Thomas Coram Foundation for Children

Thomas Coram Foundation for Children Inspection report for voluntary adoption agency

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Unique reference number SC048496 Inspection date 07/03/2012 Inspector Rosemary Chapman Type of inspection Social Care Inspection

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Setting address Coram, 49 Mecklenburgh Square, LONDON, WC1N 2QA

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Telephone number 0207 520 0383 Email adoption@coram.org.uk Registered person Thomas Coram Foundation for Children Registered manager Alice Kathleen Noon Responsible individual Henriette Jeanne Kaniuk Date of last inspection 22/10/2008 Website: www.ofsted.gov.uk

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This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

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You can obtain copies of The Children Act 2004, Every Child Matters and The National Minimum Standards for Children’s Services from: The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop

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About this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000.

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About this inspection

This report details the main strengths and any areas for improvement identified during the inspection. The judgements included in the report are made in relation to the outcomes for children set out in the Children Act 2004 and the relevant National Minimum Standards for the service.

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The inspection judgements and what they mean

Outstanding: this aspect of the provision is of exceptionally high quality Good: this aspect of the provision is strong Satisfactory: this aspect of the provision is sound Inadequate: this aspect of the provision is not good enough

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Brief description of the service

Coram is a voluntary adoption agency, registered to provide domestic adoption services and adoption support services, including birth records counselling and intermediary work.

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Brief description of the service

The London office comprises an adoption placement and support team serving adopters within a 35 mile radius of central London north of the river Thames, and a 10 mile radius of central London south of the river Thames. The team recruits, prepares, assesses and approves applicants who wish to adopt children from this country. It works in partnership with local authorities to place looked after children with adopters approved by Coram.

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Brief description of the service

The team provides a range of post adoption support to adoptive families, and others affected by adoption, where the agency was originally involved in the adoption. This includes access to information, intermediary services, and counselling to adopted adults and birth relatives seeking information about, or contact with, their adopted relative.

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Brief description of the service

The agency has a concurrent planning project, which is also subject to inspection as a fostering service, and service level agreements with the London Borough of Harrow, Cambridgeshire and Kent to improve permanence planning and reduce delay in placing children for whom an adoption placement is sought. Last year the London office placed 34 children with their approved adopters.

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Summary

The overall quality rating is outstanding.

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Summary

This is an overview of what the inspector found during the inspection.

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Summary

This is an outstanding adoption agency in all respects. Robust assessments of adopters and excellent matching processes ensure children are kept safe and their needs are met very effectively in stable, loving families. The agency is passionate about placing children as young as possible in stable adoptive families to achieve the best possible outcomes. This is exemplified by the Harrow project, which has been extremely effective in supporting early decisions to place children for adoption and in reducing the time children wait for adoptive placements, resulting in prompt and appropriate stable placements. Likewise, the concurrency project is extremely effective in reducing delay and providing stability for younger children. This results in outstanding outcomes for children, who make very good progress in stable and secure families. Extremely well-developed safeguarding practices ensure the agency responds appropriately to any such issues, and develops its practice in response to

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Summary

Children and their adoptive parents receive outstanding levels of adoption support, which is lifelong and very effective in ensuring that placements do not disrupt despite some very challenging situations. This includes a range of therapeutic support which can be accessed without delay.

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Summary

The agency is child focused and engages extremely well with children, particularly in relation to adoption support. It was able to identify four young people to meet with the Children's Minister to give their views on adoption and thus influence national policy. It also uses formal and informal feedback from children to develop its own practice.

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Summary

The agency is very committed to obtaining and acting on feedback from all its service users and to ensuring that research informs and improves practice, and therefore outcomes for children, both internally and at a national level. Excellent managerial monitoring systems at all levels, combined with a committed, well qualified and well supported staff team, ensure a high quality service is consistently delivered for the benefit of all, but particularly for children. This is confirmed by the very high level of satisfaction expressed by stakeholders and service users, both adults and children.

