‘Child Care Now: A Survey of Placement Patterns’ by Jane Rowe, Marion Hundleby and Louise Garnett

Thursday, April 1st, 2010 Digest by Robert Shaw

Jane Rowe, Marion Hundleby and Louise Garnett (1989) Child care now: a survey of placement patterns Research Series 6 London: British Agencies for Adoption and Fostering 0 903534 85 1

Key Ideas

DHSS figures understate the number of children being dealt with by the care system.

Regardless of placement, most children are discharged within six months, mostly home; a minority remain in care for more than two years.

In spite of other variations among local authorities, social workers’ expectations for length of placement were remarkably uniform.

Fewer than one in five placements end because of behaviour problems on the part of the child.

Other than for children placed home on trial, placements for the purposes of assessment or treatment were less likely to be regarded as successful.

In spite of differing success rates, no differences in outcome were related to local authorities’ organisational structure.

Long-term fostering tends to be of adolescents who first came into care when they were much younger.

Though residential care was rated by social workers as less successful few differences were found between residential placements and foster care overall.

Flats/bedsits for adolescents are as successful as fostering with relatives, other than where the aim was assessment. Placements home on trial were adjudged the least successful overall.

Though over-represented in the care population, the overall experiences of black children in care were similar to those of white children, with a small number of differences mostly related to the reasons why they had come into care.

Content

In Chapter 1 About the project: its background, evolution, aims, experience and methodology the authors describe how Rowe et al. (1984) had found that five out of six children went into foster care before the age of five but that there had been no research into the outcomes of long term fostering.  The Department of Health and Social Security had therefore funded an eighteen-month pilot project in twenty local authorities during 1984-5 as part of the Child Care Placement Outcomes Project. This had identified the importance of:

  • looking at all child care placements,
  • including a descriptive element,
  • limiting the range of information sought,
  • supplementing local authorities’ data collection resources.

The main project aimed to study:

  • the number and characteristics of children in various placements,
  • any links between placement outcomes and the organisation of services,
  • the viability of monitoring techniques,

but was limited to social workers’ views and information. It looked at all placement starts and all placement endings in six local authorities from April 1985 to March 1987; that is, it excluded children who did not move throughout that period. It also excluded holidays, trial visits, respite care and adolescent self-placements.

The authorities comprised a city, a metropolitan district, a Midlands county, a home county, a north London borough and a south London borough; the study involved 5,868 children in over 10,000 moves. They had problems with social workers saying a move was planned when it obviously had not been and they realised that ‘lasted too long’ was ambiguous; they also forgot to ask for the type of residential institution a child had left.

Noting the papers by Spencer Millham and colleagues on Place of Safety Orders (1985) and on predicting children’s length of stay in care (University of Bristol Dartington Social Research Unit, 1984), they reiterate the concern expressed by Packman (1968) about the major differences between local authorities. They add, however, that in practice most studies do not compare like with like; authorities that restrict admissions to care tend to admit older children with more serious difficulties who stay longer.

In Chapter 2 An overview of the project authorities, they outline the characteristics of the six local authorities.

In Chapter 3 Patterns of placement, they note the categorisation by Packman et al. (1986) of children into ‘victims,’ ‘villains’ and ‘volunteered’ and the problems of maintaining links between children in care and their families (Millham et al., 1986; Thorpe, 1988). Their first year cohort included 2010 children involved in 2353 admissions and 2,587 moves to new placements; 18% were re-admitted once and 7% three or more times, though there were variations among the authorities.

74% of the admissions were described as emergencies, with over three quarters of the children already known to the authority and one third having been in care before. Two thirds were in voluntary care, though were wide variations among authorities. Less than half were returned home, 12% were destined for long term care and 5% for adoption but for 24% there was no plan.

Overall, just over a third of the children went into foster care and a similar proportion into residential care, though these proportions varied from over a half to just over a quarter in different authorities; 10% went home on trial and the remainder to a variety of placements. The figures suggested that the DHSS returns were biased towards long-term placements and understated the number of short-term placements.

