Setting

X10029.doc Version 1.40 Page 1 FOSTERING SERVICE

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MK9 3HS

Lead Inspector Mr Rob Smith Announced Inspection 13th November 2006 09:30 Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 2 The Commission for Social Care Inspection aims to:

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MK9 3HS

• Put the people who use social care first • Improve services and stamp out bad practice • Be an expert voice on social care • Practise what we preach in our own organisation

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MK9 3HS

Reader Information Document Purpose Inspection Report Author CSCI Audience General Public Further copies from 0870 240 7535 (telephone order line) Copyright This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Internet address www.csci.org.uk Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 3 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Fostering Services. They can be found at www.dh.gov.uk or obtained 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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MK9 3HS

Every Child Matters, outlined the government’s vision for children’s services and formed the basis of the Children Act 2004. It provides a framework for inspection so that children’s services should be judged on their contribution to the outcomes considered essential to wellbeing in childhood and later life. Those outcomes are: • Being healthy • Staying safe • Enjoying and achieving • Making a contribution; and • Achieving economic wellbeing.

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MK9 3HS

In response, the Commission for Social Care Inspection has re-ordered the national minimum standards for children’s services under the five outcomes, for reporting purposes. A further section has been created under ‘Management’ to cover those issues that will potentially impact on all the outcomes above.

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MK9 3HS

Copies of Every Child Matters and The Children Act 2004 are available from The Stationery Office as above This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 4

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Name of service

Address Saxon Court 502 Avebury Boulevard Milton Keynes Bucks MK9 3HS

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manager (if applicable)

Type of registration Local Auth Fostering Service Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 5

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Conditions of registration:

Date of last inspection 7th November 2005

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Brief Description of the Service:

This was an inspection of the fostering service run by Milton Keynes Council which is a unitary authority covering the town of Milton Keynes and its immediate environs. The service was supporting approximately 140 foster care placements at the time of this inspection, covering a range of specific functions. These included short, longer term and permanent fostering placements and a short break fostering scheme for children with disabilities. A significant number of the short and longer-term placements were family and friends placements, where children were placed with members of their extended family.

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Brief Description of the Service:

The fostering manager and staff team were centrally located in Milton Keynes, sharing office space with the main social services teams of the local authority.

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Brief Description of the Service:

As this was a local authority fostering service no information on fees charged for placements has been included, as this would not be relevant. Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 6

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SUMMARY

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

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SUMMARY

This was an announced inspection that took place over a period of five days. The inspection involved

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SUMMARY

• Consideration of key data and self-assessment information provided by the local authority

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SUMMARY

• Analysis of questionnaires returned by carers (33) and young people (29)

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SUMMARY

• Interviews with fostering management, development and frontline social work staff

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SUMMARY

• Attendance at fostering team and allocation meetings

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SUMMARY

• Attendance at a fostering awards evening

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SUMMARY

• Visits to four foster households to talk to carers and young people

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SUMMARY

• Observation of the Fostering Panel and an interview with Panel Chair

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SUMMARY

• Scrutiny of a sample of staff, carer and child files

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SUMMARY

Verbal feedback was given at the close of the inspection to senior managers.

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What the service does well:

The service provides foster placements that offer a very good standard of direct care for young people (25 of the 29 young people who submitted questionnaires said they were always well looked after).

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What the service does well:

The overall level of support for carers is good ensuring the quality of placements for young people is sustained.

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What the service does well:

Attention to young’s people’s health and developmental care needs is very good.

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What the service does well:

The service has good systems in place to ensure young people are kept safe as far as possible in placements.

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What the service does well:

The Fostering Panel is well run and carries out its responsibilities effectively to ensure assessments and reviews of carers are thorough and children are safeguarded. Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 7 The management of the fostering team ensures effective deployment of available staff resources to meet the needs of carers.

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What the service does well:

There is commendable investment in family and friends fostering placements, as part of the local authority’s commitment to maintaining family network and relationships for looked after children.

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What has improved since the last inspection?

