Placement Stability and High Quality Referrals (children looked after)

Referrals for children and young people entering the care system in England's authorities are a catalyst for change. They mark the divide from one form of family life, however dysfunctional that may be, to a different concept of family life. A single referral may be the catalyst that provides a young person with the means to flourish.

Stability of home life, security, a loving family, continuity of education, friendships and significant relationships are at the heart of the care system, yet frequently these are problematic to attain, or may elude a young person for the duration of their life in care.

For some young people, referrals are an ongoing feature of their care journey. Every addition or subsequent revision adds a layer of complexity, extends the chronology of care or escalates the levels of placement risk.

Finding ways to increase placement stability through high quality referrals and placement matching, is imperative to providing longer term security and improved outcomes for children in care.

The following is an extract from a training programme on writing high quality referrals. It draws on the views of stakeholders, from young people, to social workers, placement officers, foster carers, residential setting managers and more. It is one outcome from a systems review of a West Midland's Council's children's services (2021), with significance for all authority's facing a myriad challenges around placements, capacity, stability and longer term outcomes.

A reports that he's desperately unhappy in the current placement.

Social Worker, Referral content.

The Referral Audience

The present and future audience for social care referrals is significant, and ever expanding. It is not a static document existing for a single purpose at a fixed point in time. It is a living document, constantly evolving with potential to be viewed by a wide audience, including the young person at the heart of the referral.

Exposure to individual referrals is extremely varied. Some within its audience may read very few referrals. Think in-house Foster Carers with long term placements. Others may skim read up to a 100 referrals a day from multiple authorities, all requiring urgent decisions in the absence of good discussions and wider contextual evidence. Small independent fostering agencies may read a handful of referrals from individual authorities sporadically, whilst running at 95% capacity.

Weighting Given to Referrals

What was striking in stakeholder discussions, was the different weighting given to referrals in decision making. For some, conversations by phone, meeting the child in person, or other communications, are more influential than the referral in a decision to offer a placement. For others, the referrals is the single and most decisive factor in decision making.

It's not always about what's written down. I want to speak to other significant people - their school or therapist. I can gain a lot more information about the child's holistic needs. Speaking to the IRO (independent reviewing officer) is also helpful. Independent Fostering Agency

Placements Moves and Mental Health

Frequent placement moves are linked to poorer mental health and a lessened sense of belonging. They can also impact on capacity to access specialist support, particularly where the placement moves take a child out of their home authority. The stop-start nature of interventions is a challenge faced by many authorities, creating a vicious downward spiral of reduced access to timely support, increased frequency of placement breakdown, escalation of risk factors and further deterioration in a child's mental health and wellbeing.

Robust decision making in children's social care is dependent on high quality referral content which is - accurate, specific, concise, up to date and relevant. Placement stability is more than stability of place - it is about stability of relationships, of education, of significant contacts.

Time Bounded Audits of Referrals

What information can you gain from a time bounded audit of referrals entering your referrals and placement service during a specific time? The audit is a low cost and straight forward activity with data that can be shared and analysed at team meetings and used in future service improvement planning.

In this authority, a 2-week audit was carried out. The following is a sample of data gathered from the audit:

• 20/30 referrals in the audit were for children already in the care system;
• 20/30 referrals were for young people aged between 15 and 18 years;
• 16/30 referrals were for residential placements as a first priority
• 23/30 referrals relate to a 3rd or subsequent placement request

How does the information shake up perceptions of the current reality? How does it marry up to current availability of fostering and residential care placements? Is it in line with expectations and reflect pressure points, or is this new information?

L reports that he's fed up moving placements all the time. This is causing him to be rather anxious. Social Worker. Referral statement.

Concluding Thoughts

Making time for training, for revisiting core activities and practices, is critical in the change and improvement process. Time to come together, to share, discuss, challenge and air views is important for all healthy, high performing teams. Where training content is drawn up bespoke, specific to the needs of the service or authority, capacity to really make a difference is strengthened.

Whilst this represents content from a handful of slides from a whole day's training exercise, I hope it gives food for thought, resonates, and holds meaning. Thank you for taking the time to read this article. Any thoughts and comments welcome.