Clare Jerrom talks to John Graham about the current challenges facing the fostering system.
Recruitment and retention of foster carers is still the critical issue facing the fostering sector, an expert in the field has warned.
John Graham, a fostering consultant, considers that a focus on the recruitment and retention of suitable foster carers will be a major outcome from Martin Narey’s stocktake of fostering - https://www.willispalmer.com/martin-narey-to-review-fostering-system, and ascribes the ‘turnover’ of foster carers as being partly due to foster carers being overworked and under-valued in a 24/7, challenging and stressful job. This is compounded by social workers being under increasing pressure whilst resources are cut, leaving them less able to adequately support foster carers.
“In my view, foster carers are the main agents of change for children in care. Their influence on the outcomes for these children is fundamental and supported by research. The turnover of social workers and other professionals involved with a child’s time in care is also well documented with some children in long-term care having up to 10 social workers – continuity and consistency, as well as basic relationship building is consequently missing with damaging effects” says John, who himself grew up in a household where his mother fostered children meaning he saw first-hand the difference that a good placement can make to a child.
Managing crises
John started out working as a psychiatric nurse in the large regional institutions that pre-dated ‘Community Care’. The Community Care Act meant that many of the large hospitals were closing down and staff numbers were drastically cut. As a Charge Nurse, he was regularly one of two staff on a 35-bed Acute ward, as opposed to having a team of 6/7 staff - “the job satisfaction went. We were managing crises all the time as a result of the cuts and could not do any therapeutic work with people in the hospital. I left and went to residential social work for a couple of years before studying for the DipSW,” he said.
His first social work role was in a Dorset children’s team where he placed children with foster carers and thus his interest in fostering began. John moved from Dorset to the Wirral where he helped set up and run a teenage fostering scheme and worked there for five years.
Having studied for his Practice Teacher award, John moved to the independent sector and worked as an Operations Manager for Foster Care Associates in Manchester for the North-West region. Together with his colleagues they began with 10 foster carers building up to 100 within five years. Having studied for an MBA during this time and gaining essential skills for management, John was asked to act as their first UK wide Quality Assurance Manager in preparation for the introduction of regulation and inspection of Independent Fostering Agencies (IFA’s) in 2002.
“I had a reputation for quality and getting it right, I was pedantic if you like, I didn’t like poor practice and wanted to set good standards,” he explains.
‘Not about the children’
His role was to support and advise the different regions to ensure that their practice was up to the required standard. Policies and procedures had to be in place and as teams kept changing, he would be sent in to trouble-shoot and stabilise teams.
“I was the first person to do the job so I was pretty much left to get on with it,” says John. “It was challenging and exciting although involved a lot of travelling and time away from home’.
After nine years in the post, following a re-organisation at FCA, the QA role was significantly changed and so he took the opportunity to move to a smaller agency where he was regional director. He found that the agency was very much financially driven and ‘not about the children’, resulting in the recruitment of unsuitable carers, poor support and consequently frequent placement breakdowns and the damage they did to children, and John decided to go freelance four years ago. Since then he has been a fostering panel chair, delivered training, updated policies and procedures for organisations, carried out service audits and tender preparations, and taken on work for WillisPalmer.
This includes Quality Assurance where he manages the contract for Rhonda Cynon Taff’s fostering service. He oversees the implementation of the contract, liaises with assessors and the authority, as well as reviewing all expressions of interest from prospective carers. He also carries out Quality Assurance work for other contracts with WillisPalmer but still carries out some Form F assessments of prospective foster carers periodically for other agencies to “keep his hand in”.
“We are certainly recruiting from a bigger pool now. For example, when I first began work in Local Authorities, it was much more difficult for gay couples to foster and recruitment from ethnic minorities was poor - now that’s not the case,” said John. “However, the assessment process is constantly being amended and it’s more thorough and evidence based now. It used to be a ‘history taking’ process whereas now it’s much more analytical and focuses on how people measure against certain skills and competencies. However, different agencies apply their own standards to the process and consequently the quality of service to the children differs”.
‘Eventually, the child shuts down’
As stated, John feels that in some fostering agencies in the independent sector the rules and regulations are interpreted differently and it has become more about getting “heads on beds”. “The smaller companies are bought up by private equity companies with the emphasis on return on investment, leading to cost cutting, much larger workloads for Supervising Social Workers and poorer support to carers” he adds.