There have been increases in staffing establishment within the fostering team and a dedicated administrative support team is being introduced to ensure more adequate resources to run the service.

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What has improved since the last inspection?

Access to therapeutic services for carers and young people from local child mental health services had been made simpler and quicker providing better support for this area of need.

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What they could do better:

The service needs to continue to develop a broader range of fostering resources to enable scope for more considered placement choice and matching.

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What they could do better:

Better attention needs to be paid to the evidencing and recording of placement planning, placement agreements and matching processes to ensure these processes are carried out as fully as possible.

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What they could do better:

Specific safe caring guidelines for each foster household need to be introduced to ensure the safety and welfare of placed children and foster families are safeguarded as fully as possible.

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What they could do better:

The quality of record keeping in children’s files needs improvement and more consistent monitoring. This includes more consistent attention to the holding of personal education plans for young people.

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What they could do better:

The local authority needs to keep the adequacy of staffing levels in the fostering team under close review to ensure resources are adequate to meet the fast growing work demands.

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What they could do better:

The Fostering Panel would benefit from a permanent ‘home’ to ensure its running is subject to minimal disruption.

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What they could do better:

Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 8

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CONTENTS

Statutory Requirements Identified During the Inspection Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 9

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The intended outcome for this Standard is:

• The fostering service promotes the health and development of children.(NMS 12)

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The Commission considers Standard 12 the key standard to be

inspected at least once during a 12 month period.

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JUDGEMENT – we looked at the outcome for Standard:

Quality in this outcome area is excellent.

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JUDGEMENT – we looked at the outcome for Standard:

The service helped ensure foster carers appropriately promoted the health and development of placed young people

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JUDGEMENT – we looked at the outcome for Standard:

This judgement was made using the available evidence including a visit to this service

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EVIDENCE:

The service had good systems in place to evaluate and subsequently monitor the health care needs of placed young people. The Looked After Children’s (LAC) nurse was a key part of the fostering team, attending both allocation and team meetings, to ensure health care needs were identified and followed up. There was good liaison via this post with the local primary health trust to ensure good initial assessment and subsequent follow-up, where necessary, of placed children’s health care and developmental needs.

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EVIDENCE:

Provision of detailed health backgrounds was noted by carers to be variable, reflecting some inconsistency in the quality and depth of information provided about placed young people at the time of placement, although was out of the immediate control of the fostering service itself. (This issue is addressed more fully later in this report). Older young people were provided with a Health Fax folder that provided key information on a range of health matters, details of other agencies to contact for advice and scope for recording of personal health needs and development.

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EVIDENCE:

Feedback from young people’s questionnaires showed good attention paid by their carers to their health, and to promoting a healthy lifestyle through diet and exercise. Young people’s and carers’ files sampled during this inspection showed consistent evidence of prompt GP and dentist registration following Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 10 placement and good attention to regular routine screening of eyesight and dental health checks etc. The LAC nurse was also available to offer particular advice to carers with children with complex health issues and to facilitate access to specialist services, if required.

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EVIDENCE:

Placed young people had access to a range of support, advice and mental health input from the local Child and Adolescent Mental Health services. Recent health authority changes to referral routes and the tiering of such services was aimed at supporting quicker and better targeted referral and response than had previously been the case.

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EVIDENCE:

Training in areas of first aid, health and safety, developmental issues and sexual health were available to carers as part of the service’s training framework.

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EVIDENCE:

The local authority was also currently in the process of developing a range of clearer expectations around smoking in carer households to minimise the potential health risks to placed children. Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 11

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The intended outcomes for these Standards are:

• Any persons carrying on or managing the service are suitable. (NMS 3) • The fostering service provides suitable foster carers.(NMS 6) • The service matches children to carers appropriately.(NMS 8) • The fostering service protects each child or young person from abuse and neglect.(NMS 9) • The people who work in or for the fostering service are suitable to work with children and young people.(NMS 15) • Fostering panels are organised efficiently and effectively.(NMS 30)

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The Commission considers Standards 3, 6, 8, 9, 15 and 30 the key

standards to be inspected at least once during a 12 month period.

