CHH0027

Written evidence submitted by Home for Good

Home for Good’s Submission: Children’s Homes Inquiry

Summary:

This submission outlines the current landscape of children’s homes across England, including the increasing shift towards the privatisation of these homes. It outlines how the backdrop of sufficiency across the children’s social care system is driving an overuse of children’s homes because of a lack of families ready and waiting to welcome children, particularly teenagers. The increasing focus on unregulated provision in recent years and the stories that have emerged, which demonstrate how much of this provision is inappropriate and unacceptable for young people, are driven by the same sufficiency challenges. This submission provides a response to the Government’s recently published plan of action to address unregulated settings and calls for urgent priority to be given to creating more family-based settings for children and young people, rather than an increase in places in children’s homes.

Home for Good is a UK-wide fostering and adoption charity whose vision is a home for every child who needs one. We are delighted to have the opportunity to make our submission to the Education Select Committee to feed into their inquiry into children’s homes.

With the recent commencement of the Children’s Social Care Review in England and the Government’s announcement in February 2021 in response to their consultation into unregulated provision, this inquiry is incredibly timely in its focus on an issue that is in need of significant and long-overdue attention. We trust that our contribution will support the Committee in developing a robust picture of the children’s homes scene across England and some of the challenges that must be addressed with urgency.

 

Introduction

In March 2020, there were 6,780 looked after children living in children’s homes, representing 8% of the total population of children in care across England. While most children in the care system have experienced abuse or neglect and are living with the legacy of such trauma, children and young people living in children’s homes often have some of the most complex needs. One study demonstrated that 62% of children living in these homes had clinically significant mental health difficulties and 74% were reported to have been violent or aggressive in the past six months.

It is our view that there will be a small group of children for whom a residential care setting, perhaps for a limited period, may enable them to flourish to a greater degree than they would outside of this setting. However, we also identify and contend that there is currently an overuse of residential care settings for young people due to challenges around sufficiency and the widespread shortage of other suitable placements available, many of which are family-based, including foster families. 

Furthermore, whilst they may be called ‘children’s homes’, the evidence demonstrates that the majority of those living in such placements are teenagers and young people, with 56% (n=2,970) aged 10 to 15 years old and 41% (n=2,180) aged 16 or over in 2015. Overall, this means that the average age of a young person living in a children’s home is 14.6 years old.

Many of these young people have experienced significant instability in their lives which can be perpetuated through these placements, as 37% of children and young people living in children’s homes were placed outside their local authority and further than 20 miles from home. While for some this may be due to necessary safeguarding measures and for their protection, it also means that many young people are residing in accommodation that is far away from familiar territory and often, their wider support network.

Furthermore, Narey’s 2016 review of residential care highlighted that more than half of placements in children’s homes last less than three months and that a children’s home was the first-choice placement for only one quarter of children living in these homes.[1] Only 18% of placements last longer than a year. Devastatingly, almost a third of those in children’s homes have had 6 or more previous placements. This evidence demonstrates the reality that many children and young people living in children’s homes have experienced the most chronic instability.

It is important to note that children living in children’s homes may be there for a number of reasons; for some, their behavioural or emotional needs may be so acute that only a children’s home is able to provide the ongoing, intensive support they need.

Others may require a short-term therapeutic stay to enable them to settle and be re-integrated back into a family setting. In Northern Ireland, there has been a shift towards using residential care settings in this way for younger children who are showing signs of struggling to settle in foster families. Residential care is used to intervene at an early stage where consistent placement breakdown is looking likely and is used as a tool to provide more intensive support, with the aim of reintegrating a child or young person back into a family environment after a short period. This is not, however, how residential care is being utilised for most children in England.

Instead, it is more common for children’s homes to be used as a last resort after other successive placements (often including foster families) have broken down. In addition, a young person may express a preference for living in a children’s home because they want to be in a more independent setting. Sadly, there is an additional cohort of young people who are placed, either short- or long-term, in a children’s home because of a lack of other available placements. This will be explored in greater depth later on in this submission. 

 

Background

The use of residential care in England peaked during the mid-1970s, when it accounted for approximately 40% of all local authority placements for looked after children (~40,000 children).[2] Since then, there has been a severe decline in both the use of residential care and in the size of residential care homes. This decline was most likely due to a combination of factors, including the occurrence of several high-profile scandals within children’s homes in the 1980s and 1990s, which led to increased regulation and the closing of unregistered homes, and an overall move towards family-based care in response to emerging child development research that demonstrated that children thrive best in families, not institutions.[3],[4]

 


Children’s Homes in England today

Despite this ideological shift, there remains today a significant number of children and young people who are living in residential care facilities, including children’s homes.

