The Importance of Healthy Endings for Children Looked After and Those with Care Experience

On January 16th, 2024, Ofsted published research and analysis exploring stability for children and young people with ‘complex’ needs. The 2020 Children’s Commissioners Stability Index referenced in the report revealed that between 2018 and 2019, one in four children in care experienced two or more moves of home across those years – anywhere up to 20,960 children if the rate remained the same today and a 34% increase from 2016. With many professionals citing increasing complexity of needs as the primary reason for placement instability it is important to challenge narratives, promote best practice and wherever possible ensure healthy endings for our children and young people moving home.

The 6 Categories of Need

The 6 categories of need as defined by Ofsted in the research and analysis are:

• Behavioural - when children present behaviours that can place themselves or others at risk, or that staff in homes find challenging. This includes aggressive or violent episodes and offending behaviours.
• Mental Health - the care children require to support them with their mental health and the symptoms of poor mental health. This includes supporting children who experience depression or other mental health disorders, self-harm, or suicidal ideation.
• Learning - supporting children with learning disabilities, difficulties or other characteristics that can affect their ability to engage in learning. This includes autism, ADHD, and sensory impairment.
• Safeguarding - This relates to children who have substantial safeguarding risks, and need care that can protect them from these. This includes being at risk of sexual or criminal exploitation, gang membership and going missing from their home.
• Physical - care children require to support their physical health or cater to their physical disabilities. It includes the need for accessibility adaptations, nursing-style care such as tube-feeding or administration of medications, and support with addiction or substance misuse.
• Social - supporting children to maintain relationships and engage socially with others. Including supporting contact with their family members or other people who are important to them.

Challenging Narratives

Agencies highlighted that ‘many children considered to have complex needs have had traumatic experiences that caused lasting harm’. However, we know that there has been increasing pressure on local authorities to ensure children remain at home wherever safe and possible to do so, meaning children and young people in care will have experienced anywhere from one to all of the Adverse Childhood Experiences, and have often experienced ongoing disruption, difficulties, or hardships throughout their childhood which is known to have an impact on their emotional, physical, and social wellbeing, their education and increases the likelihood of associated safeguarding risks due to vulnerabilities. This means it is reasonable for a child to have needs across these areas, and for this reason it is important to define what we truly mean when we use the term ‘complex’ and avoid undertones of blame. Reframing from ‘children experiencing changes of home (placement instability) because of ‘complex’ needs’ to ‘children experiencing changes of home because of matching and unserved or unmet needs’ is a positive way to acknowledge that needs are an expected and reasonable part of having care experience and underlining that where they were placed may not have been the best match for those needs or that needs may have changed over time.

Additionally for commissioners, placement teams and providers, frequent moves can often be seen as synonymous with a more ‘complex’ child, however this unfairly disadvantages children for whom a well-matched placement was unavailable at the time of being placed or for whom the plan was short term care.

Placement Instability and Increasing Likelihood of Moves

DFE data for 22/23 shows that there were 57,690 placement moves for children in care under the ages of eighteen, only 2150 of these are recorded as at the request of the child. 20,740 of the placements had a duration of less than eight weeks and a further 14,000 lasted less than six months. The last Stability Index published by the office of The Children’s Commissioner was in 2020, and showed at that time year-on-year increases to the frequency of placement moves for children in care. Data published by the DFE on the frequency of moves for 2022/23 indicates that a minimum of 31% of children experienced more than one move that year, however, the data presented excludes all of those in short-term arrangements or with multiple short-term moves meaning the true figure is significantly higher.

The Impact and the Lens of Lived Experience

Many Care Experienced people have shared experiences of moving in excess of ten times during their time in care and experiencing prolonged instability and change. Information from the leading mental wellbeing charities cite moving home as one of the most stressful life experiences, with adults moving an average of three times across their entire lives. Imagine the impact of sixteen moves across three years on the emotional wellbeing of a child. Each move a new home, a new area, a new set of people and a new routine to adapt to. Imagine knowing that the place you call home, can be taken away from you at any moment and you often cannot pre-empt or predict why. Things that are a normal part of childhood are used against you as a reason you can no longer stay in the home. Imagine for some of our young people that these moves are not planned, that they get use to the idea that at any moment they may need to move – so much so that they stop unpacking as they are sure this won’t last.

