The proof of the pudding: What difference does multi‐agency working make to families with disabled children with complex health care needs?

More than 20 years of research with disabled children, young people and their families has highlighted the need for the different professionals and services that support them to work more closely together. The British policy and legal framework for ‘joined up working’ has never been stronger. However, there has been an assumption that multi‐ or inter‐agency working will inevitably be a ‘good thing’ for families. This paper discusses findings from a 3‐year research project which looked at both the process and impact of multi‐agency working on families with a disabled child with complex health care needs. Interviews with 25 parents and 18 children and young people who used six developed, multi‐agency services were carried out. Findings suggested that the services had made a big difference to the health care needs of disabled children but were less able to meet the wider needs of the child and the family – particularly in relation to social and emotional needs. Multi‐agency working appeared to make some positive, but not significant, differences to the lives of families.     

My life in care: experiences of non-participation in decision-making processes

The extent to which young people are involved in legal decision‐making depends on assumptions and perceptions about their ability to participate in decision‐making in general. This paper draws on research with four young people, looking at their experiences of involvement in a variety of decision‐making processes whilst in the care of the local authority. Through narratives, games and other activities, the thoughts and emotions of the four young people are explored, identifying the development of feelings of helplessness, low self‐esteem and poor confidence that have followed the lack of opportunities made available to them to make decisions about their own lives. The efficacy and tension of corporate parenting is also explored with suggestions from the participants on how the care system could be constructed differently to facilitate their voice and that of much younger children than themselves. Thus, the debate becomes one of adult ability and preparedness to involve young people in decisions about their own lives, rather than whether they are able to participate effectively.     

Safeguarding young people through confidential advocacy services

The political agency of children and young people is gaining ascendancy as government agendas prioritize the need to listen to children. Recent guidance on inter-agency working to safeguard and promote the welfare of children and young people takes account of new research, experience, and legislation concerning abuse. In the past, children and young people have been failed by the services designed to help them, and many have been silenced through the lack of a safe space where they will be listened to and taken seriously. The development of advocacy services for children and young people has been actively encouraged by recent legislation, but many existing services tend to remain at the passive end of the advocacy continuum – advocating on behalf of rather than enabling them. This is inevitable as children continue to be marginalized in a powerful adult world. This paper examines the need for advocacy services to have clear policies of confidentiality if they are to be a credible option to young people, when services to safeguard them emphasize the importance of agencies working together and sharing information.     

Professionals' attitudes to children's participation in decision-making: dichotomous accounts and doctrinal contests

The attitude of professionals to the involvement of children in decision-making is unclear. This paper discusses a recent research study that utilized qualitative and quantitative methods to explore the views of professionals working in family support and child protection about two different aspects of children's participation in decision-making: the age at which children should make decisions and whether or not they should be involved in child protection conferences. The results showed that social workers tended to favour one of two diametrically opposed viewpoints about the age at which young people should make decisions and then in discussions with colleagues they sought to persuade others to change their perspective. Social workers who believed that young people should not make decisions until much older nevertheless thought that they should be involved in conferences whereas non-social workers did not make this distinction: for them, children who were not old enough to make decisions for themselves should not be involved in conferences. The results are discussed in the light of some of the implications for practice. The paper concludes by outlining how the results informed the design of a training pack commissioned by the Department of Health concerning the involvement of young people.     

Sons and daughters of foster carers and the impact of fostering on their everyday life

The paper presents results from a study of sons and daughters of foster carers, and the impact of fostering on their lives. Children and young people participated in focus groups and discussion groups, and 684 answered a questionnaire. Eight were interviewed in‐depth. The results from the study showed that sons and daughters of foster carers were highly involved in the fostering assignment. Most children and young people valued their relationship with foster children, but even though relations to foster children were good, fostering could imply complicated changes of everyday life. Sons and daughters of foster carers may have to cope with conflicts connected to behavioural disorders of foster children, and they gained knowledge about foster children’s problematic lives. Fostering also implied contact with natural parents of foster children. Such contact could challenge children’s and young people’s’ perception of adequate parenthood. For some respondents it was hard to become aware of the dysfunctional parenting, abuse and/or neglect to which foster children might have been exposed. The results of the study provided evidence of the need to acknowledge the contribution to fostering made by sons and daughters of foster carers, and also to recognize the impact fostering may have on their lives.     