The average new home had 3.5 places, while the average closing home had 4.0. This continues the trend of new homes often being smaller than old ones.[9] It thus follows that the consistent pattern over the last 5 years has been of homes increasing at a greater rate than places. While the number of all children’s homes increased by 19% between March 2015 and March 2020, the number of places increased by only 3% over the same period.[10]

Despite these national patterns, children’s homes are not evenly distributed across the country:

 


The Backdrop of Sufficiency

It is significant that 8% of all looked after children in England are living in a children’s home. It is Home for Good’s view that there will be some children for whom a residential care setting, perhaps for a limited period of time, may be the right place for them to be. However, we argue that there is currently an overuse of residential care placements for children and young people due to sufficiency challenges; that is, a shortage of other suitable placements able to meet a child’s needs. Significantly, this shortage is often of family-based provision.

At present, there is a lack of foster carers with the right skills and in the right places ready and available to welcome children. As a result, children’s homes are sometimes used on an emergency basis when suitable foster homes cannot be found, even when a foster placement has been deemed best for a child. For some of these children, what begins as an emergency or temporary placing can become a much longer-term placement. This is particularly the case for older children entering the care system, as there is a severe shortage of experienced foster carers who are able to care for teenagers.

To provide a care system that is truly able to meet the needs of each child within it, we need a continuum of care. While there is a place for children’s homes to exist as part of this continuum, we are concerned that sufficiency challenges are resulting in the overuse of children’s homes for some children who with the right support would flourish in a family environment. In addition to this, the current overuse and outsourcing of children’s homes is incurring significant costs for local authorities. Given the annual overspend on children’s social care that has been well-documented over the past decade or so, both the current scale of use and commissioning practices around children’s homes are financially unsustainable for the system. The aspect of cost will be explored and outlined more fully later on in this submission.

We believe that there is now a ripe opportunity to explore whether, with the right support in place, a proportion of children currently residing in children’s homes could be transitioned into family-based placements.

The desire to see children living in families, where this is appropriate for their needs, stems from two reasons: firstly, for the past several decades, international research has demonstrated the poorer outcomes for children growing up in institutional or residential settings, in comparison to family-based settings. Most recently, domestic research has highlighted the poorer health outcomes experienced by those spending time in childhood in residential settings, including research[14] published in 2020 by UCL which demonstrates that adults who lived in residential care during childhood had a 40% chance of reporting poor health ten years later, rising to an 85% chance over the following two decades. Those living with a relative or growing up under their birth parent’s care reported significantly lower rates of poor health over this period. Significantly more research is needed at a domestic scale to strengthen our understanding of the impact and outcomes for children living in children’s homes in comparison to other placement types.

Secondly, while children’s homes may provide strong, positive relationships with staff while a child is living there, we are concerned about the continuity of these relationships beyond the age of 18, or when a child leaves the home. While pilot projects such as ‘Staying Close’ have been developed in some parts of England and are designed to support young people to remain living nearby to a hope with the aim of continuing these relationships, we are concerned that these schemes are not providing the long-term place of belonging that young people need. No person, no matter how old they are, ages out of the need for a tribe or family to belong to. We must do more to enable the formation and continuation of positive, committed relationships with adults for the young people living in and leaving children’s homes. It is imperative that we do this if we want to set them up well and provide a stable base for them to go on to achieve all they are capable of in adult life.

 

RECOMMENDATION: The Department for Education should commission research on the long-term impacts of Staying Close pilot projects, to understand the extent to which it is facilitating the longer-term continuity of positive relationships for young people ageing out of the care system.

 


Costs of Residential Care settings

Residential care in England is becoming increasingly privatised, with most homes run by private companies and voluntary sector bodies rather than local authorities.

Over recent months, reports have emerged that reveal the astronomical profits that the independent sector is making, causing many to question its viability and quality. However, the number of new residential homes of all types continues to rise in England at what some consider to be an alarming rate, thus raising questions about the future sustainability of residential care for looked after children.

Analysis of the costs of residential care within the children’s social care sector is particularly important given the well-documented financial overspend faced by many local authorities.

