Families on the brink: the effectiveness of family support services

This paper presents findings from a study of the costs and effectiveness of family support services offered to 40 families with a high level of need, in two neighbouring local authorities in North Wales. It describes the level and type of services offered by different agencies in each of the authorities, estimates the costs of these services, and assesses outcomes for the families receiving them after three months. Information is also provided about families’ experience of the support they received, and the kind of help they would have liked. Parents’ well‐being and family functioning were found to improve over the intervention period in both authorities, although only to a limited extent. Improvements were greater among those who were living with partners, and less among families identified by social workers as having financial difficulties or problems with drug or alcohol abuse. Respondents who rated their problems as very severe showed less improvement. The pattern of service provision and the costs involved turned out to be similar in both authorities, so it was not possible to reach conclusions about the relationship between services and outcomes. However, a number of themes emerging from the data are discussed, including the role of day care services in supporting families with young children, the impact of poverty and deprivation on parents’ ability to provide good care for their children, and the importance of an interagency response to children's and parents’ needs. The article also includes a discussion of problems encountered in undertaking comparative outcomes‐based research and cost‐effectiveness analyses in the social welfare field.     

Children living with parental substance misuse: A cross‐sectional profile of children and families referred to children's social care

Parental substance misuse is a significant public health and children's rights issue. In the United Kingdom, social workers frequently work with children and families affected by substance misuse. However, relatively little is known about this population, particularly at point of referral to children's social care. This paper reports on the largest known study of parental substance misuse as a feature of children's social care work in England. The paper provides a cross‐sectional profile of 299 children living with parental substance misuse and referred to children's social care in one local authority in England. Data were collected from social work case files at the point of referral to social care about the child, family, the wider environment, and parental substance misuse. The findings show that children affected by parental substance misuse frequently had other support needs relating to their well‐being and mental health. Children were also likely to be experiencing other parental and environmental risk factors. The significant historical—and in some cases intergenerational—social care involvement for some families indicates potential issues with the capacity of services to meet needs. Recommendations for practice are discussed with a particular focus on the need for early, comprehensive support for children and families.     

'Mingling together': promoting the social inclusion of disabled children and young people during the school holidays

The promotion of social inclusion of disabled children and their families is currently high on the UK political agenda. Research shows that disabled children and their families are highly disadvantaged, both economically and socially. This paper reports some of the findings of a qualitative study, entitled On Holiday! , which involved analysing the views of 297 people across six local authority research sites in England including 86 disabled children and young people. The study showed that many disabled children and their families experienced high levels of social isolation and exclusion during out-of-school periods and during the school holidays in particular. The paper recounts some of the experiences of disabled young people and their families and ways in which local authorities can promote their social inclusion. We argue that disabled young people and their families can only be truly socially included and empowered when all levels of the local authority (managers, officers and elected members) recognize the rights and entitlements of disabled children and have the political will and commitment to implement them.     

An analysis of Ofsted inspection reports for children's social care services in England

The Office for Standards in Education, Children's Services and Skills (Ofsted) is responsible for inspecting services that care for children and young people in England and Wales. This paper presents findings from an independent study of Ofsted inspections into children's social care in England, covering reports under three inspection frameworks during the period 2009 to 2016. The research aimed to identify the main themes of recommendations made in Ofsted reports and to explore similarities and differences between frameworks and between local authorities. The methodological approach was document analysis. A stratified sample of 60 reports was prepared on the basis of inspection framework and local authority characteristics such as local deprivation, Ofsted rating, and urban/rural category. A thematic analysis was conducted of the recommendations in each report, with emerging themes subjected to an iterative process of coding and categorization. The findings identified nine categories of themes, the most common of which were performance management, casework, oversight of practice, and multiagency working. Overall, the recommendations were strongly oriented towards process issues and compliance with standards. Recommendations were found to differ somewhat between inspection frameworks but remained largely consistent between local authorities with different characteristics. The paper concludes by examining the implications of findings for the current regulatory framework in children's social care.     

Resettlement challenges faced by refugee claimant families in Montreal: lack of access to child care

Adult refugee claimants experience several well‐documented post‐migratory challenges. Little is known about the resettlement process for refugee claimant families with children. This study reports on 75 open‐ended, in‐depth interviews with refugee claimant families in Montreal about their resettlement challenges and their proposed solutions to them. These interviews were conducted with 33 dyads and triads of children and parents attending a paediatric hospital. Experiences accessing formal and informal child care in Montreal were addressed. Subsequently, a comparative policy analysis was conducted on residency eligibility criteria for child care subsidization. Twenty‐eight out of 39 parents (73%) report a lack of informal or formal child care and 15 out of 33 families (39%) propose improving access to formal child care services. They describe a lack of informal child care as a result of reduced social networks, and affordability as a barrier to formal child care services. Refugee claimants are not eligible for subsidized child care in Quebec. A comparative policy analysis within Canada and comparable countries reveals that this situation is not unique to Quebec. However, most provinces and European countries offer child care subsidies to refugee claimants. Refugee claimants should qualify for child care subsidies. Social workers and community organizations should consider their clients' child care needs in designing programmes and services.     