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Summary

One shortfall has been identified as a result of this inspection. This relates to ensuring assessments of adopters are brought to the adoption panel within eight months of their formal application to adopt, to improve the timeliness of approvals and increase the availability of adoptive families for children who wait.

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Improvements since the last inspection

At the previous inspection, one requirement and eight recommendations were set. These have all been satisfactorily completed. Complete information is now obtained on all members of staff; the application to adopt is now taken prior to preparation; local authority checks are taken over 10 years; and documentary improvements have been made to information from adopters, panel minutes, policies and procedures, and the children's guide. These changes have improved and developed the service for children and adopters.

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Protecting children from harm or neglect and helping them stay safe

Outstanding arrangements, both procedural and implemented in practice, ensure that children feel safe and are safe in their adoptive families. Children are placed with families who have been recruited and assessed to ensure they are safe and competent people to undertake the task of adoptive parenting with skill and sensitivity. The preparation and assessment processes are extremely thorough, and address issues such as social networking and child development, so adopters understand appropriate ways of ensuring safe care. A social worker commented that a child felt safe from the very beginning because of the firm boundaries in place in the adoptive family.

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Protecting children from harm or neglect and helping them stay safe

Children's health needs are very well met. Adoptive parents ensure children are promptly registered with local primary health care services such as the doctor and dentist. They also demonstrate an enormous commitment to accessing appropriate specialist services, such as the child and adolescent mental health service, or dietary advice, to ensure children thrive. For example, one child had a very restricted diet, but with the advice and support of the Coram social worker and other professionals, the child now eats a greater variety of food, and has put on weight. A child's social worker commented about an adoptive family: ‘They are able to meet physical, emotional and social care needs with stability.’ Another social worker who placed two children with an adoptive family said: 'It’s a long haul but the progress is incredible, their health is great, they do activities, and get stimulation.'

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Protecting children from harm or neglect and helping them stay safe

Coram has a partnership arrangement with the London Borough of Harrow, whereby the Coram manager for this partnership chairs permanency planning meetings for children where adoption is a possibility, and tracks these children monthly to prevent drift. This means that potential adopters are identified at an early stage, preventing delay for children. All children are placed within six months of the decision to place them for adoption and there have been no disruptions for the 35 children, 40% of whom were over four years of age on placement, who have been placed during the four years this arrangement has been in place. This is extremely effective in ensuring excellent outcomes for children, by placing them promptly with families who provide stability. Children also benefit from early placement through the concurrency project which ensures they are placed with foster carers who will become their adoptive

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Protecting children from harm or neglect and helping them stay safe

parents if rehabilitation to their birth family does not occur. This means they do not have the unsettling experience of moving and re-attaching to permanent carers.

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Protecting children from harm or neglect and helping them stay safe

Children benefit from, and make very good progress in, stable placements with adoptive families who can meet their needs exceptionally well, including those relating to ability, culture and ethnicity. Family finding and matching processes are robust and help identify the right families to ensure that adopters will have the resilience and skills to meet a child’s needs. For example, the adoptive family of a child placed transracially is part of a culturally mixed community and friendship group, clearly understands the issues that the child may face in the future and is therefore able to offer a real depth of emotional and practical support. Other children are placed with families who reflect their ethnic origin as far as possible.

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Protecting children from harm or neglect and helping them stay safe

Prospective adopters have a comprehensive understanding of the needs of the child who they may adopt and the implications for them as potential parents. For example, prospective adopters can meet the Coram medical adviser as well as the local authority’s medical adviser so they have full and accurate medical information. Introductions are very well supported. Coram social workers play a full and active role and are in contact with the families on a daily basis to pick up any issues and provide advice, guidance and support. This ensures a smooth, well-planned transition for the child. A social worker expressed significant satisfaction with the way the matching, introductions and placement were carried out in relation to a child he placed. He commented that the prospective adopters were very well prepared for the initial visit, and their social worker asked very relevant questions to ensure that the child had been properly prepared and that it was the right match. More significantly,

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Protecting children from harm or neglect and helping them stay safe

the Coram social worker was proactive in considering the future and ensuring there was a contingency plan to support the placement. Introductions were handled very well and sensitively when there were some difficulties, he was kept very well informed and the social worker was extremely helpful. This child has now told him: ‘I am enjoying being part of a loving family.'