Being counted? Examining the prevalence of looked‐after disabled children and young people across the UK

Since the 1970s, there has been growing academic interest in children and young people living in state care and, more recently, in the lives of disabled children. However, there has been little attention on the lives of disabled children who are looked after by the state. This paper compares and critiques what is known about the numbers of disabled children who are looked after in England, Northern Ireland, Scotland and Wales. We discuss the conceptual and methodological limitations of systematically collecting data on disabled children in state care across the UK. We argue that to ensure that the rights of disabled children in state care are identified, acknowledged and upheld, ‘being counted’ is a fundamental first step.     

'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.     

Children’s Participation in Child Protection Practice in Ghana: Practitioners’ Recommendations for Practice

Abstract

The United Nations Convention on the Rights of the Child (UNCRC) includes provisions to ensure that children and young people participate in decisions affecting their lives. Ghana ratified the convention in 1990 making a commitment to review its child protection policies and legislation in compliance with provisions in the UNCRC. Yet, national policies and legislation do not include practical guidelines to promote children’s participation in the child protection process. Thus, this qualitative study presents findings from in-depth interviews with 15 child protection practitioners on their views about some practical guidelines to promote children’s participation in child protection. Data from the interviews were subjected to constructivist grounded theory analysis. The study findings revealed the age of the child, separate room for children, creating a friendly environment and education as some important factors for practitioners to consider in promoting participatory practices for children. Child protection policies and legislation in Ghana should include these suggestions to ensure that children’s views are heard in the child protection process. To realize the overarching goal of achieving active child participation in child protection, further research may focus on the views of parents and children on how to develop culturally relevant strategies to promote child participation.     

Family support, social capital, resilience and adolescent coping

All too often young people are excluded in practice from the general policy and professional consensus that partnership and participation should underpin work with children, young people and their families. If working with troubled and troublesome young people is to be based on family support, it will require not only the clear statement of that policy but also demonstration that it can be applied in practice. Achieving that involves setting out a plausible theory of change that can be rigorously evaluated. This paper suggests a conceptual model that draws on social support theory to harness the ideas of social capital and resilience in a way that can link formal family support interventions to adolescent coping. Research with young people attending three community‐based projects for marginalized youth is used to illustrate how validated tools can be used to measure and document the detail of support, resilience, social capital and coping in young people's lives. It is also suggested that there is sufficient fit between the findings emerging from the study and the model to justify the model being more rigorously tested.     

Combining Work and Care: Carers' Decision-making in the Context of Competing Policy Pressures

Issues related to paid work and care are of global importance, reflecting the twin pressures of population ageing and efforts to increase labour market participation. Informal carers of sick, disabled or older people can experience tensions between policies aimed at support for care and support for employment. This article discusses a study of carers’ decision‐making around work and care, drawing on evidence from interviews with 80 working‐age carers in England. Carers are not homogeneous; their circumstances and needs differ reflecting age, gender, ethnicity, labour market participation, and the condition and/or needs of the person they support. This diversity is illustrated by contrasting rural and urban carers’ decisions and experiences about work and care. Key factors that impact on carers’ decisions are: current and anticipated financial need; the constraints arising from receipt of carers’ and other means‐tested income maintenance benefits; personal identity; job opportunities and scope for flexibility; social services provision; carers’ own health. Distance, travel times and transport are unique additional challenges for rural carers who (wish to) work. These difficulties are further intensified when they intersect with other factors such as the Carer's Allowance, the local labour market and social services provision. The findings are evaluated in terms of the adequacy of current government policy measures.     