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JUDGEMENT – we looked at outcomes for the following Standard(s):

The persons carrying on the service were judged to be suitable with a clear focus on ensuring best outcomes for young people.

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JUDGEMENT – we looked at outcomes for the following Standard(s):

Appropriate processes were in place to ensure foster households were safe places for young people.

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JUDGEMENT – we looked at outcomes for the following Standard(s):

Within the constraints of the current range and level of placements available service good attention was paid to matching but resource limitations meant some aspects of matching and placement choice were often limited.

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JUDGEMENT – we looked at outcomes for the following Standard(s):

Clear and effective systems were in place to minimise the likelihood of children suffering abuse and neglect in placement.

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JUDGEMENT – we looked at outcomes for the following Standard(s):

Appropriate and thorough recruitment and assessment processes were in place to help ensure staff and carers working for the service were suitable people.

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JUDGEMENT – we looked at outcomes for the following Standard(s):

The fostering panel was working effectively to ensure the quality and consistency of foster placements and working practices.

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JUDGEMENT – we looked at outcomes for the following Standard(s):

These judgements were made using the available evidence, including a visit to this service. Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 12

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EVIDENCE:

The service was run by the unitary authority of Milton Keynes, and the senior managers, and the more immediately responsible fostering manager, were judged at previous inspections to be suitable people to carry on the service. No changes to personnel at these levels had occurred since the last inspection nor had concerns arisen about their suitability. Systems were in place for regular renewal of CRB checks for these and other staff and for carer household members.

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EVIDENCE:

Initial assessment and ongoing annual review of carer households incorporated detailed assessment of the safety and suitability of carer households with regard to the physical environment, pets, storage of medicines and alcohol etc. Copies of such assessments were seen on carer files and referred to in Fostering Panel meetings and paperwork observed during this inspection. In the carer households visited this year no evident health and safety concerns were noted.

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EVIDENCE:

Unannounced visits were being conducted by fostering staff to check on the care provided in foster households and the safety of the physical environment.

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EVIDENCE:

Matching procedures for consideration of long-term or permanent fostering placements were clear and effective. Good examples were seen on files of detailed matching reports for carers and young people. Observation of Panel, which now took on permanent fostering placement matching approval, and scrutiny of recent minutes confirmed this newer area of Panel practice was addressed conscientiously.

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EVIDENCE:

Files seen, and discussion with carers, indicated matching processes for Family Link respite placements for children with disabilities were equally well thought through, with scope for gradual introductions and liaison and information sharing between family link carers and birth families to ensure the match was as ‘right’ as possible.

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EVIDENCE:

The scope for accurate and considered matching with regard to mainstream shorter notice and emergency placements was less extensive. Figures provided by the local authority about the nature of placements indicated a growing weight of very short-notice or emergency placements. This was in part attributed by the local authority to the emphasis placed on keeping children at home or in family networks as long as possible with resultant increase in significant breakdown at the last moment.

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EVIDENCE:

While feedback from carers and family placement staff indicated that care was taken to ensure, as far as possible, carers stayed within their approval categories when considering short-notice placements, there was evidence of Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 13 growing use of exemptions to place children outside of carer approval category. For example there was evidence of short-term emergencies being placed with Family Link carers. Such placements were not undertaken in an unconsidered way, and due account was taken of carers’ views before any such placements were made. Exemptions were also monitored by Panel, which was required to formally ratify any longer-term exemption situations. However the situation did highlight the pressure on carer resources in the local authority in that the scope and range of carer capacities were often being pushed to the

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EVIDENCE:

The potential problems related to the matching process for short notice and emergency placements were exacerbated by the occasional inadequacy of information provision and considered and recorded placement agreement processes. This was evidenced in feedback from carers in person, in questionnaires and from the sample of children’s files seen. These files often lacked the complete set of LAC documentation, including signed and fully completed placement agreements drawn up with carers. In the absence of such documents it was difficult to judge whether specific shortfalls in placement matching, and their resolution, had been identified and raised questions about the thoroughness and consistency of initial placement planning processes.