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Protecting children from harm or neglect and helping them stay safe

The agency demonstrates an excellent, proactive and thorough approach to safeguarding children. It developed an improvement plan and workforce development plan last year, which is fully implemented. All staff, including administrative staff, have regular training to ensure they have a clear and up-to-date awareness of their responsibilities to safeguard children. All staff have accessible policies and procedures, which specifically address children placed for adoption and historical abuse, ensuring that appropriate referral and action are taken in response to any allegations. This is implemented very effectively in practice, and as a result, children are safe and feel safe. The agency handles any allegations appropriately, working well in partnership with other safeguarding agencies. It has an excellent system for monitoring allegations, complaints and accidents. The senior management team receives a quarterly report so it can monitor trends, identify learning and

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Protecting children from harm or neglect and helping them stay safe

develop safe practice. For example, the vulnerability of teenage girls and social networking have emerged as themes, have been discussed at senior management level and as a result, additional training for staff and adopters was arranged, to raise awareness and suggest strategies to keep them safe. Issues are discussed at team meetings and are a regular agenda item so this arrangement is formalised; the team also considers relevant research and findings in its journal club and through practice discussions.

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Helping children achieve well and enjoy what they do

Coram provides an exceptional level of adoption support, both post placement and once children are adopted, to ensure children enjoy and achieve in their adoptive families. Adopters are extremely well prepared so they understand the challenges of adoptive parenting, particularly how children may behave in challenging ways because of former experiences of abuse, neglect and trauma. Adopters are guided effectively to address prejudice-based bullying. As a branch, Coram provides a 12- week parenting skills course with a crèche, which adopters and children find extremely effective in helping them understand and develop strategies for managing difficulties. Adopters comment very positively about how effective this course is in helping them cope and manage behaviour appropriately, including seeing a significant reduction in challenging behaviour and a much calmer child. The crèche is a useful way for children to meet other adopted children and forge positive

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Helping children achieve well and enjoy what they do

relationships with them. It is also used effectively for some applicants to gain experience of caring for adopted children. An independent reviewing officer commented that a child was, ‘enjoying being part of a loving family, was settled, had a positive relationship with the adopters and was developing a good attachment with people able to meet all the identified needs.'

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Helping children achieve well and enjoy what they do

Children develop confidence and self-esteem and make friends with other adopted children so they have a positive view of their situation. For example, they attend the summer picnic or the crèche for the parenting skills group. Children enjoy a variety of activities in their adoptive families, for example, swimming, ballet lessons, learning to play musical instruments and singing; this improves their self-confidence, skills and sociability.

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Helping children achieve well and enjoy what they do

Coram social workers provide support to families on a needs-led basis where educational issues are identified. For example, they negotiate funding, speak to teachers on an individual or group basis, attend review meetings and appeals, and support families in finding alternative facilities. As a result, children make good progress educationally. For example, one young person is completing her A levels. Another child no longer needs extra support in school due to the progress made since being with the adoptive family. A social worker commented: ‘The progress is incredible.’ He also remarked on how good the adopters are at advocating for their child, for whom they want the best education. Social workers have recently had training in educational issues for adopted children from a renowned expert in the field, to ensure they deal effectively with such matters.