Reasons for moves shared by those with a lived experience of care include, falling out with other children in the home, not coming in on time for curfew, minor disagreements, spending time with birth parents, getting a lower grade at school, carer did not have enough money, carer moved home, allegations and more. The length of time young people had to prepare for moves also varied with a surprising number of children sharing they lost their home on the day or were dropped at social services office or called and told they could not come home. Children and young people have shared managing difficult emotions and feeling confused, surprised, let down, like they are not good enough and that no one would want them as a result of moves.

Frequent moves can have a significant effect on attachment, relationship building and emotional wellbeing. For this reason, it is important that all moves are handled with care and that wherever possible healthy endings are promoted alongside the avoidance of blame.

Emotional closure is refers to the process of acknowledging and accepting the emotions associated with the end of a relationship or significant emotional experience. It involves understanding and resolving any feelings such as grief, anger, or sadness. Closure can be categorised as the sense of peace, understanding and release that comes with accepting a relationship is over.

Promoting Healthy Endings

Here are some best practice ways to promote healthy endings for unavoidable moves:

• Challenge Unplanned Endings – unplanned endings without a fair notice period should always be challenged unless there is an immediate safeguarding risk for anyone involved. Planned endings create the time for meaningful conversations, preparedness and honest explorations of future options enabling children to feel part of decision making and allowing them time to come to terms with the transition and change.
• Promote Honest Conversations – It is important that changes are addressed and not shied away from, especially when it comes to a change that will impact every part of a child or young person’s life. It is important they know at the soonest opportunity and that they understand the reasons why in a child-centred and empathic way.
• Avoidance of Blame – a child should never be made to feel like their adult caregivers not being able to meet their needs or continue to care for them is their fault. It may not be the right match or home, but there is someone or somewhere out there for everyone and children should be reminded of this. It is possible to avoid blame while addressing ways to improve behaviour and coming up with ways to encourage a child to put their best foot forward with a new family or home.
• Continued Connections – foster families and children’s homes are designed to bridge the gap for children’s families and provide them with support networks and care. In traditional family networks families may have issues but they will likely speak and address issues and reiterate care but that things just did not work at a calmer time. Wherever reasonable to do so enabling children to continue the connection in the short term is a positive way to encourage a healthy ending and promote opportunities to for closure.
• Reporting and Recording with Care – Sometimes the healing from a loss doesn’t take place for some years. For this reason, it is important that reporting and recording is child-centred and provides insight and understanding as to why the move was in the best interests of the child. One day this may be the only window into understanding a significant life event such as a move.
• Allowing Children to Feel – stop expecting children to normalise and desensitise from moves. It is reasonable and rational for a child to be hurt, upset, and disrupted by a move. Enabling them to feel and supporting them through it, creating space for processing emotions and finding outlets for grief, anger or sadness is an important part of healthy endings and ensuring children process their feelings.
• Better Future Matches – placement instability does not have to be an expected part of the experience for a child in care. Every move should be analysed with lessons learned to ensure the next match or home has the highest potential of being the forever home. Stability, reassurance, and consistency is a straightforward way to work towards healing attachment trauma from moves.
• Healthy Matches Across the Board – Children have had difficult scenarios of separation, for this reason it is important to model and promote healthy endings across the board, with friends, schools, during a change of social worker and more. Enabling young people to have healthy endings wherever possible, increases their ability to manage change and manage the transitions of trusted individuals over time.

Placement instability should never become accepted as a normal part of the experience of being in care. All children deserve stable and loving homes where they can thrive, be accepted, nurtured, and encouraged to reach their full potential. Whilst it is important to know ways to promote healthy endings in the unfortunate event of a move, the best practice principle is to do everything in our power to avoid children moving unnecessarily at all.

Please see here for more information on placement instability through the lens of lived experience and ways to promote stability for children in care.

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You can see the latest CLA and placement DFE Data Here:

Childrens_social_care_in_England_2023_underlying_data.ods ( live.com ) Browse our open data, Data catalogue – Explore education statistics – GOV.UK ( explore-education-statistics.service.gov.uk )

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And can read the Ofsted research here:

How local authorities and children’s homes can achieve stability and permanence for children with complex needs - GOV.UK ( www.gov.uk )

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(This article is intended to bring together lived and learned experiences, reflections and perspectives of social work and best practice. It is not intended to represent the views or opinions of any organisation I or those referenced are affiliated with.)