Making a home, finding a job: investigating early housing and employment outcomes for young people leaving care

This paper presents findings from a new study of outcomes for young people leaving care funded by the Department for Education and Skills. It reports findings for a sample of 106 young people in relation to progress made in housing and employment some 12–15 months after leaving care. The generally poor employment outcomes of care leavers are acknowledged, but ingredients that make for success are also highlighted, including the value of settled care and post‐care careers, sound career planning and, significantly, the value of delaying young people’s transitions from care. Early career paths also interconnect with how young people fare in housing, in developing life skills and with other problems in their lives after leaving care. Housing outcomes were more encouraging and predominantly shaped by events after leaving care, and faring well in housing was the factor most closely associated with positive mental well‐being in young people. Some groups that are at risk of faring badly are identified, including young people with mental‐health problems, young people with persistent offending or substance misuse problems and, in some respects, young disabled people. The implications of these findings for leaving care services are considered.     

Residential care: an effective response to out‐of‐home children and young people?

The ever‐growing number of out‐of‐home children in Italy over the last decade has urged an assessment of the available care services. Although foster care is spreading rapidly, many young people are still housed in residential facilities. Reflection on residential care quality has intensified at both a national and an international level. This paper presents the results of a study on residential care facilities for children and young people in the region of Northern Italy (Lombardy). Four dimensions of ‘quality’ are considered: efficiency, effectiveness, participation in planning and intervention, and empowerment of children and their family relationships. The combined effects of these dimensions are defined as ‘relational quality’. The results show that residential care facilities are generally good, while Social Services resources often appear inadequate for interventions aimed at birth families (efficiency). The well‐being of children in residential care facilities is high, even if they tend to move from one facility to another, rarely returning to their birth family (effectiveness). The involvement of children and their families at different stages of the care path is limited (participative approach). Finally, the most critical element is the failure to properly involve birth families (empowerment).     

“Build a friendship with them”: The discourse of “at‐risk” as a barrier to relationship building between young people who trade sex and social workers

Young people in statutory care and protection interact with social workers, who hold potential to provide a supportive adult role in their lives. Many however, run away at an early age and end up on the street trading sex for money or other favours. There is potential to improve outcomes for young people in care if the relationship between young people and their social workers is better addressed. This paper uses data from a qualitative study of 14 young people who traded sex and who had experienced interactions with social workers. A thematic analysis identified three themes: the rigidity of social work practice; contesting the family situation; and resisting the at‐risk label. We argue that to have any impact on outcomes for young people in care, social workers need to prioritise relationship‐building above the need to conform to organizational protocols and guidelines. Such guidelines assist the social worker in assessing whether family situations pose high risk for a young person, but the “at‐risk” label is contested by young people, which results in a lack of trust and a barrier to relationship building.     

The good life for children: Do we really care about the trends?

How do we know if Australian children and young people are having a ‘good life‘? What about their lives compared to children and young people in other countries? To answer these questions, the Australian Research Alliance for Children and Youth (ARACY) produced a Report Card to compare Australian average, Indigenous Australian average, and international or Organisation for Economic Co‐operation and Development (OECD) average for a number of measures of child and youth wellbeing. The ARACY Report Card shows that Australian results are average when compared to other OECD countries in most areas of child and youth wellbeing. Most importantly for nearly all indicators, Indigenous Australian children fare substantially less well than the Australian average and the majority of children in other countries. It is argued that community attitudes and behaviours toward children and young people, and our society's focus on wealth creation, are detrimental to children's and young people's wellbeing. The need for a better balance between economic progress and a socially and environmentally sustainable society is discussed, along with a strategy to better meet the emotional needs of children and young people.     

The welfare state, the individual and the need for care: older people's views

The aim of this qualitative study was to study how older people experience aging and reflect on their need for care in the Swedish welfare context. Sixteen people were interviewed, aged between 77 and 92 years. Staying healthy and independent in their everyday lives were prized values for the informants. Some brushed aside thoughts of being in need of home help services in the future and others had a more reflecting attitude. The informants did not want to burden either society or their children. Through mass media and the experiences of their neighbours, they had gained a negative impression of eldercare. They were uncertain if there would be any helping hand of good quality in the future. On the other hand, informants who already had home help thought that it was helping them to maintain independence in everyday life and they were also satisfied with the help they received.     