Children’s homes make up a significant proportion of this overspend, with figures showing that in 2018/19, spending on independent sector children’s homes services by councils was over £1 billion.[20]

Given that the children living in residential care make up 8% of all looked after children, it means that around 27% of spending on looked after children is being given to private providers of children’s homes. The key question then becomes whether such spend is delivering the outcomes that we want to see for these young people, given the high fiscal investment. There is a lack of research into the medium- and long-term outcomes for children living in children’s homes, but we know that the outcomes generally for looked after children remain consistently poor:

Between 2011/12 and 2017/18, the cost of local authority residential care placements rose steeply, increasing by 42% in real terms, from £2,999 to £4,705 per child per week. Not only are children’s homes expensive, but they are becoming increasingly privatised, with little market regulation and national oversight surrounding the health of children’s social care markets.

As such, we welcome the letter from the Chair of the Children’s Social Care Review in England, which caused the Competition and Markets Authority to announce that they would investigate the children’s social care market in March 2021.[28]

RECOMMENDATION: The Committee should invite the Competition and Markets Authority to give evidence as to the progress of their investigation.

RECOMMENDATION: The Competition and Markets Authority should consider introducing a financial cap on the cost of places in children’s homes to ensure that the demand for stable, loving homes for children is not being exploited for excess profit.

 

Unregulated Provision

Teenagers in care comprise the largest and fastest-growing cohort of children in our care system. They often present with more complex challenges than younger children and there is currently a shortage of foster families with the right skills ready to care for them. Media coverage over the past few years has highlighted the significant numbers of young people in care who are being placed in unregulated accommodation, often not because this is deemed as an appropriate setting to meet their needs, but rather due to a lack of options faced by social workers.

While some of this unregulated provision is of a good quality, there is substantial evidence that much of it is not. In the worst cases, reports have highlighted stories of young people being placed on their own in tents, caravans and canal boats many miles away from home and with little or no support. Such scenarios are extremely inappropriate for any child or young person, but particularly for those who have had adverse experiences in their lifetime and are often incredibly vulnerable as a result.

In February 2021, the Government published its response to the Consultation on unregulated provision launched in February 2020.[29] We welcome their decision to ban unregulated placements for all children under the age of 16, recognising that semi-independent and independent provision will never be suitable for this cohort of children. They have also announced plans for new legislation to increase the powers of Ofsted to enable them to act quickly and decisively where unregistered settings are identified.

However, 16- and 17-year-olds can still be placed in unregulated settings, with the Department for Education seeking to develop a set of national standards to uplift the quality of provision. 16- and 17-year-old young people remain hugely vulnerable and their need for support, love, and a place of belonging does not disappear overnight with the arrival of their 16th birthday. While some unregulated provision is of good quality, the variation of quality across this provision is unacceptable and the rising numbers of young people placed in unregulated provision only enhances the need to ensure that poor quality provision is eliminated or significantly improved in a timely way. We welcome the Government’s commitment to identifying any forms of placement that will never be able to suitably meet the needs of 16- and 17-year-olds.

In our submission to the Government’s consultation, we raised concerns about the suggestion of there being one set of standards that span across both independent and semi-independent accommodation, recognising that there is huge variation in the type of provision offered across this spectrum. It is vital that the standards developed are appropriately tailored to differing placement types so that they are specific enough to be effective in driving up the quality of provision.

 

RECOMMENDATION: The Committee should make recommendations to the Government around the content of the national standards in development.

RECOMMENDATION: The Committee should seek clarity from the Government about what steps they are taking to ensure that national standards developed are appropriate to the breadth of provision within the category of ‘unregulated’ placements.

 

We strongly believe that the national standards should be developed in consultation with care-experienced young people, particularly those who have lived in unregulated accommodation. Alongside this, Government should also consult with a broad range of stakeholders with varying expertise and should ensure that robust mechanisms are developed in order that standards are maintained through an Ofsted-style registration and inspection regime. Should the consultation and implementation process for these national standards be completed with a high degree of rigour and excellence, we are hopeful that this will result in an appropriate form of regulation for existing unregulated provision. We are of the view that some degree of regulation is necessary in order to provide necessary protections for vulnerable young people, but that existing regulatory frameworks, including those for children’s homes, are not suitable for semi-independent and independent forms of provision.

We believe that it remains problematic that the terms ‘support’ and ‘care’ govern whether provision for teenagers is regulated. We concur with others in the sector that the system is in danger of producing a two-tier system that risks assigning provision to children based on age rather than need and does not reflect the evolving and changing needs of young people. With children living within a ‘care system’, we deem it to be unhelpful to attempt to distinguish whether young people require support or care, particularly when these terms remain poorly defined. We hold that regulation will be most effective when its degree is determined in response to a young person, rather than a blanket absence of regulation applied to a category of provision, which is provided to young people with hugely varying needs and circumstances. The degree of regulation should not be based on whether a young person is assigned as needing ‘support’ or ‘care’, as though any person ‘ages out’ of the need for care in their lives. Rather, the focus should instead be on the degree and nature of care that is needed to meet a young person’s needs.