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Helping children achieve well and enjoy what they do

Adoptive families receive a letter from Coram once the adoption order is granted; this invites feedback about the whole process but also informs families of the support which is available, encourages them to contact the agency in the future, and reminds families of the importance of talking to the child about their adoption. Adoptive families and children are extremely positive about the help and support they have been given and comment that they would not have been able to manage without it. One child commented: ‘Coram is fantastic’, and a young person said Coram is ‘extremely helpful and very nice’. Coram has access to a multidisciplinary team, at the Tavistock clinic, which includes a child psychiatrist, family therapist, social worker and psychologist, all of whom have an excellent knowledge of adoption and fostering issues. This complements the work of the social workers from Coram. As well as the

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Helping children achieve well and enjoy what they do

12-week parenting course referred to earlier, Coram also runs a 10-week course for parents of children who are reaching adolescence to help them address the issues that this brings and develop skills to manage these. Additionally, there are study days, for example, on communication and telling difficult stories, training courses, and social events, to supplement the one-to–one work, telephone advice, consultations, and story stem assessments. Adopters are kept in touch with the agency and updated on what is available by a twice yearly newsletter. Coram as an agency provides music and art therapy and this service is also available to adopted children, with a great deal of success. All of these are effective in sustaining children in placements despite some significant issues, and the disruption rate of 1.8% is well below the national average of 6% as a result.

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Helping children make a positive contribution

Although Coram is not the agency with case responsibility for the children placed with its adopters, it is extremely child focused, and proactive in eliciting and acting upon the views they express. One young person commented that Coram ‘helped me through some of the worst times of my life. They are always there to help you figure things out and find other solutions.’ Children know how to complain and contact independent people as they are provided with child-friendly information in the form of a children’s guide and complaints leaflet. A small number of young people who were adopted by Coram families were recently involved in talking to the Children's Minister about how the government can improve adoption. Coram was able to provide four young people for this extremely important consultation exercise, due to their existing active and effective consultation and involvement with them. It also uses the views of young people to inform its own practice. For example, a group of

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Helping children make a positive contribution

young people have produced a DVD about their experiences which is used very effectively on the preparation course for prospective adopters.

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Helping children make a positive contribution

Understanding a child's heritage is addressed very effectively on the preparation course, using a variety of techniques, such as a sculpting exercise, and participants writing a child's life story book from case studies. Adopters demonstrate very positive attitudes to the child's birth family as a result of their preparation and increased understanding of the issues. This in turn helps the children develop a more positive self-view and better knowledge and understanding of their past to enable them to move forward more positively. Coram staff also undertake sensitive life story work with children to help them make sense of their history, and life story books of a high quality are produced as a result of this. The agency also provides training for local authorities on how to undertake effective life story work. The feedback from participants on the course is very positive.

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Helping children make a positive contribution

Coram has developed very safe practices in relation to contact issues. This is particularly evident in relation to the use of social networking, where there are examples of Coram staff taking appropriate action when unofficial contact has been made with birth families. A young person has also raised this issue with the Children's Minister in a consultation session. It also develops effective working relationships with birth families when these issues arise. For example, a young person wanted some involvement with the birth father and this was gradually introduced with great sensitivity to all parties. Another young person had made unsolicited contact with the birth family through a social networking site and the social worker made contact with the birth family member to address the issues raised, and continues to work with both parties so that contact is effective, meets needs and improves outcomes. Contact issues, including suggestions for writing

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Helping children make a positive contribution

appropriate letters, are addressed in the preparation course. As a result, adopters view contact arrangements positively and in the best interests of the child, and some are engaged in direct contact with members of the child's birth family. Coram also manages a letterbox if adopters prefer to have this through their agency rather than the local authority. This promotes effective and safe contact arrangements for birth families and children.

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Helping children make a positive contribution

The views and wishes of birth parents are taken very seriously and influence the development of the agency. This relates more specifically to the work of the concurrency team. For example, birth parents provided feedback at the six-weekly reviews that they were concerned about the use of different contact workers; as a result, the team has improved consistency in contact workers. The team has also developed naming ceremonies through discussion with birth parents, who want to be involved in a Christening-type event but without the religious beliefs which underpin it. This is carried out extremely sensitively and provides birth parents with an excellent memory of a significant event with which they were involved. Coram social workers work effectively with birth parents to help them provide appropriate information for the child's life story book, so that children have as much information as possible about their life prior to being adopted. They will also engage with other

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Helping children make a positive contribution

agencies who are involved with birth parents, for example, if birth parents have learning disabilities, so they provide a consistent and more effective service.