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EVIDENCE:

Detailed procedures and guidance were in place for staff and for carers on child protection matters and responses to allegations and concerns. Training for staff and for carers in these areas was also satisfactory, covering safe care, safeguarding and promoting children’s welfare, management of disclosures and specific areas such as the role of male carers and working with sexually abused children.

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EVIDENCE:

Carers spoken with were aware of their responsibilities to ensure safe care and to respond promptly to any concerns arising. One very recently approved carer spoken with during this inspection had had to manage a serious disclosure at the early stages of placement and records showed this had been managed well and in line with procedures and guidance.

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EVIDENCE:

Ongoing notification to, and liaison with, CSCI since the last inspection confirmed that when serious concerns arose appropriate procedures were initiated to secure the immediate safety of children in placement. One particularly serious incident since the last inspection, involving serious injury to one young person, was still subject to internal investigation and review however the inspector was reassured this was being undertaken thoroughly and conscientiously by the local authority.

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EVIDENCE:

One area that did need further development was that of safe caring guidelines for carer households in line with standard 9.3. While feedback from staff and carers and scrutiny of records indicated that current practice was safe in these areas, with cares aware of the steps they might need to take, the Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 14 establishment of clear guidelines for each household will help further safeguard the welfare of placed young children carers and, where relevant, carers’ own families.

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EVIDENCE:

Detailed complaints procedures were in place for carers and for young people. Four formal complaints had been made since the last inspection relating to various aspects of the current service and in one case to historical allegations of poor care provision. Records seen indicated these had been fully and openly investigated and appropriate actions taken in response. In two of the cases the complaints were found be partly substantiated. None involved serious concerns about the current welfare of placed children.

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EVIDENCE:

Procedures for staff recruitment were sound and appropriate documentary evidence of necessary checks being carried out was seen on a sample of staff files.

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EVIDENCE:

Carer files and associated Panel papers showed that assessments of new carers were thorough, covering all required areas under the standards. Carer feedback reinforced the view that assessments were appropriately challenging and probing. Observation of Panel proceedings confirmed that the quality and consistency of assessments were robustly tested by the Panel process.

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EVIDENCE:

The Fostering Panel was appropriately constituted with a suitable range of fostering service and independent members. The Panel Chair, who was unchanged since the last inspection, was appropriately skilled and experienced in managing the business of the Panel. Observation of the Panel confirmed it carried out its role effectively in respect of individual approvals and reviews and in relation to overall monitoring of service quality and sufficiency. Panel administration was well supported with a high quality of record keeping.

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EVIDENCE:

The Panel did not currently have a permanent ‘home’, due to office refurbishments within the local authority. Repeated changes of venue were disruptive to the smooth running and administration of the Panel and made the provision of suitable facilities for attending workers and carers difficult to provide consistently. The local authority was advised to ensure provision of a regular consistent venue, once office refurbishments are complete. Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 15

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The intended outcomes for these Standards are:

• The fostering service values diversity.(NMS 7) • The fostering service promotes educational achievement.(NMS 13) • When foster care is provided as a short-term break for a child, the arrangements recognise that the parents remain the main carers for the child.(NMS 31)

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The Commission considers Standards 7, 13, and 31 the key standards

to be inspected at least once during a 12 month period.

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JUDGEMENT – we looked at outcomes for the following standard(s):

The fostering service helped ensure the diverse needs of young people were recognised and addressed in placements.

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JUDGEMENT – we looked at outcomes for the following standard(s):

Good support was offered by the service to ensure young people’s educational achievement was promoted and celebrated.

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JUDGEMENT – we looked at outcomes for the following standard(s):

Respite care arrangements for parents were clearly aimed at ensuring birth parents primary responsibilities as carers were not undermined

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JUDGEMENT – we looked at outcomes for the following standard(s):

These judgements were made using the available evidence including a visit to this service

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EVIDENCE:

The local authority had a clear overarching policy and strategy in place aimed at addressing the increasingly diverse needs of the growing population of the city. This was supported by clear policy guidance on the impact and implementation of equalities legislation and good practice in relation to issues of race, culture, gender disability etc.

