Friday, 4 April 2014

The Social Worker's Question: Is Care Any Better?

I am a social worker and in a few months I will have been a social worker for 40 years.

In that time I have met thousands of children and young people and worked with many hundreds of them. This fact alone does not give me any right to express a view about how the world might seem to ‘looked after’ children. It does however place me in a strong position to hold a determined view on the progress that I have seen in child care practice for children raised by the state between the implementation of the Children and Young Persons Act 1969 and the present day in 2014.

I firmly believe that the systematic, institutional physical, emotional and sexual abuse of children in care by their carers (both in residential and foster care settings) is no longer commonplace. Only a fool would say that it has been eradicated, and we as social workers must continue to be vigilant.
It is also less common for boys to leave care and go straight into custody now. I vividly recall too many troubled boys leaving care directly for the ‘custodial apprenticeship’ so common in the past. The ‘short sharp shock’ in Detention Centres, so often lauded by politicians but rarely effective, often followed by ‘graduation’ to borstal.

Far fewer young women are placed in ‘mother and baby’ homes now and as far as I am aware, we no longer deport children to ‘the colonies’ to enjoy a better life away from their ‘inadequate’ parents. It is chastening to remind ourselves that it was well into the 1960’s when we stopped doing that.
These are pleasing developments but I still regularly ask myself “is care any better now for those children and young people living in it?” For many children, care is a positive experience that helps them negotiate the rest of their lives. It has been my role in life to ensure that as many children as possible find care to be a real springboard into a successful and happy life. Sadly though, this is not true for all.

If we examine the real outcomes for many children in care now and compare them with the same outcomes for children in care in the 1970’s there is far less difference than we would have anticipated back then. 
For example:
  • ·         Are care leavers still massively over-represented in the prison community? – Yes, they are.
  • ·         Has there been a discernible change in the proportion of children from care who end up in custody in the last 40 years – No, there has not.
  • ·         Are care leavers still massively over-represented in adult mental health wards? – Yes, they are.
  • ·         Has there been a discernible change in the proportion of care leavers with mental health issues during the last 40 years – No, there has not.
  • ·         Is suicide more prevalent among care leavers than amongst the general population? – Yes, it is.
  • ·         Has there been a discernible change in the proportion of young people from care who commit suicide during the last 40 years?  – No, there has not.
  • ·         Are care leavers still massively over represented among the ‘homeless population’? – Yes, they are.
  • ·         Has there been a discernible change in the proportion of care leavers amongst the homeless population during the last 40 years? – No, there has not.

This list of outcomes is not endless, but I find myself asking how much longer does this catalogue of disadvantage have to continue before Society is persuaded that we are still getting something very badly wrong? Is there another explanation I am missing? Are care leavers perhaps all victim of some unknown genetically transmitted condition? Of course they are not. In fact children in care have shown themselves over many years to be remarkably and wonderfully average – given the chance.

The answer is that it is their childhood that is abnormal. There is a mass of literature on the key issues that I have merely hinted at, but this piece is not about the reform of the child care system. Indeed, it is about one very small but crucial aspect of that system.

I have been fortunate to have worked in and around the same geographic area for much of my life. I have seen and known third and fourth generation ‘care families’. Should we be surprised that this is happening? I don’t believe that we intuitively know how to parent well and if a child’s early experience is lacking and their departure from care is abandonment, should we be shocked that there are young adults who simply do not know how to be good enough parents?

Abandonment? Too strong a word? I don’t think so. Imagine if you will a child who becomes looked after – for whatever reason - aged about nine. Imagine that this child then spends time in a number of different foster homes but fails to ‘settle’. As each foster placement ends the attachment difficulties that developed as a consequence of the child’s parents simply not meeting its needs are self-evidently more acute – after all, each failed attachment in each placement has reinforced them. It is not that the child is necessarily ‘unfosterable’ as some may have it. It is as likely that they can’t cope with the pressures of life and relationships in a family at that time of their life.

Imagine that this child is by now about 13 years of age and is placed in a children’s home that is affordable to his corporate parent, but like the foster homes is not supported by a therapeutic programme. It is very likely that with their basic needs not being met, the child will continue to be  ”disruptive”, such  that the placement will fail, and another children’s home will need to be found. Another broken placement, more broken relationships, broken friendships, broken education, declining self-esteem and capacity to trust. It is likely that by now the child is regularly absconding, and our now 14 year old may be spending time on and off the streets, stealing to eat and experimenting with illegal drugs.

Children experimenting with drugs can lead to an accidental (?) overdose. Imagine our 14 year old is kept in hospital for a few days and then as an alternative, they are placed in a very ordinary children’s home with extraordinary staff who know about children with attachment difficulties and are supported by a therapist. These staff will have been helped to understand that therapy isn’t an event that takes place in an hour a week but a process that involves all those caring for the child 24 hours a day. In such a setting, over the next two years these staff help the growing but still vulnerable young person to piece together what has happened in their early years, to grow to understand that their future is not pre-determined but within their ability to change – given the appropriate support.

With support, the young person may go on to college and be successful. Having started after their classmates, they will have a great deal of time and work to make up and may not ready to take their GCSE’s at 16. Perhaps our young person will gain GCSE’s at 17, and show real potential.

Now the young person faces a real dilemma. In a few months they will be 18 years old and be expected to be ready to leave care.  Perhaps their transitions worker is really good and realises that the child needs support beyond 18 if they are to meet their untapped potential and move successfully into adult life. The worker may suggest to the young person that they need to move to a foster home where they can stay until they are 21.

By now, the young person may have lived in their (children’s) home for several years, surrounded by those people who have helped them on their journey, people they trust. They may be settled and relate well to the other kids too. They are not ‘real’ family but to the young person they may certainly feel like family. Our young person had been fostered before and it didn’t work. They are happy with their life as it is in the children’s home. They have friends, relationships, trusted people around them and a social life.

Why should it have to change? The only reason is because they are looked after, and looked after in a children’s home. As a result, their wishes don’t count as much as if they lived in a foster home. They are faced with making a choice that they don’t want to make or potentially being abandoned.

This is not a real story but it is based on very many real lives that I have witnessed in my 40 years in social work. There are many brilliant foster carers and brilliant children’s homes (Ofsted say as much). There are many brilliant children in care in both types of placement. These children must be given every opportunity to succeed and supported until they are able to move on successfully and with confidence. “Every Child Leaving Care Matters” – wherever they happen to live on their 18th birthday.

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