Fostering accounted for the majority of placements of under-elevens and residential care provided just over half the placements for those eleven-plus. Few social workers envisaged long-term care on first placement but this went up to one fifth after a move. Conversely a third of social workers saw the first placement as for temporary care but rarely mentioned this after a move; 10% of moves were emergencies. Overall 57% of children had no moves, 26% one, 9% two and 8% three plus (but 15% of 16-17 year-olds).

In terms of placements used, 44% had one placement and 28% three or more; though the over-sixteens had most placements, the under-fives came second. Social workers’ expectations for the length of placement were remarkably uniform across the authorities.

In practice, discharges followed the leaving care curve with 31% still in care after two years though that varied from 21% in the metropolitan district to 43% in the home county.

Of the 923 who had had moves but were still in care at the end of the project, only 27% had been moved because of behaviour and only 17% were in voluntary care.

In Chapter 4 Patterns of outcome, they report that at six months there were few differences between the foster and residential placements among the placements that ended, other than that there were more short foster placements; 51% had lasted as planned, 32% had ended early and 17% had lasted longer than planned with placements for adolescents more likely to end early. Most discharges were to home; 29% of residential moves were between residential homes, 20% of foster home moves were between foster homes and 34% of lodgings moves were between lodgings.

Though only 29% overall were in care with a sibling, that proportion rose to 65% for the five to ten year-olds. Excluding those home on trial, 60% were in contact with their family at least once a month and 20% had had no contact in six months; however, only 18% of those in foster care for more than three years had any family contact and 38% had had no contact in the previous six months.

Using a combination of measures, they assessed fostering as most successful and home on trial as least with residential care in the middle but found very little difference in the success rates of the various local authorities. 43% of moves were within the care system, twice as many to another foster home as to residential care and 80% of discharges were back home. There was little evidence of drift.

Where placement problems led to an ending, 18% took the form of starting well and then going wrong and 13% involved behaviour problems though these might be underestimates as foster parents tend not to report behaviour problems (Rowe et al., 1984) and the 7% of endings put down to an unexpected event in the foster home may cover some behaviour problems.

Overall, placements with an assessment aim were most likely to end prematurely, and those with a treatment aim were next most likely, though placements were generally more likely to be unsuccessful with adolescents.

Specialist fostering was used by only two authorities; it was not expected to be short term but only 29% lasted as long as planned. 29% of children returned home, often unplanned, 25% moved into residential care and 13% to another foster home.

Fostering with relatives accounted for 6% of placements and was predominantly used for older adolescents needing care and upbringing, but there were wide variations among the authorities. Though superficially they appeared to do no better than fostering with strangers, once the temporary placements were excluded, they did better.

No differences in outcomes were found which related to organisational structure, whether fostering services were organised centrally or locally, for example. Rather the success rates related more to differences in aims.

In Chapter 7 Long-term fostering and adoption, they consider the 10% of endings to long-term fostering and adoption, half of which involved adolescents; most of the 345 young people left care, but 58 who did not went into residential care, and 41 into another foster home. Looking at the breakdowns, white children were slightly more likely to have a breakdown than black/mixed parentage children; most had been in care before and over 25% were in remedial education. They were perceived as having behavioural difficulties and also as having fewer positive qualities than other children. Like Berridge and Cleaver (1987), Rowe et al. found the experienced foster parents more successful. 62 of those in long-term foster care had been adopted, over half of them after more than five years in the placement.

In Chapter 8 Residential care, they begin by noting that residential care covers a wide range of provision. Residents are more likely to be adolescent and male but 6% were infants. There was little difference from foster care in sibling placements among younger children and slightly more were in weekly touch with families. They were more likely to have serious problems but behaviour only ended 3% of under 11 placements and 16% of adolescent placements. 41% returned home, 29% went to another residential home and 8% into lodgings. Only 4% of placements lasted more than three and a half years and the flow of children to foster homes was matched by the flow from foster care.

102 children were in secure units, three quarters of them boys and one quarter non-offenders. Temporary placements in secure units were the most successful and treatment the least successful, through there were variations among local authorities.