Ascertaining the wishes and feelings of young children: social workers' perspectives on skills and training

The research was undertaken in the context of the ongoing debate about child care social work training and children's participation. Its aim was to explore the views of qualified child care social workers about their skills in eliciting the wishes and feelings of younger children and the relevance of social work training for this task. Questionnaires, focusing on their skills and training, were completed by 70 UK child care practitioners from the Children and Families Court Advisory and Support Service, voluntary agencies and local authorities. On average, practitioners felt able to ascertain the feelings and wishes of children as young as 4 years old. Nevertheless, at qualifying level, only 30% had training in communicating with young children, 16% in ascertaining children's feelings and wishes, and 66% in child development. Many had subsequently relied on in‐service training and their own initiatives to acquire further skills and understanding. In conclusion, most participants were experienced practitioners working in supportive organizations and had developed considerable communication skills. However, concerns remain because they identified deficits in child care social work qualifying and post‐qualifying training. Consequently, more effective training at all levels is required if social workers are to engage younger children successfully and facilitate their participation.     

Health Authorities, Priority-setting and Resource Allocation: A Study in Decision-making in New Labour's NHS

This paper analyses the decision‐making process of health authorities under New Labour in the NHS through a study of their qualitative responses to questionnaires. We find a considerable frustration and cynicism with the government's plans for reform, with its interference at the local level with services, and an acknowledgement of the differences between health authorities’ practice and what they believe the government requires, with, often, only minimal effort being made attempting to achieve new governmental performance targets. We conclude by making suggestions for an alternative strategy less likely to antagonize local health service providers.     

Numbers of children looked after in England: a historical analysis

This paper is an analysis of the relationship between policy, practice and the rates of children looked after by local authorities in England. It examines the trends in the numbers of children looked after by local authorities in England over a period of approximately 40 years. The increase in children looked after in the decade after 1994 is shown to be the result of fewer children entering care, but those that do tend to stay longer. This two-part dynamic appears to have been the underlying determinant of the care population over a long period of time. The fact that time spent in care is such a key factor suggests that planning for children who are already looked after is a crucial determinant of the numbers in care. However, it is argued that poorly developed family support services limit current options for reducing the size of the care population. A range of effective family support services could potentially have an impact on the number of children in care in three ways: by helping to maintain more children within their families; by identifying those children who need care earlier; and by improving the chances of some children being successfully returned home.     

Unequal Partners? Local Government Reorganization and the Voluntary Sector

British local government has recently undergone its most far-reaching reorganization for twenty-five years. The impact of this reorganization was considerable within local authorities but it also substantially affected other organizations with which they worked at a local level. This paper explores the perspectives of voluntary sector organizations involved in social care: a set of actors which, prior to reorganization, had been encouraged by central and local government, through notions of partnership and through community care legislation, to undertake more direct roles in service delivery, consultation and strategic planning. During the consultative period prior to reorganization, many voluntary organizations reported that they had been marginal to the process. Reflecting on the process of reorganization itself, many voluntary organization respondents commented that it had been disruptive and provoked considerable anxiety. Post-reorganization, voluntary organizations felt that rebuilding of relationships was necessary and that the promise of partnership had meant little in practice at a time of potential crisis for local.     

Exploring drivers of demand for child protection services in an English local authority

This paper reports on an empirical study of child protection services in a local authority where rates of investigations and interventions rose to unprecedented levels during the course of a single year. The aim of the research was to explore explanations for this rise in demand among the providers of children's social care in the area. Using an interpretative qualitative design, a series of focus groups and interviews were carried out with practitioners and managers (n = 25) from statutory services and Early Help. The findings identified a combination of long‐term and short‐term drivers of demand. Long‐term factors emphasized the impact of rising levels of deprivation combined with cuts to community‐based services for children and young people. Short‐term factors ranged from a more proactive approach to child neglect to more effective multi‐agency partnerships and joint decision making. The interaction between these factors was found to be accentuating an underlying shift to “late intervention” across the sector. The findings are contextualized in relation to contemporary debates about the crisis of demand for children's social care and the complex relationship between prevention and protection.     