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EVIDENCE:

Within the fostering service increasing recruitment of carers from minority ethnic backgrounds was aiming to increase the range of choice of placements to support racial and cultural matching wherever possible. Figures provided by the local authority indicated that the percentage of minority ethic carers at Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 16 least matched that of the typical referral range of young people from similar backgrounds.

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EVIDENCE:

Where feasible, matching on grounds of race, culture and language was sought, though not always achieved, due to the overall pressures on placement availability. Feedback from staff and carers was that advice and support was offered for carers in meeting diverse racial, cultural and linguistic needs that they might be unfamiliar with, although, as with other areas of matching consideration, this was not always explicitly addressed in records as part of placement planning and matching processes. Carer feedback in questionnaires indicated these matters were addressed thoroughly by the fostering service.

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EVIDENCE:

Training on diversity issues was offered as a key part of both carer and staff training and addressed in guidance to carers in their handbook.

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EVIDENCE:

Support for children with disabilities was primarily offered through the respite Family Link service. Carers spoken with indicated good attention was paid to planning for, and meeting, disability needs and this was also reflected in the respective carer and child records seen for Family Link support services.

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EVIDENCE:

Feedback from young people was that they consistently received good support to achieve educationally from their carers. Figures provided by the local authority for the year ending March 2006 indicated a good level of placement of school age fostered children in full time mainstream or special education settings.

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EVIDENCE:

Carers’ own feedback was that support over educational difficulties was occasionally patchy form the education authority, though not the fostering service itself. A small number of carers were particularly concerned at what they saw as low levels of formal education input for young people excluded from school, or with very minimal required attendance levels. The local authority did have a dedicated Looked After Children’s Education Team (LACET) that carers generally found very helpful and supportive over a range of educational matters. A small number of carers were critical of the delays faced in finding appropriate full-time educational placements, which appeared to reflect more on the processes of the education authority than the LACET team itself.

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EVIDENCE:

Scrutiny of children’s files, maintained by children’s social workers, revealed inconsistencies in the keeping of Personal Education Plans (PEPs) with only one of the seven child files seen having such a document in place. While other records indicated these had been drawn up, and may indeed have been stored elsewhere, definitive copies should also be maintained on children’s individual files. Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 17 Senior managers indicated that a review of the LACET team function and associated support for looked after children’s educational needs was planned for the near future.

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EVIDENCE:

The primary direct respite support for parents in the community was the respite service for children with disabilities, Family Link. This service was incorporated within the overall fostering team structure. Feedback from some Family Link carers indicated concern about a lack of continuity of support and focus following the departure of a member of staff dedicated to that service, however this had now been addressed by the fostering service with allocation of one worker with a primary focus on support of these carers.

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EVIDENCE:

The ethos of this service, and feedback from one set of respite carers visited, confirmed that a proper focus was maintained on the continuing primary role of parents in the safeguarding and promotion of their children’s welfare. This was also reflected in a sample of Family Link files looked at.

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EVIDENCE:

The local authority was also looking at developing more comprehensive respite support by foster carers for a broader range families in the community, in addition to that offered via Family Link for children with disabilities, as part of a strategy to prevent family breakdown and possible longer-term admissions into care. This was seen as a positive and imaginative use of foster carer resources by the inspector. Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 18

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The intended outcomes for these Standards are:

• The fostering service promotes contact arrangements for the child or young person. (NMS 10) • The fostering service promotes consultation.(NMS 11)

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The Commission considers Standards 10 and 11 the key standards to

be inspected at least once during a 12 month period.

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JUDGEMENT – we looked at outcomes for the following standard(s):

The service ensured carers were aware of the need to ensure contact with families was meaningfully supported, where it was in the best interests of placed young people.

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JUDGEMENT – we looked at outcomes for the following standard(s):

Young people had a range of ways to try to ensure their views were taken account of.