‘It's about changing services and building relationships’: evaluating the development of Children in Care Councils

The introduction of Children in Care Councils under the Care Matters reforms in England set a challenge for local authorities to find effective ways by which children in care could contribute their views to the planning and provision of services. This paper discusses a review of progress across London which combined a survey of boroughs with focus group discussions with young people, local authority staff and elected members. The research found that considerable progress had been made in that virtually all boroughs had some mechanism for representing children in care, and that staff and young people were proud of their achievements. However, major challenges remain – to embed a culture of participation in services, to ensure continuity, to reach all children including the many placed ‘out of borough’ and to defend what has been achieved in the face of severe cuts in public spending. The paper highlights a tension between empowering young people and meeting targets as corporate parents. The results support other research pointing to the need for a better understanding of the relationship between participation in governance and participation grounded in ordinary life.     

Professional Advocacy as a Force for Resistance in Child Welfare

Correspondence to Jane Dalrymple, University of the West of England, Glenside Campus, Blackberry Hill, Stapleton, Bristol BS16 1DD, UK Summary The development of child and youth advocacy is a relativelyrecent phenomenon, increasingly recognized by both practitionersand politicians as a way of establishing communication spacesfor young people who are looked after in state care. Literatureto date has focused on the development and underpinning principlesof child and youth advocacy, which is a necessary starting pointfor establishing good practice. However, while policy and legislationpromote the view that young people are actively involved indecision making, their advocates can be placed in a passiveposition, effectively denying young people a position as socialactors. This paper argues that the problemitizing of independentadvocacy as unprofessional can serve to further marginalizeyoung people and render advocates impotent. It suggests thatwhile it is structurally necessary for adults to take on theadvocacy role, this must be undertaken in a way that activelyresists the oppression of young people. Through considerationof accounts of advocacy activity, by way of illustration, thepaper takes the debate beyond the principles of participation,empowerment and rights to a consideration of strategies thattake into account the complexities of advocacy practice in childwelfare.     

Enablers of help‐seeking for deaf and disabled children following abuse and barriers to protection: a qualitative study

Research internationally has highlighted the increased vulnerability of deaf or disabled children to abuse and the frequently inadequate response of services. However, first‐hand accounts of deaf or disabled children have rarely been sought. This paper reports selected findings from one of the first studies exploring experiences of deaf and disabled children regarding help‐seeking following maltreatment. Innovative and sensitive research methods were employed to support 10 deaf or disabled people (children and adults) to take part in guided conversations. The study identifies three enablers of help‐seeking of deaf or disabled children: the capacity of adults to detect abuse and respond to disclosures, supportive relationships or circumstances which facilitate disclosure and for Deaf children, access to registered interpreters. Barriers to protection related to these are also discussed. Recommendations directed at policy makers, practitioners and families include education and awareness raising amongst practitioners, children, parents and carers; addressing isolation of deaf and disabled children; providing comprehensive support services that address the needs of the child holistically; ensuring that the voice of the child is heard; routine access to registered interpreters for Deaf children within mainstream and specialist services and measures to address disablism at local and institutional levels.     

Participation in social,leisure and informal learning activities among care leavers in England: positive outcomes for educational participation

Against a background of research and national statistics that consistently show that educational participation and achievement of young people in and leaving care is significantly lower than is the case for the non‐care population, previous research has shown the positive impact that social, leisure and informal learning activities can have on the educational participation and achievements of young people, and particularly those from disadvantaged backgrounds. The UK: Care Matters Green Paper stated that involvement in leisure and social activities can have a positive impact on the self‐esteem of young people in and leaving care and upon their educational attainment and later success in the labour market. This paper reports on the English results of a cross‐national study of young people from a public care background and their pathways to education in Europe. Using case study examples it explores the impact that social, leisure and informal learning activities can have on educational participation and educational pathways of young people in and leaving care. The paper argues that, in view of these findings, encouraging and supporting young people in and leaving care into these types of activities should be a priority for social care professionals, carers and teachers.