“In the 1990’s, foster carers were generally getting poor support from local authorities in a culture that didn’t see them as ‘professional’ and excluded them from decision making, and consequently moved to the private sector in droves where they were valued for the work they did, got better pay and more support. This trend now appears to be reversing and local authorities have got their act together and they have much more support in place for foster carers. They have realised that foster carer retention is cheaper than recruitment and whereas the private sector used to pay better, local authorities now compete.”
He believes that this change in the dynamics in the market, the chronic shortage of good foster carers and the fact that Ofsted, as the Regulatory body in England, is over-worked, should be themes addressed by Narey’s stocktake.
He considers that the increase in the commercialisation in the independent sector and the exclusive focus on shareholder return, is resulting in more placement breakdowns for children and young people because carers are less likely to be carefully matched with children.
“The needs of the child should be matched to the skills of the foster carers but when there is pressure to get heads on beds, children are placed inappropriately. Together with poor support, this results in placements breaking down and the process has to start again. Eventually the children shut down, afraid of being hurt again and this results in lifelong damage,” says John. “Some children have been in 10-12 placements – some a lot more- and it creates awful damage in the young person.”
‘Children don’t need therapy at home, they need a safe environment’
The young people being fostered have already had awful experiences of physical, emotional or sexual abuse or neglect and both abuse and neglect present difficult problems and developmental delay. Some children may not be in education, warns John which in itself poses difficulties. “All have low self-esteem, poor self-image, and frequent placement moves makes it difficult for them to attach to others,” he says.
John was one of eight siblings raised by a single parent who fostered more than 200 children. He explains that whilst this gave him a good insight into foster care and influenced his views, he concedes that things were very different back then. “It was a hectic household, we didn’t see a social worker back then - we were left to get on with it. I have fond memories of some of the children who stayed with us, less fond memories of others, there were some babies who were with us for a short time then moved on, but with that many children there wasn’t time or the background information to deal with individual psychological needs. Many kept in touch and some came to my mother’s funeral. For me, it was the consistency of care and acceptance for all the children, and my mother’s ‘unflustered’ style that helped these children and young people”
Again it is his first-hand personal and professional experience that influences his thoughts on who makes a good foster carer and what it takes to do the job well. He considers, based on that experience that there is no template for the ‘ideal’ foster carer, but notes that some ‘professionals’ e.g. social workers, psychologists, doctors etc rarely make the successful transition, although he would like to see research in this area – “from my recruitment experience over many years, they can interpret the role as an extension of their day job – children don’t need therapy at home, they need a calm, safe environment”. He does point out that there are exceptions to this, with a few making very good carers. He has found that applicants with a background of direct work with young people with a learning difficulty generally have very transferable skills. He also acknowledged his own limitations – “I couldn’t foster – I don’t have the patience of my mother!”
It’s a 24/7 job
Foster carers need warmth, compassion, resilience and the ability to communicate with young people, says John. Some parenting experience is ideal, although not essential, with a good attachment to their parents or where they have overcome poor parenting positively can be good indicators. “A good support network is vital. It has always been demanding but foster carers go through a rigorous assessment and the children placed get more challenging every year, especially now the residential sector is much reduced. A fundamental skill is the ability to separate the child from the behaviour and not personalise it, but recognise where it is coming from – not an easy task”.
He explains that there has been an historical attitude among some authorities that foster carers should do the job for free but “social workers get paid, teachers get paid, why shouldn’t foster carers – it is a career choice,” says John – “there is nothing wrong with that if they care about the children and do a good job. It’s a 24/7 job – if you break down the £300 or so fee they get a week, subtracting the costs of feeding/clothing/pocket money etc. It probably works out at £1 an hour or less,” he adds.
“If you want good foster carers, you need to pay them well, train them well, support them and match the children to them that they are most skilled to deal with,” he said. “Training should be tailored to the needs and presenting behaviour of the children and young people - if the children are showing harmful sexual behaviour, their foster carers should receive training in how to manage this; If the child has disabilities caused by the mother abusing alcohol during pregnancy, the foster carers should receive training in foetal alcohol syndrome; if they are self-harming etc.”
“Foster carers need regular visits, regular support and respite to provide them with the opportunity to attend training, peer support groups with other foster carers, and also get a break. This kind of support makes foster carers feel valued and can make all the difference. It’s also the little things that make a difference to maintaining a difficult placement – ring them in the evening if they’re having problems, remember birth children’s birthdays, offer experienced carer mentors to new carers etc” John concludes.