Privatising Foster Care: The UK Experience within an International Context

Foster placements for children in care in the UK are being increasingly provided by non‐governmental organizations. However, although local authorities are purchasing almost one third of their required placements from these external agencies, the UK has not yet followed the examples of other English speaking countries. In parts of the USA and Australia all fostering and other child welfare services have been wholly outsourced or transferred from the public to private and non‐profit organizations. A number of these initiatives have been independently evaluated and some of their findings resonate with what seems to be happening in the UK. This article explores these but also other factors which appear to distinguish the policy and practice of foster care in the UK from those of the USA and Australia. Using theory related to the privatization of welfare and relevant domestic and international research, the article examines the development of external commissioning of foster care in Britain. In the light of changing law, ideology and policy, the article concludes by speculating on how the future of fostering and wider child welfare provision in the UK may look, at a time of political change and economic austerity.     

The role of the voluntary,community and social enterprise sector in Early Help: Critical reflections from embedded social care research

The independent review of children's social care (2022) has proposed a radical reset of England's children's services, shifting a remote, assessment heavy system towards one that works alongside communities to help prevent statutory interventions. However, notions around the harnessing of community resources to deliver Early Help are often underpinned by assumptions regarding the voluntary, community and social enterprise (VCSE) sector and the ease with which such organizations can be integrated into preventative strategies. This paper reports findings from embedded research within a unitary authority in Southwest England during remodelling of its Early Help service to work more collaboratively with local VCSE organizations. The study generated data from ethnographic observations, semi-structured interviews and focus groups with 95 participants, including local parents, service providers, VCSE organizations and Council leaders. The findings illustrate that families value the compassionate, responsive and flexible support available within many VCSE settings. However, differences in practice cultures, regulatory pressures on statutory providers, the need to (re)build trust in communities and sensitivities around power-sharing and resourcing meant negotiating VCSE sector integration was fraught with complexities. Few studies have gained such privileged access to a Local Authority's remodelling of Early Help services, and this paper has significant insights for the debates surrounding the independent review of children's social care (2022) and its recommendation to bring services ‘closer to communities’.     

Choice,Competition and Care – Developments in English Social Care and the Impacts on Providers and Older Users of Home Care Services

This article critically examines recent changes in markets for home (domiciliary) care services in England. During the 1990s, the introduction of competition between private (for‐profit and charitable) organizations and local authority providers of long‐term care services aimed to create a ‘mixed economy’ of supply. More recently, care markets have undergone further reforms through the introduction of direct payments and personal budgets. Underpinned by discourses of user choice, these mechanisms aim to offer older people increased control over the public resources for their care, thereby introducing further competitive pressures within local care markets. The article presents early evidence of these changes on:

• The commissioning and contracting of home care services by local authorities and individual older people.
• The experiences and outcomes for individual older people using home care services.

Drawing on evidence from two recent empirical studies, the article describes how the new emphasis on choice and competition is being operationalized within six local care markets. There are suggestions of small increases in user agency and in opportunities for older people to receive more personalized home care, in which the quality of care‐giving relationships can also be optimized. However, the article also presents early evidence of increases in risk and costs associated with the expansion of competition and choice, both for organizations providing home care services and for individual older service users.     

Alternative care options and policy choices to support orphans: The case of Mozambique in the context of the SADC

Contextualizing the situation of orphans within the Southern African region and drawing on quantitative and qualitative field research, this article analyses care options and social protection policy for orphans in Mozambique, with its focus placed on children in orphan support centres. Seeking to offer new insights and greater understanding of the experiences of children in care and of the social protection available to them, the research highlights that orphaned children living in informal foster care arrangements are more likely to experience abuse, neglect and maltreatment than those living in non‐governmental care organizations. The research emphasizes the need for a more careful selection of foster families in which children are placed. Recommendations include the need to focus on capacity building and institutional reforms that provide social protection policies for orphaned children as part of an overall social protection floor. The monitoring and evaluation of organizations providing care to orphaned children is deemed a priority.     

An ecological systems approach to understanding social support in foster family resilience

Families who care for children in the foster care system often experience challenges related to the system, accessing services and supports, and managing relationships. Despite these challenges, many families thrive because of unique attributes and strengths that contribute to experiences of resilience. Using an ecological framework, this study examined social support among resilient foster families to better understand how foster caregivers experienced positive reciprocal transactions across systems. As part of a larger study, in‐depth narrative interviews were conducted to examine the process of resilience for families who foster. Findings revealed that families accessed and benefited from social support on micro‐level, meso‐level and macro‐level. Understanding how families cultivated social support across multiple levels offers implications for practice and policy when considering how best to retain and support families who care for vulnerable children.     