Furthermore, by continuing to use the terms ‘support’ and ‘care’, high quality semi-independent or independent provision is in danger of acting illegally by becoming unregistered if a provision responds to the changing needs of a young person and crosses the poorly demarcated threshold between support and care. In recognition that young people’s needs are never static but always evolving and changing in response to their circumstances and life stage, it is vital that the system is set up with sufficient agility to respond to the needs of young people, rather than being held back from responding appropriately due to unhelpful and arbitrary categories and thresholds.

 

RECOMMENDATION: The Committee should invite the Minister for Children and Families to give evidence on the Government’s response to the Consultation around Unregulated accommodation, launched in 2020. In particular, they should seek clarity on the weight provided to the perspectives of children and young people consulted and the decision to not pursue stronger definitions of the terms ‘support’ and ‘care’.

 

While discussions about older children in care are often centred around regulation and the suitability of accommodation, we want to see the emphasis shift to a more ambitious vision to provide holistic care for this cohort to enable them to truly thrive throughout their lives.

While the steps outlined by Government in their response to the consultation are welcome, they do not adequately solve the crisis in options for teenagers. Only around 100 children under the age of 16 are placed in independent and semi-independent settings at any one time[30], and while the national standards are vitally important, the only solution that the Department for Education has put forward to address the lack of available placement options is to commit to increasing the number of places in children’s homes.

 

Teenagers in care are six times more likely (compared to children under 13) to be living in residential or secure children’s homes.[31] While residential care is right for some children, it is imperative that the Government also commits to investing in family-based options for teenagers. With the continuing rise of older children coming into care, more options are needed as demand is far outstripping supply, which has resulted in the increased use of unregulated accommodation in past years.

There is thus a pressing need for more foster carers for teenagers, as well as a recognition of the value of provisions such as supported lodgings in meeting the needs of teenagers looking for a more independent setting, but still within a family environment. Provision such as supported lodgings is underused and poorly defined, with huge variations in practice as a result, thus greater investment and guidance is needed in order to make this a viable option.

 

RECOMMENDATION: The Government should prioritise increasing capacity within family-based settings for young people, including foster care or supported lodgings, as part of their response to poor quality unregulated provision, rather than focusing solely on increasing capacity in children’s homes.

 

The Impact of Covid-19

Covid-19 has presented significant challenges to the children’s social care sector. During the first lockdown in particular, many local authorities sufficiency challenges were exacerbated, with older foster carers stepping back from caring for children due to feeling vulnerable to the worst effects of the virus and concerns around children coming in and out of their home and the risk of transmitting the virus. In addition, it was identified that calls to helplines relating to the ‘toxic trio’ of domestic violence, poor mental health and substance issues, showed notable increases during the pandemic, causing many to predict that there could be a surge in children entering the care system as a result of these enhanced challenges faced by families.

Currently, it remains unclear whether such a surge has happened to the extent that was predicted, but nevertheless the pandemic has only exacerbated the existing, ongoing challenges in the system which are driving the overuse of unregulated provision and causing challenges for social workers who are looking to place children and young people in settings where their needs can be met. Should sufficiency challenges be increased as a result of the pandemic, which we will only be able to fully determine over the next year or so, this could result in an enhanced demand for all types of homes for children, including places in children’s homes.

 


Conclusion

In conclusion, we welcome the Committee’s inquiry into children’s homes, recognising that a significant number of vulnerable young people are living in these settings every year and yet the landscape in which they are operating has undergone little scrutiny or analysis. Broader challenges in the sector around sufficiency are driving an over-reliance on these settings which are not always used in children’s best interests. The increasing involvement of the private sector needs significant attention to ensure that children’s interests are fundamentally remaining the top priority of all those involved in providing care to our most vulnerable children.

April 2021

14

 


[1] Narey, M (2016) Residential Care in England; Available online HERE

[2] Narey, Martin. 2016. Residential Care in England: Report of Sir Martin Narey’s independent review of children’s residential care. Available: https://assets.publishing.service.gov.uk/government/uploads/system/
uploads/attachment_data/file/534560/Residential-Care-in-England-Sir-Martin-Narey-July-2016.pdf
. Page 6.

[3] Nelson III, Charles A., Zeanah, Charles H., Fox, Nathan A., Marshall, Peter J., Smyke, Anna T., and Guthrie, Donald. 2007. 'Cognitive Recovery in Socially Deprived Young Children: The Bucharest Early Intervention Project'. Science 318. Available: http://www.bucharestearlyinterventionproject.org/
Nelson_et_al__combined__2007_.pdf. pp.1937–1940.

