.

However, the culture of compliance is deeply embedded into the very structure of child care planning. The question has to asked, is this the most efficient way of taking the best possible decisions for vulnerable children and young people?

I’m in favour of built-in checks and balances, and also of the value of independent scrutiny. However, the current system is confusing and stifles the creativity of professionals who work face to face with children, young people and their families, precisely the point where the best social work is done. The balance has to be right.

The Care Planning, Placement and Case Review Regulations in England became effective in April 2011. Reacting to long-standing problems in the planning process, they made it a requirement for foster carers and children and young people to be fully heard and responded to in reviews. They also gave the Independent Reviewing Officers (IRO) greater authority. For example, anyone with a significant interest, including the child or young person, can contact them at any time should there be a problem or implementation delay.

In principle I’m in favour of this. Note the role of the IRO has been beefed up because of perceived failings in the system with poor decisions and lack of implementation resulting in drift. Potentially, however, it creates uncertainly and a lack of clarity.

Typically, the child’s social worker has most contact with the child, their family and their carers. In the current climate, they are at best wary and at worst disempowered from taking the decisions relating to that child, deferring to their manager.

At the Review, the IRO creates the Care Plan. In my experience, team managers sometimes feel powerless. Recommendations may be made that the manager disagrees with or for resources that may not be available. The Care Plan goes back into the mix. The manager may say the resources are not available. Increasingly, the manager and social worker have to go to an eighties-style resource panel where the recommendations of the care plan are effectively reevaluated, but crucially in the absence of key participants.

Meanwhile, the IRO, who as an employee of the local authority is not as independent as their job title makes out, is now feeling undermined. One said to me last week, ‘I despair. This is the third review in as many weeks that when I’ve come back to a key decision I took 6 months ago, nothing has happened due to resource constraints.’

Being connected to but outside the whole process, people talk to me, and anyway I have a kind face. I’ve also got the time to stop and listen, unusual these days. The thing is, managers and social worker feel exactly the same – disempowered, undermined and uncertain. Who exactly takes the decision? It feels sometimes as if any decision is temporary, subject to review at any time. Children require consistency and stability. It saps morale. Managers complain about IROs, IROs grumble about standards. Disharmony where everyone should be working together.

Compliance also takes its toll at an organisatonal level. Independent residential and fostering providers are snowed under with quality assurance demands. Again, I fully accept why this is required and both authorities and children have a right to know they are getting good value for their money and that the best possible standards are in place.

However, it is astonishingly time-consuming and costly. As in any business, those costs are passed on. The unit cost of any placement increases because more backroom staff and/or systems are needed to provide the seemingly endless flow of data for tenders and compliance. And that’s not including Ofsted.

In fostering, although a National Contract exists, few use it. In consequence, all authorities require what is effectively the same information but in an ever-so-slightly different format. This is complex, draining and favours large organisations who can pay for their own compliance unit.

Let me make it perfectly clear – IROs, social workers and their managers undertake some phenomenally good work that benefits so many children. However, in a signficant number of cases that I come across, they are hindered by the system, not helped by it. The unintended effects of well-meaning processes suck up both resources and precious energy. Professional creativity and innovation are stifled. The balance has to be right. The BBC would do well to learn from social work’s mistakes.

Tell Tim He’s Sacked

One cold evening a couple of years ago I went to hear Tim Loughton, the former Children’s Minister shuffled out of the pack yesterday, speak at a meeting of the All Party parliamentary group for children in care. We queued to the sound of shrill chanting and ominous bullhorns. The Comprehensive Spending Review was being debated in the House, the first indication of the true extent of the government’s spending cuts and Whitehall was closed to traffic as a protest rally gathered.

Accompanied by two young women in foster care, we dawdled through Westminster Hall and the corridors of power. It’s a privilege to be so close to government, never to be rushed. As we hung around in the lobby, the division bell sounded. Members appeared from all sides and dashed into the Commons chamber. They left the door open for a while so we could peer around the corner to see democracy in action.

Given the significance of the evening’s events he could have easily been excused but to his great credit, Loughton appeared as scheduled to address the packed committee room full of young people from all over the country. His speech was a characteristically robust endorsement of the value of foster care and the rights of children and young people in care to the same opportunities as their peers.

With the eloquence of experience, a succession of young people politely but firmly pointed out the flaws in his argument. You say education is important for children in care but you’ve just voted to do away with educational maintenance, the money that supports us. You say jobs are important but unemployment for young people is rising. You say we all deserve good foster carers but there’s a chronic shortage of resources to recruit them. Thanks for coming, though.

And that’s Tim Loughton in a nutshell. Unfashionably sticking up for children and young people in care and defending the social work profession whilst simultaneously his Cabinet eviscerated the resources he claimed were in place  to support them.

That night Loughton bobbed and weaved with the skill of an experienced politician, riding out the storm without properly satisfying anyone in his responses. Most ministers would have ducked out: he was there because he wanted to stay. Loughton is no placeholder or careerist. Shadow Children’s Minister for several years before coming to power, this is the portfolio he sought and prepared for.

The former minister is extremely well-informed about fostering, adoption and children in care. Unusually his main source was the people involved rather than his civil servants. Over an extended period he’s taken the time to understand the sector by making himself available to children, young people and carers. He created a telephone hotline, “Tell Tim”, and met regularly with organisations representing young people and carers, offering an unprecedented degree of accessibility. Last night on twitter they lined up to thank him and praise his commitment. For a group who voice is seldom heard, his willingness to listen meant an awful lot.

One of the things children and young people in care told him was that they were fed up with needing to get permission from social workers for school trips, holidays, activities and sleepovers with friends. You couldn’t mark them out as more different from their peers if you felt-tipped a red cross on their foreheads. A group of young people confronted him on television about this. Loughton shifted uneasily under the pressure, yet he delivered on his promise to respond. His first act as a minister was to write to local authorities to remind them that they had the power to give foster carers discretion on these matters. I showed a copy to one of the young women who appeared in the programme – “You did this,” I said. Now it’s enshrined in the revised Fostering Standards. The fact authorities have still not got the message is not his fault.

It’s not all so positive. He defends social work yet I’ve heard him dismiss the content and nature of assessments with the sarcastic panache of a Daily Mail leader writer. His promised fostering action plan is still to materialise. Hearing him several times subsequently, I continued to admire his grasp of the fostering task whilst growing weary of disingenuous references to the deficiencies of authorities he knew full well were tottering under the burden of  his government’s cuts.

Ultimately his departure may say less about the man and more about the government’s perception of the sector. The adoption agenda has been dominated by Gove and Cameron. Martin Narey joined the chorus of praise and regret but in terms of policy creation made him largely redundant.

They have seized the big issues, relating it to other props of Tory policy around the family and budgets cuts. In this world, an understanding of the details, of the everyday problems facing children, carers and social workers, gets in the way. The struggles with resources, with finding the right placement, with whether a child can stay with her friend this weekend, have little significance. More than this, they may actually obstruct the agenda for change because they don’t fit together with policy as neatly as the Department may wish.

Yet these are the issues that make life better for children and young people in care. For children and carers alike, nothing is more important. Gove’s distance from this awkward day-to-day reality leads to dogmatic policy. It leaves you to wonder if there is ever a place for any minister who thoroughly masters not his brief but an understanding of the people affected by it. It’s hard to understand social work. Loughton did, but in the end all it got him was the sack.