Observation and assessment centres were most highly rated and community homes with education least, but there was little difference in overall ratings for residential care and foster care. While foster placements were more prone to end prematurely, residential care was rated as less likely to achieve its aims or to help the child.

In Chapter 9 Placements for older children- lodgings, hostels, flats, the authors look at the use of lodgings (which accounted for 4% of placements but 14% of those for young people over 15 and 25% of placements for offenders), hostels and flats/bedsits. The last accounted for 10% of placements among over-fifteens and were as successful overall as fostering with relatives, though the young people in them tended to have less contact with their families.

Most of those in this group left care but some moved to another similar placement, a small number went into residential or foster care and an even smaller number into a penal establishment.

In Chapter 10 Placement of offenders, the authors consider children on S7(7) Care Orders  under the Children and Young Persons Act 1969 and those on remand, noting that these do not account for all the offenders in their sample.

38% of those on remand had been in care before; they tended not to have many placements. Children on S7(7) accounted for only 2% of admissions of those over ten years old, but for 13% of the placements, which were mostly in observation and assessment centres and community homes with education but also in penal institutions, secure units and children’s homes. 5% were home on trial but very few in foster care.

A small number of the sample were non-school attenders who tended to stay in care for a long time even though their later placements were not related to non-school attendance.

Penal establishments accommodated 183 boys and eight girls who between them had 330 penal placements; 170 came from residential care, 64 from being home on trial and 14 from foster care.

Though three quarters of those on remand were on S7(7) orders, twelve were in voluntary care, five on Parental Responsibility Orders and 38 on civil Care Orders. Most were in care for less than one month and only 10% for more than six months.

In Chapter 11 Home on trial, the authors consider the 859 children who were home on trial; there were wide variations among authorities but more of them were boys, especially adolescents and half were on remand or a care order. 48% came from residential care, 26% from foster care and 10% from a penal establishment. 30% returned to residential care, 14% to foster care and 8% to penal establishments. Home on trial was generally the least successful placement except where there aim was assessment, though there were variations among local authorities.

In Chapter 12 Black children in care, they look at the small number of black children in the sample, though they were disproportionately represented, accounting for 17% of admissions, mostly temporary care. They were mostly of mixed parentage, for whom adoption was often considered.

At the time there was no census data with which to compare the figures but it was evident from the available statistics that Asian children were under-represented and African and Afro-Caribbean over-represented. There were more pre-school admissions but Afro-Caribbean adolescent admissions did not exhibit the ‘bulge’ which white and mixed parentage admissions did.

More were expected to return home and fewer were on Place of Safety Orders. Though mixed parentage children were more likely to be on Care Orders, there were fewer home on trial because there were fewer on Care Orders but more specialist fostering. They were more likely to be placed with siblings if they were African/Afro-Caribbean or Asian; overall, though there were some variations compared with the experiences of white children, the similarities outnumbered the differences.

In Chapter 13 Conclusions, the authors conclude that:

  • The DHSS end of year statistics conceal turnover.
  • Young children continue to enter care but stay for shorter periods.
  • Re-admissions in residential care conceal higher occupancy rates and throughput.
  • Foster care is mostly temporary, only 35% is task centred and it is generally less successful with adolescents.
  • Long-term foster care is mostly used for teenagers.
  • Very few children are placed for adoption.
  • There is little drift but a lot of dislocation.
  • There are wide variations in local authority success rates.
  • Outcomes are not linked with organisational structure.

Consequently, care is characterised by lots of premature endings while task-centred placements are rarely successful. There need to be more resources for home on trial and more attention to residential care. Local authorities are providing a lot of pre-school placements without enough support for those involved and a lot of temporary care for ethnic minority children, who would benefit from more black foster parents.

Among the areas for future for research are black and mixed parentage children, multiple admissions, breakdown rates, leaving care, reasons for variations among local authorities and home on trial.

Discussion

This study was significant for highlighting that the number of places in residential care had declined not just because of the decline in the birth-rate since the 1970s but also because turnover in foster and residential care had increased in the 1980s. At the time, the idea that children were remaining in care for shorter periods seemed a good idea, but the following year Wiener and Wiener (1990) showed that once children had had five moves in care the chance of a successful outcome began to decline.