[4] van IJzendoorn, Marinus H., Bakermans-Kranenburg, Marian J., Duschinsky, Robbie, et al. 2020. ‘Institutionalisation and Deinstitutionalisation of Children 1: A Systematic and Integrative Review of Evidence Regarding Effects on Development.’ The Lancet Psychiatry, 7 (8). Available: https://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366(19)30399-2.pdf?code=lancet-site. pp. 703-720.

[5] Ofsted. 2020. Main findings: local authority and children’s homes in England inspections and outcomes autumn 2020. Available: https://www.gov.uk/government/publications/local-authority-and-childrens-homes-in-england-inspections-and-outcomes-autumn-2020....

[6] Ibid.

[7] Ibid.

[8] Ibid.

[9] Ibid.

[10] Ofsted. 2020. Main findings: children’s social care in England 2020. Available: https://www.gov.uk/
government/publications/childrens-social-care-data-in-england-2020/main-findings-childrens-social-care-in-england-2020
.

[11] Ofsted. 2020. Main findings: children’s social care in England 2020. Available: https://www.gov.uk/
government/publications/childrens-social-care-data-in-england-2020/main-findings-childrens-social-care-in-england-2020
.

[12] Ofsted. 2020. Main findings: local authority and children’s homes in England inspections and outcomes autumn 2020. Available: https://www.gov.uk/government/publications/local-authority-and-childrens-homes-in-england-inspections-and-outcomes-autumn-2020....

[13] Institute for Government. 2019. Children's social care. Available: https://www.instituteforgovernment.org.
uk/publication/performance-tracker-2019/children-social-care
.

[14] Murray, E.T., Lacey, R., Maughan, B & Sacker, A (2020) Association of childhood out-of-home status with all-cause mortality up to 42 years later: Office of National Statistics Longitudinal Study; BMC Public Health; 20: 735

[15] Ofsted. 2020. Main findings: local authority and children’s homes in England inspections and outcomes autumn 2020. Available: https://www.gov.uk/government/publications/local-authority-and-childrens-homes-in-england-inspections-and-outcomes-autumn-2020...

[16] Ibid.

[17] Ofsted. 2020. Main findings: children’s social care in England 2020. Available: https://www.gov.uk/
government/publications/childrens-social-care-data-in-england-2020/main-findings-childrens-social-care-in-england-2020
.

[18] Institute for Government. 2019. Children's social care. Available: https://www.instituteforgovernment.org.
uk/publication/performance-tracker-2019/children-social-care
.

[19] Morse, Amyas (Comptroller and Auditor General of the National Audit Office). 2018. Financial sustainability of local authorities 2018. Available: https://www.nao.org.uk/wp-content/uploads/2018/03/Financial-sustainabilty-of-local-authorites-2018.pdf.

[20] Rome, Andrew. 2020. Profit making and Risk in Independent Children’s Social Care Placement Providers. LGA and Revolution Consulting Limited. Available: https://www.revolution-consulting.org/wp-content/uploads/2021/01/Profit-Making-and-Risk-in-Independent-Childrens-Social-Care-Placement-Providers-Published-end-January-2021.pdf.

[21] National Audit Office (2015) Care leavers’ transition to adulthood

[22] Young & Homeless 2018 (2018) The Homeless Link Research Team; Link here

[23] Timpson, E (2019) Timpson Review of School Exclusions

[24] Murray, E.T et al (2020) Non-parental care in childhood and health up to 30 years later: ONS Longitudinal Study 1971–2011; European Journal of Public Health

[25] Department for Education. 2020. Children looked after in England including adoptions.

[26] Ibid.

[27] Ibid.

[28] Local Government Association. 2021. Private equity involvement in care placements needs reviewing amid concerning profit and debt levels. Available: https://www.local.gov.uk/private-equity-involvement-care-placements-needs-reviewing-amid-concerning-profit-and-debt-levels.

[29] Department for Education. 2021. Reforms to unregulated provision for children in care and care leavers: Government consultation response. https://
assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/962686/Unregulated_government_response_Final.pdf
.

[30] Department for Education. 2020. Looked after children in independent or semi-independent placements. https://www.gov.uk/government/publications/looked-after-children-in-independent-or-semi-independent-placements).

[31] Children’s Commissioner. 2019. Stability Index 2019: Overview report. https://www.childrenscommissioner.gov.uk/wp-content/uploads/2019/07/cco-stability-index-2019.pdf.