Long term foster care as a pathway to ‘permanence’ – messages from practice. By Renuka Jeyarajah-Dent

Renuka Jeyarajah-Dent is Director of Operations at the Coram Centre, London.

The guiding principle for all children in care should be to help them achieve ‘permanence’. This is more than a placement; it is everything the child needs to repair from separation and loss and become resilient.

I have worked as an educational psychologist in schools, in Child and Adolescent Mental Health Services (CAMHS), and most recently in the voluntary sector – managing partnerships with local authorities to improve the speed at which stable placements were found for children requiring long term foster care. Most of these children have multiple and complex needs and have all suffered loss and separation from parents and often siblings and friends.

A child coming into care is dependent on an organisation rather than a loving parent to be its steady base. In reality, high staff turnover – at every level in children’s social care – and long waiting lists for specialist health and education services are barriers to securing the much needed continuity, valued relationships, and in-depth needs and risk assessments that are essential for a child’s development.

Families are universally recognised as the foundation of warm relationships and parents as those best placed to advocate passionately for their children. The corporate parent seeks to enable children in its care to experience family life which it sees as key to ‘permanence’. However, there is more to ‘permanence’ than experiencing family life. How do we know when ‘permanence’ has really been optimised? The child will have growing self-esteem, self-efficacy and an increasing repertoire of problem solving skills that will help them to navigate the challenges of adult life – in short the child will be developing resilience.

The warmth of a family that will stick with children when they fall is perhaps the most important ingredient. Children need consistent care and the love of an adult so that they can feel safe. As well as practical care and love, other routes to resilience include opportunities to enjoy time with siblings and friends and a good education. This may sound simple, but it is difficult to deliver without a well-resourced and expertly propelled plan.  Far too often, local authorities and their partner agencies find a foster carer but cannot deliver  an on-going plan – often complex – as children’s needs change. Children who have suffered need targeted support to achieve this thing called ‘permanence’ and timely, flexible multi-professional support is key to this.

Significant numbers of children in care are fostered with the aim of giving them the benefit of a family. However, there is a shortage of foster families – especially for children with multiple or complex needs. Despite best efforts children are sent, especially in emergency, to wherever there is a ‘bed’. Ideally, the rigour and scrutiny encompassed by the adoption process also needs to be applied to foster care.

In foster care services, there is no requirement for the formality of a family finder or the rigour of adoption panels that include the expertise of medical advisors or for the matching process to be concluded within a defined timescale and yet these are the children who are frequently older and have experienced more distress. In one LA I know, the number of dedicated family finders doubled resulting in significantly more matches with foster carers and in another, beginning to use the panel for all children under 16 requiring long term foster care resulted in much more discussion of the detail and resourcing behind the plan.

While there are national minimum standards that are applicable to adoption, the guidance is less clear for foster care. There is no clearly defined process that assesses the factual and interpretive evidence relating to the prediction of ‘good parenting’. Remuneration to include the child as part of family life is available but the training and support required by these families to really incorporate the child with warmth and stick by them when problems emerge is certainly complex to deliver. Foster carers are a great resource and children benefit from their talent and commitment, but the shortage often and perhaps inevitably means the system focusses on the needs of the foster carer more than those of the child within the household. We need to be far more child centred. CAMHS, virtual schools and others need to better help foster carers understand that skills must include the ability to relate both emotionally and with understanding to what the child is experiencing. In one perhaps unusual example, reward charts were recommended when problems were far more complex and removal back in to ‘care’ was used as a threat with a child who had been ‘abandoned’ in earlier years. Both her anxiety and problematic behaviour heightened as a result.

For children in foster care, there are other practicalities which promote resilience: the ability to read, write, add up and problem solve. If the foster carer cannot enable this then the corporate parent must arrange for advocates and provide the child with the necessary support to catch up and do well at school. Falling behind only serves to further disenfranchise the child – quite simply it is hard to belong if you are struggling. We need to recognise that for children who have suffered, their engagement with and benefit from family life cannot be optimal if we simply offer them experience of it without other input to recover.

Unlike adoption, the private sector is allowed into the provider market and there are currently 293 independent fostering agencies (excluding trusts) operating in the country (31 March 2019). There will be a commissioning framework that undertakes a due diligence process but across the country there is little available evidence on the ‘value added’ – and by this I mean the real costs for the different elements offered and how they relate to better outcomes.  In order to understand this we need to consider how we measure the value added, using a well-defined national framework that continues to try and understand what is required to achieve sustainable outcomes.

In conclusion, we need to build expertise within teams by making them multi-professional so that they not only support children within families but act swiftly to assess and advise on children who cannot at that time benefit from family care. For some children the intensity of living in a family and handling one to one relationships is too great. To optimise resilience for these children, nurturing residential homes with education, health and social care on site are required, providing a 24 hour curriculum of integrated trauma informed practice.

We have 78,150 children in care, a 28% rise in a decade1 and resources which do not keep pace with this extra demand. Too many children do not reach their potential because we do not have the multi-professional services to assess, triage and intervene early and consistently enough to make a difference. We cannot tolerate the fact that care leavers are estimated to represent between 24%2 and 27%3 of the adult prison population. This is despite less than 1%4 of under 18s entering local authority care each year, the majority in foster homes.

Children need foster carers to provide a ‘steady base’ characterised by warmth and care and we need the corporate parent to take a project management approach which ensures that well assessed and designated resources are in place for very swift deployment when they are needed. If we don’t get this right, too many children will not have the stability they need to progress to ‘permanence’.

Renuka Jeyarajah-Dent B.Sc., PGCE, M.App. Sci., AFBPsS, C.Psychol

  1. The Guardian January 9th 2020
  2. Prisoners’ childhood and family backgrounds. Results from the Surveying Prisoner Crime Reduction (SPCR) longitudinal cohort study of prisoners (Ministry of Justice 2012)
  3. Reducing re-offending by ex-prisoners (Social Exclusion Unit (2002)
  4. Harker, R. & Heath, S. (2014) Children in Care in England: Statistics, SN/SG/4470, House of Commons Library


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