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Helping children make a positive contribution

Coram works with a very small cohort of people in relation to intermediary services and access to information. Although this work is limited, it is undertaken with sensitivity and professionalism, by a worker who is very skilled and knowledgeable about the potential difficulties and issues, which promotes the safety and well-being of all parties.

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Organisation

The recruitment of adopters is focused on assessing and approving those families who have the emotional resilience to care for children with the most challenging needs, some of whom are from minority ethnic backgrounds. The agency is very successful in approving a diverse range of adopters, from a variety of ethnic backgrounds and family situations, for example single adopters and same sex couples, reflecting the community where the agency is based. They have enlisted the expertise of minority ethnic adopters to provide them with advice and support in targeting communities and faith groups as a means of making this even more successful. Currently one third of approved adopters are from a non-white British background. It is proactive in developing its strategy based on recognising which children may need an adoptive placement. For example, it has recently developed its website to encourage applicants who want to adopt younger white children, in

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Organisation

response to the increasing numbers of these children who require adoptive families.

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Organisation

Enquirers, of which there are over 500, are given information very promptly and within the timescales, to enable them to make an informed choice about whether they wish to proceed. This includes written information, an information evening and an initial visit. The preparation and assessment of adopters are extremely thorough, exploring areas such as dealing with difference, bullying, and behaviour, with practical advice on how to deal with these issues. Adopters comment that the preparation is 'first class'. Social workers from local authorities who have placed children with Coram adopters comment universally about how well prepared the adoptive families are. In response to feedback from adopters, the number of preparation sessions has increased from four to five to cover the information in a less hurried fashion. Additionally, there are then two further sessions for adopters who wish to be concurrent carers, and a separate two sessions for adopters taking older

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Organisation

The adoption panel is properly constituted with a diverse range of appropriately skilled, knowledgeable and experienced members from the central list who make very thorough and carefully considered recommendations about the suitability of prospective adopters. The majority of assessments are considered by the adoption panel within the eight-month timescale, although all assessments are completed within 12 months unless there is a significant area which requires further exploration. This shortfall is being addressed by the agency and has resulted in recent improvements in timeliness. For example, sessional workers have been appointed who can also undertake family finding as well as adopter assessments and there is senior management approval for the appointment of a worker to concentrate on post adoption support, so that other social workers are freed up to work on assessments. The panel provides a very rigorous report to the agency on the outcomes and quality

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Organisation

of the work and has formal meetings to provide feedback and drive improvement. The agency decision maker makes a very thorough and considered decision based on all the reports and the minutes and is very clear about how this is documented, in line with the guidance. This provides excellent accountability.

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Organisation

The agency has a clear, child-focused, comprehensive and up-to-date Statement of Purpose, with a picture of a diverse group of children on the front cover, reflecting the children for whom Coram provides families. This is readily available to staff and service users so they are clear about what the agency hopes to achieve. This is underpinned by comprehensive policies and procedures which give clear and consistent guidance to staff about their roles, responsibilities and practice issues. There are two children's guides which are suitable for a variety of ages and abilities and can be customised to reflect the child's particular situation, for example, if they are in a family with two mums. They are well written, accessible and contain information in an appropriate form, so that children using the service know what to expect and what they can do if they are unhappy.