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JUDGEMENT – we looked at outcomes for the following standard(s):

These judgements were made using the available evidence, including a visit to this service.

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EVIDENCE:

Feedback from young people spoken with, and scrutiny of carer and child files showed good support of, and encouragement for, family links and contacts where this had been deemed to be in children’s best interests. Carer preparatory and subsequent training covered issues to do with contact and birth family working relationships.

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EVIDENCE:

The fostering service, in liaison with children’s placing social workers, made generally satisfactory arrangements for contact visits and transportation where contact need to take place away from the carer’s home. There were however a small number of examples from carers and children where plans for contact had fallen through, or been changed at the last minute with little if any communication with or consideration for the impact on young people and their carers. The local authority indicated that plans were in hand for re-tendering of contact support services in part acknowledgment of problems that had been experienced. Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 19 Young people had opportunities to express their views and opinions through various routes. Feedback in children’s questionnaires was reassuring in the confidence that children had that they were fully involved and consulted on a

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EVIDENCE:

day to day basis in their foster homes about everyday life. They had opportunities through statutory care reviews and foster household reviews to express their views more formally about their care arrangements, and any concerns they might have about their foster placement. Young people also had ready access to an independent advocacy service contracted by the local authority, alongside good information about complaints processes. Children’s questionnaires showed nearly all respondents knew whom to approach if they were worried about anything.

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EVIDENCE:

More formal consultation and input into looked after children’s service planning processes was available via representative forums such as Young People Inc (YPInc) and care leaver groups supported by the local authority.

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EVIDENCE:

The fostering manager outlined the intention to develop a focused piece of work to gain the views of young people leaving the fostering service, to provide another avenue for more specific feedback on the quality of fostering provision. Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 20

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The intended outcomes for these Standards are:

• The fostering service prepares young people for adulthood.(NMS 14) • The fostering service pays carers an allowance and agreed expenses as specified.(NMS 29)

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JUDGEMENT – we looked at outcomes for the following standard(s):

The fostering service provided a regular and efficiently administered system of fees and allowances to support carers in providing satisfactory care for young people

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JUDGEMENT – we looked at outcomes for the following standard(s):

This judgement was made using the available evidence including a visit to this service

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EVIDENCE:

The local authority had continued to work at simplifying and improving the structure of financial support for carers so that it was transparent and consistent. Levels of financial support were continually under review to ensure both their adequacy and a reasonable degree of competitiveness with independent agencies in the area.

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EVIDENCE:

Carers did not raise any significant concerns about the adequacy of payments received and confirmed that systems for payment of allowances and reimbursement of additional expenditure ran smoothly. Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 21

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The intended outcomes for these Standards are:

• There is a clear statement of the aims and objectives of the fostering service and the fostering service ensures that they meet those aims and objectives.(NMS 1) • The fostering service is managed by those with the appropriate skills and experience. (NMS 2) • The fostering service is monitored and controlled as specified. (NMS 4) • The fostering service is managed effectively and efficiently.(NMS 5) • Staff are organised and managed effectively.(NMS 16) • The fostering service has an adequate number of sufficiently experienced and qualified staff.(NMS 17) • The fostering service is a fair and competent employer.(NMS 18) • There is a good quality training programme. (NMS 19) • All staff are properly accountable and supported.(NMS 20) • The fostering service has a clear strategy for working with and supporting carers.(NMS 21) • Foster carers are provided with supervision and support.(NMS 22) • Foster carers are appropriately trained.(NMS 23)

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The intended outcomes for these Standards are:

• Case records for children are comprehensive.(NMS 24) • The administrative records are maintained as required.(NMS 25) • The premises used as offices by the fostering service are suitable for the purpose.(NMS 26) • The fostering service is financially viable. (NMS 27) • The fostering service has robust financial processes. (NMS 28) • Local Authority fostering services recognise the contribution made by family and friends as carers.(NMS 32)

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The Commission considers Standards 17, 21, 24 and 32 the key

standards to be inspected at least once during a 12 month period.

