Scotland's care system needs 'radical overhaul'

An independent review of care services in Scotland has called for a radical overhaul of the country's care system.
The in-depth examination of Scotland's care system has revealed that it is fractured, bureaucratic and unfeeling for far too many children and families. It also fails to adequately value the voices and experiences of children and families.
Fiona Duncan, Chair of the Independent Care Review said: “I have heard countless stories of when the care system gets it wrong; separation, trauma, stigma and pain. Too many childhoods have been lost to a system that serves its own convenience
rather than those within it."
The Care Review has listened to more than 5,500 experiences and half of those were children and young people with experience of the care system, adults who have been in care as a child and their families. Other views were sought from the workforce.
The review has revealed that the ‘care system’ including children and families support services, Children’s Panels, Children’s Hearings Scotland, Scottish Children’s Reporters Administration as well as delivery of other universal services like education and mental health to children in care costs £1.2 billion annually.
The costs of the ‘care system’ letting down children and their families was calculated at £1.6 billion and includes a combination of £875 million in meeting the needs care experienced people have as a result of the ‘care system’ failing them and £732 million in lost income tax and national insurance.
The report says that for Scotland to be the best place in the world for children to grow up, a fundamental shift is required in how decisions are made about children and families. For lives and futures to change, Scotland must change the way it supports families to stay together.
"Because despite Scotland’s aspiration for early intervention and prevention, its good intentions, and the hard work of many, the experience of far too many children and families is of a fractured, bureaucratic, unfeeling ‘care system’ that operates when children and families are facing crisis," the report added.
There are almost 15,000 children in Scotland's ‘care system’.
- Many have and continue to go through deeply distressing and disturbing experiences that are often severely traumatic. The impact can be profound and lifelong.
- Perpetuation of trauma and failure to support healing where children and families are already experiencing poverty and inequality is reflected in poor outcomes for many who have experience of the ‘care system’.
- Despite the system being focused, above all else, on protecting against harm, it can prolong the pain from which it is trying to protect.
- Some children who have experienced trauma told the Care Review that being taken into care and growing up in the ‘care system’ was among the most traumatising experiences they had ever had, exacerbated by being separated from their brothers and sisters, living with strangers and moving multiple times.
The Care Review calls for the following changes:
* The balance of power must be upended so that listening to children and young people is always the basis of all decisions made about their lives.
* There must be a focus on building and maintaining life-long relationships – that includes a broader understanding of the risk of not having long term, loving relationships.
* Scotland must parent, not process, children so there is no difference between the lives of children in care and their peers. Care experienced children must not miss out on the kind of childhood that many take for granted and the future that all our young people deserve.
* Families must be kept together wherever it is safe to do so. Families must get the support that is right for them at the earliest opportunity and it must be flexible, consistent, patient and free from stigma. This will mean that more children can live a safe, happy life at home with their families.
The report has identified five foundations for change, with over 80 specific changes that must be made to transform how Scotland cares for children and families as well as the unpaid and paid workforce.
The five foundations are:
1) Voice - the voice of the children must be heard at all stages;
2) Families - families should receive support to thrive;
3) Care - that builds childhoods for children who Scotland has responsibility for;
4) People - with a relentless focus on the importance of relationships and
5) Scaffolding - so that the structure is there to support children and families when needed.
The Care Review has also published The Plan, an approach to implementation plotted out over 10 years whilst demanding urgency is maintained in the pace of change.
Fiona Duncan, Chair of the Independent Care Review said: “The Care Review has listened to what care experienced people have said needs to change and those voices have driven its work and underpins its conclusions.
“It has sought to understand how the system feels to those who live and work in and around it. And it has produced the what, how, why and when of what needs to happen next.
“This is a radical blueprint for a country that loves, nurtures and cherishes its children. This is Scotland’s chance to care for its children, the way all good parents should," she added.
First Minister Nicola Sturgeon said: “In 2016 I accepted a challenge to listen to the experiences of 1,000 looked-after young people because I knew the care system needed a transformation and I wanted to hear first-hand what had to change. These early conversations inspired me to announce an independent root-and-branch review of the care system.
“So for the first time ever the voices of people with experience of the care sector have been, and will continue to be, at the heart of shaping care policy. Over 5,500 people, including care experienced individuals and their families, as well as paid and unpaid care workers, took the time to discuss their thoughts, feelings and experiences to highlight where things are going well and where we need to improve.
“I have had the privilege of meeting many young people with experience of care who are doing extremely well, I have also been given the chance to see the dedication, commitment and passion of those who work in the care sector.
“But I’ve also heard some extremely difficult stories which portray the care sector as bureaucratic and even unfeeling.
“It is clear that despite the efforts of those within the system, the actual experience of too many people in care is not what we want it to be.
“We will keep listening to and working with care experienced people because the case for transformational change is now unarguable and their voice must shape that change. We will work with them and with local authorities, care providers and others to deliver that change as quickly and as safely as possible," she added.
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