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Organisation

A highly knowledgeable, skilled, and experienced agency manager provides very effective leadership to the branch manager and staff. Staff and managers are very well qualified, most having a post-qualification award, and many have worked for the agency for a number of years. Staff and members of the central list are recruited by thorough procedures to ensure their suitability to work with children and other service users and promote safe practice. They are all extremely knowledgeable, skilled and passionate about adoption and are very well supported by regular and effective supervision of a very good quality, and access to consultation with a psychologist. There is a real emphasis on developing staff. For example, staff initiated a journal club, whereby they read and discuss a relevant article over lunch. They also access very relevant training, both internally and externally, and have case discussions on a two-weekly basis. For example, there is an in-house training session

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Organisation

on moving pre-verbal children, and findings from longitudinal research, with external speakers. As an agency, Coram holds regular Coram Talks discussions, a recent one focusing on Lesbian, Gay, Bisexual and Transgender issues. These measures mean that they provide a very effective service to families and children. Staff have commented that they are 'proud to work for an agency with such high professional standards.'

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Organisation

The whole staff team is extremely committed to providing an adoption service of exemplary quality, and do this through rigorous monitoring processes and feedback from service users, which inform developments to the service. Service users are asked for feedback following any involvement with the service, and this is monitored and evaluated by the manager, the head of service, senior managers and the trustees, and used to drive improvements. For example, the number of preparation sessions has been increased as a result, and panel has also looked at its practices as a result of feedback. All Coram service users, including young people, are invited to an annual workshop to give their views. Their attendance is facilitated by the provision of lunch, transport costs, interpreting services, crèche and childcare costs, which shows the importance the agency attaches to this event, and its welcoming and inclusive ethos. The agency, through its research department, recently sought

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Organisation

the views of adopters over the last 10 years. Only two out of 108 responses raised any concerns and these were rigorously followed up by the manager to learn from and improve practice. Learning from research underpins the ethos and practice of the agency. It also uses this to inform national practice; for example, it has produced practice notes on concurrent planning and contact, and provides training for local authorities. Additionally, senior members of staff are involved in consultations and practice developments nationally.

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Organisation

The agency and this branch excel at working in partnership with other agencies, and in particular local authorities. The branch is responsible for working with the London Borough of Harrow to provide the majority of its adoption functions. This has been extremely effective, and a recently commissioned independent report comments on significant improvements for children in timeliness and stability of placements, as well as value for money. Coram has recently provided a manager for another local authority and is working with others to see how they can help improve practice and outcomes for children. Coram has been commissioned by the Department for Education to provide consultation, along with another voluntary organisation, to look at how 13 local authorities can improve their adoption services. Additionally the agency works well on an individual level with children’s social workers, who are effusive in their praise. One social worker commented: ‘They are good and easy to

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Organisation

The manager has very effective systems for monitoring the day-to–day work of the social workers. She provides a very high level of managerial oversight in relation to case file recording, which is not only an audit tool but also offers very reflective guidance to improve practice. Senior managers also have effective means of monitoring. For example, all safeguarding issues, complaints and accidents are monitored on a quarterly basis, and themes identified with ways to address these.

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Organisation

The agency is financially viable. Coram has a challenging development plan to drive forward improvements. It reports regularly to the trustees on the outcomes for the service and to ensure its financial viability so that a continuity of service is provided. The premises are appropriate for the purpose and provide sufficient space for staff to work in, and comfortable meeting rooms so service users and other visitors feel welcomed and valued. The administrative support is very effective, records are well maintained to give an accurate account of the work undertaken, and are kept in secure conditions to promote their confidentiality.

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Organisation

The promotion of equality and diversity is outstanding. All documents have images which promote inclusivity. This ethos is implemented in practice through the agency's recruitment of a diverse range of adoptive parents who reflect the community, and its welcoming and facilitative arrangements. The agency places children with a wide range of complex needs, including those relating to ability and culture, and is able to match these children with families who meet their needs exceptionally well.

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Recommendations

To improve the quality and standards of care further the registered person should take account of the following recommendation(s):  ensure the adoption panel makes a considered recommendation on the suitability of a prospective adopter to adopt within eight months of receipt of the prospective adopter’s application to be assessed. (NMS 17.7)

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