Unfortunately, though the authors cite the study by Bullock et al. on social workers’ expectations (University of Bristol Dartington Social Research Unit, 1984) which references Fanshel and Shinn (1978), they do not appear to have read the latter and therefore do not seem to have taken it or Taylor and Alpert (1973), into account in planning their research. So some of their findings replicate these earlier findings without taking things forward.

For example, the observation by Bullock et al. that social workers put more effort into placements and therefore into contact with parents if they expected them to be short may help to explain why parental contact is the factor most associated with successful outcomes - it may well be accompanied by greater social worker input anyway. The finding that organisational structure had no impact on outcomes parallels Taylor and Alpert’s finding that specific interventions had no impact on outcomes and the finding that using foster and residential care for treatment or assessment is generally less successful echoes the experiences of George Lyward (Burn, 1956), A. S. Neill (1962) and Winnicott and Britton (1957) that creating a healing environment is more successful than offering individual therapy.

As Trotzkey (1930), Skeels (1966) and Wiener and Wiener (1990) found, children placed in residential care tended to have more problems than those placed in foster care but it is not clear whether that difference was taken into account by social workers when assessing the helpfulness or success of residential placements compared with foster placements.

Finally, there was no attempt to seek the views of parents or children about the processes or outcomes of care. This leaves many questions unanswered, not least whether parents and children would have agreed with the social workers’ verdicts on the length, helpfulness and success of the placements.

References

Berridge, D and Cleaver, H (1987) Foster home breakdown The practice of social work 16 Oxford: Blackwell

Burn, M (1956) Mr Lyward’s answer London: Hamish Hamilton See also Children Webmag May 2009.

Fanshel, D and Shinn, E B (1978) Children in foster care: a longitudinal investigation Guildford: Columbia University Press See also Children Webmag March 2009.

Millham, S, Bullock, R, Hosie, K and Haak, M (1986) Lost in care Aldershot: Gower

Millham, S, Bullock, R, Hosie, K, Little, M and Cleaver, H (1985) Place of Safety Orders Evidence to the DHSS Child Care Law Review Committee

Neill, A S (1962) Summerhill: a radical approach to education London: Victor Gollancz Originally published 1960 Summerhill: a radical approach to child rearing New York: Hart See also Children Webmag July 2009.

Packman, J (1968) Child care needs and numbers National Institute for Social Work Training 15 London: Allen & Unwin

Packman, J, Randall, J and Jacques, N (1986) Who needs care? Oxford: Blackwell

Rowe, J, Cain, H, Hundleby, M and Keane, A (1984) Long-term foster care London: Batsford

Skeels, H M (1966) Adult status of children with contrasting early life experience: a follow-up study Monographs of the Society for Research in Child Development 31 (3), 1-65 Extracts reprinted in M Wolins (Ed.) (1974) Successful Group Care Chicago: Aldine See also Children Webmag June 2009

Taylor, D and Alpert, S W (1973) Continuity and support: following residential treatment New York: Child Welfare League of America See also Children Webmag March 2009.

Thorpe, D (1988, April) Career patterns in child care - implications for service British Journal of Social Work 18 (2), 137-154

Trotzkey, E L (1930) Institutional care and placing-out: the place of each in the care of dependent children Chicago: The Marks Nathan Jewish Orphan Home See also Children Webmag November 2008.

University of Bristol Dartington Social Research Unit (1984) Predicting children’s length of stay in care and the relationship of family links Bristol: University of Bristol School of Applied Social Studies (By Roger Bullock, Kenneth Hosie and Spencer Millham)

Wiener, A and Wiener, E (1990) Expanding the options in child placement Lanham MD: University Press of America See also Children Webmag January 2010.

Winnicott, D W and Britton, C (1957) Residential management as treatment for difficult children. In D W Winnicott (Ed.) The child and the outside world: studies in developing relationships, Chapter II:6, pp. 98-116 London: Tavistock See also Children Webmag October 2009.

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