“A game of two halves?” Understanding the process and outcomes of English care home closures: Qualitative and quantitative perspectives

With care services increasingly delivered via a market there is always a risk that care homes could fail financially or struggle in terms of quality, ultimately having to close. When this happens, the received wisdom is that subsequent relocation can be detrimental to the health and well‐being of older residents (possibly even culminating in increased mortality). However, there is very little formal evidence in the United Kingdom (UK) or beyond to guide policymakers and local leaders when undertaking such sensitive work. Against this background, this article reports findings from an independent evaluation of what is believed to be the largest care home closure program in the UK (and possibly beyond). This consisted of qualitative interviews with older people, families, care staff, and social work assessors during the closure process in one case study care home and one linked day center, as well as self‐reported health and quality of life data for older people from 13 homes/linked day centers at initial assessment, 28 days after moving and at 12‐month follow up. The study is significant in presenting public data about such a contested topic from such a large‐scale closure process, in its focus on both process and outcomes, in its mixed‐methods approach, and in its engagement with older people, families, and care staff alongside the use of more formal outcome measures. Despite significant distress part‐way through the process, the article suggests that outcomes either stayed the same or improved for most of our sample up to a year after moving to new services. Care homes closures may thus be a “tale of two halves”, with inevitable distress during the closure but, if done well, with scope for improved outcomes for some people in the longer term. These findings are crucial for current policy and practice given that the risk of major closures seems to be growing and given that there is virtually no prior research on which to base local or national closure processes. While some of this research is specific to England, the underlying issue of care home closures and lessons learned around good practice will also apply to other countries.     

Challenges of operationalizing trauma‐informed practice in child protection services in New Zealand

New Zealand is undergoing major change in service delivery to children and families. A new Ministry for Children Oranga Tamariki has been established to oversee 5 work streams, one of which provides intensive intervention with families requiring a statutory response to child protection concerns. The government minister responsible promised that the service would be child‐centred and trauma‐informed. To date, these terms remain undefined, and there is no shared understanding of their meaning. Practice frameworks to support the work of the new ministry are still being developed, creating something of a vacuum in the meantime. The focus of this paper is the challenge of implementing trauma‐informed practice in the child protection service provided by the Intensive Intervention work stream. Limited research or commentary on trauma‐informed practice in this context currently exists. Drawing on the relevant available literature, the concept and its application in child protection social work is explored. An ecological framework is used to discuss the changes needed to achieve this. Particular attention is paid to the impact of historical trauma for indigenous people due to New Zealand's colonial history and their over‐representation in care and protection services.     

The Common Assessment Framework form 9 years on: a creative process

Legislation within England states that local authorities should provide services for all those families in need. However, research has identified that regardless of the introduction of strategies to identify need and enhance family support, ongoing barriers to services adhere. Taking a social constructionist approach, this study explored professionals' experiences of the use of the Common Assessment Framework form. Data were collected in four different local authorities in two phases. Forty‐one professionals from a variety of agencies took part in semi‐structured interviews. Data were analyzed thematically. Findings demonstrate that the professionals experienced difficulties in working through the Common Assessment Framework process, for example, in completing the form and engaging families. This situation led to the more experienced and knowledgeable professionals utilising creative ways to successfully navigate the ‘referral process’. Such creative working practices included the terminology used to complete the form and how the process was ‘sold’ to parents, so that they could be in a better position to engage parents and complete the Common Assessment Framework form. Because of this, more experienced professionals seem to be able to accelerate the referral process in order to access much needed support services for children and young people.     

Overcoming barriers to effective practice in child care

This paper describes the work of three Action Learning Sets – two groups of child care social workers and one group of health visitors. Given the substantial investment in child care research and its dissemination, we wanted to examine barriers to effective practice from the vantage point of workers themselves. Our core question was: ‘What can we do about the things that get in the way of effective practice?’ The method, based on that of ‘co‐operative inquiry’, sought to engage front‐line practitioners as active collaborators in the research. While several of the barriers can be seen as part of the common predictable experience of professionals working in large public sector organizations, a key message is the importance of re‐invigorating models of supervision that can sustain high quality practice. What emerges is a contemporary picture of the pressures on child care workers and of the struggles to make sense of professional roles in different organizational landscapes. We are committed to evidence‐based practice, practice that is derived from the best knowledge available. We would simultaneously stress the importance of ‘holding environments’ to promote effective learning. Our experience suggests that Action Learning offers a constructive method for encouraging such environments and facilitating better practice.