Written evidence submitted by Five Rivers Child Care

Since 1989 Five Rivers has been helping children rediscover their childhood. Our purpose is to help children recover form neglect, abuse, trauma, or family breakdown. Turning their livers around so they can flourish and fulfil their potential.

Innovative, Expert and creative, we are a leader in this field and one of England’s most experienced providers.

We strive to implement evidence-based best practice through our integrated care model throughout our education, residential, fostering, assessment and therapeutic services. We use developmental, attachment and trauma informed care using the ATIC model to help the children we care for thrive.  A social enterprise we invest in research and have entered into a number of knowledge transfer partnerships.  Our practice models are under continuous research with our partners University College London, The Anna Freud Centre, and the Bowlby Centre.

Our homes provide specialist therapeutic care based on our model of care which is built on a developmental knowledge to create personalised care plans with individual and group therapies. Our teams are trained professionally and receive reflective supervision from their clinical teams and therapists.

Five Rivers seeks the best outcomes for children in care not only for the children we care ourselves. With significant professional experience for decades in this sector we believe more can be done for children in care and wish to advocate on their behalf.

Submission to the committee:

We need to be aspirational for our children, ensuring no child gets left behind and every single one reaches their enate potential.

Unfortunately, for children living in residential care aspiration can become secondary to other considerations. We believe that caring for a child fundamentally means nurturing their potential, sparking inspiration, and aspiring for them to live their best lives. For a long time, the test of treating young people in care the same as your own children is not met, especially within residential care which looks after children repeatedly failed by the care system.

A particular problem that concerns us, as a residential care provider, is a sole focus on safety and finding a placement as soon as possible. Whilst both objectives are important and the safety of children in care is paramount, we urge the committee to look at the real barriers preventing these children from achieving their true potential.

Safety from some commissioners is understood on a too simplistic level as the mental health consequences borne from significant trauma are too often not considered or misunderstood. Without addressing the trauma experienced by the child before entering care and during, we are not meeting the child’s needs with sometimes tragic consequences. We know from research such as Hawton et al (2012)[1] that children whose previous life problems and developmental difficulties have placed them at detriment are at high risk of completing suicide. Something that all children in care have experienced at some point which needs to be a key factor in addressing through a care plan for their mental health.

As a service provider we encourage the commissioners and social workers we work with to look for ‘the right placement first time’. Often there is every good intention that the first placement will be a temporary one while a permanent placement is identified, however and sadly from that point many children will have multiple placement moves.

The priority in all cases will be to place the child in a foster family, without an assessment of the impact of that child’s adverse childhood experiences (ACE’s); you move from trying to make one child safe to potentially disrupting a family who could successfully look after a child. If a proper assessment is made at the start, these issues could be tackled, and more children could live in foster care rather than needing residential care due to the system failing to meet their needs over a long period of time. Permanency and stability are the foundations any child needs to address trauma and thrive which in our experience is something many children in care lack.

Our research shows that a child coming into a family where they are young enough to be able to be part of a family, can attend a local school where they can have good attendance, successfully make relationships, and have really positive outcomes through their childhood into adulthood. Conversely, complex experiences of trauma, confused contact plans, and special educational needs arising through neglect and violence, all contribute to the likelihood of placements breaking down, also placing the family looking after the child into unnecessary crisis.

When a child is considered for residential care, it is often only after multiple placement breakdowns. This will have meant that child has experienced trauma which cannot be overcome, or supported, or helped to recover and over time they are seen as a child with presenting behaviour. However, we know the behaviours of the child is based on adverse childhood experiences, from trauma that has not been addressed throughout the child’s experience in the care system.

Placement breakdown and constantly moving placements re-traumatises children. Their ability to form lasting attachments with trusted adults becomes impacted, they develop an armour of mistrust and they face a an ever changing and uncertain future.

Our children’s youth council with representatives from around the country, fed back to us that they do not get support in school. They are met with signs of frustration and impatience about why they have to go to a medical in school time, attend a review meeting which is determining their future, and not seeing them as needing support and understanding. It concerns us that from our children’s experiences, professional colleagues are not in touch with the needs of these most vulnerable children and young people. Addressing trauma and enabling a child to reach their true potential requires all professionals working together which is why many of the children we look after in residential care attended our educational provision. The advantage of this is the therapeutic approaches used in the home, at school and with our therapists is consistent, delivering better outcome for the child.

We are very pleased to read the Chairman’s comments announcing the launch of this inquiry of the references to traumatic experiences. It has taken many years for trauma to be acknowledged alongside adverse childhood experiences when considering the best interests of the child. You have only to look at how recently it has been accepted that a child witnessing violence from one parent to another is traumatised by this experience. Previously the children’s experience was not considered or acted upon and we see this shift in discourse as positive. Once we have a common understanding, we can then have a common language, and a common set of expectations, all of which demonstrates our willingness to be aspirational for all children.

We hope that the committee will focus particularly on the role trauma plays in residential care, how it impacts the child and how left untreated it prevents care leavers from achieving their full potential.

We would encourage the committee to also review why residential children’s care is typically viewed as a last resort and with a 7% annual increase in England according to Ofsted (2020) does this mean the system has fundamental issues in how it traumatises children?

Financially, we understand why it may be the last resort given residential care is much more expensive than foster care. The main reason for the geographical imbalance of children’s homes comes out of the desire councils have to keep costs low; this coupled with the economic reality of running a business in different parts of the country and the additional cost barriers placed upon us by regulation. The cost of residential care could be lowered if standards for children’s homes were streamlined. Many of the Standards do not contribute to the safety or well- being of the child. There are rules imposed on residential homes that would not be imposed on foster families and there is no clear reason why. These costs are then passed onto councils and ultimately the taxpayer, disincentivising choosing a residential placement from a commissioner view, due to cost when it is in the child’s best interests. It is also important to point out many providers in this sector are social enterprises like ourselves, or charities putting any surplus directly back into the children we work with.

As a provider of residential care, we feel it is important that the committee talks to children with lived experience of residential care. We encourage the committee to focus on good and outstanding models of care and how these can be replicated nationwide. The residential care sector already has strong and successful practice; however, it is about how this is shared so all children can benefit.

We believe that whilst there is much room for improvement, we need to celebrate and acknowledge the wonderful care and outcomes that many young people achieve and the professionals who enable that. From our experience the children’s social care workforce feels marginalised, and it is important to recognise the positive role they play to support the most vulnerable children in our society.

The committee intends to focus on the impact of Covid19 which has had a major effect on residential care; for our workforce this has meant many staff members putting in a lot of extra work to maintain services. We believe that whilst residential care in the adult sector is celebrated and even given a bonus in Scotland, children’s residential care lacks the same support. We hope the committee will uses the opportunity of this inquiry to celebrate the work of children’s residential care staff.  As an organisation we felt that there was a lack of clear information from the government in managing the children’s social care sector through the pandemic in comparison to other sectors.

April 2021

[1] Hawton K, Saunders K and O'Connor R (2012) Self-harm and suicide in adolescents, The Lancet, 379, 2373-2382