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JUDGEMENT – we looked at outcomes for the following standard(s):

The service had an up to date statement of purpose that satisfactorily described the range of services offered.

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JUDGEMENT – we looked at outcomes for the following standard(s):

Staff in the service were very well managed, in a challenging staffing context, to meet the needs of carers and placed young people satisfactorily. Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 22 Despite some recent improvements to staffing levels and managerial responsibilities pressures on staff time had been considerable, leading, for example, to some occasional shortfalls in support for carers.

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JUDGEMENT – we looked at outcomes for the following standard(s):

The service had an overall very good strategy in place to ensure carers were well supported in providing quality care for young people.

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JUDGEMENT – we looked at outcomes for the following standard(s):

Case records for children had occasional shortfalls in key information that might impact on the continuity and consistency of care offered to them.

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JUDGEMENT – we looked at outcomes for the following standard(s):

General administrative records were well maintained, ensuring accurate records were kept of the running and monitoring of the service.

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JUDGEMENT – we looked at outcomes for the following standard(s):

The local authority continued to develop its determined focus on the role of family and friends as carers to ensure young people experienced minimum disruption of family relationships should they need to be looked after.

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JUDGEMENT – we looked at outcomes for the following standard(s):

These judgements was made using the available evidence, including a visit to this service.

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EVIDENCE:

The statement of purpose for the service was informative, up to date and covered the areas of information required by the standards and regulations. General information on being looked after in Milton Keynes and more specific information for children being fostered was also available.

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EVIDENCE:

Feedback from staff and observation of the day-to-day running of the service during the inspection confirmed that staff team was very well managed and supported by the fostering manager. There had been significant change in the team since the last inspection and, although inevitably disruptive, this period appeared to have been managed as well as possible. Some use had been made of agency and seconded staff to cover particular staffing gaps.

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EVIDENCE:

Staff felt the balance and demands of the work had been sustained despite a period of staff shortage and it was evident that confidence and morale in the team had remained high. The various potentially conflicting and growing demands on staff time appeared to be have been managed as well as possible, to avoid undue detriment to any particular part of the service. More senior and experienced staff in the team were taking lead responsibility for key specific areas of practice such as private fostering and family and friends care.

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EVIDENCE:

Permanent recruitment to vacant posts, a number of which had been filled on temporary basis was in hand in the near future, with an apparently encouragingly high level of applicants. The manager and team members Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 23 anticipated this would lead to a somewhat more settled period of staffing and team deployment.

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EVIDENCE:

Overall staffing levels did however remain under pressure. A new group manager post had been recently introduced to relieve some of the considerable range of day-to-day management responsibilities carried by the fostering manager, allowing her more time for strategic planning and service development. While this is clearly a welcomed and needed development, the rapidly increasing workload of the frontline fostering team means the local authority will need to ensure the team establishment keeps pace with demand

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EVIDENCE:

Discussions with staff and analysis of information provided by the local authority pointed to significant increases in demand for family and friends carer assessments, both as part of everyday practice and also allied to court procedures. The greater expectations of local authorities in respect of private fostering arrangements were also now generating a significant increase in workload, as did the developing pattern of increased levels of emergency or very short notice placements. Alongside these developments the team was also undertaking carer recruitment, family finding, initial assessments and preparation groups, carer training and ongoing support of fostering placements.

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EVIDENCE:

While these various tasks appeared to be largely on track at the present moment, if the overall quality and consistency of work in the fostering service is to be sustained in the future, in a context of likely further increases in demand as the local population grows, serious consideration will need to be given to increasing the team size. Consideration could also usefully to given to the possible benefit of creating dedicated sub-teams within the fostering service with a focus on key more specialist practice areas, such as family and friends care, or family finding, rather than the more generic approach adopted across the team at present.

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EVIDENCE:

Team members were appropriately experienced and qualified for the roles undertaken. Social work assistant support was provided for the Family Link service but key assessments and review tasks were undertaken by qualified staff.

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EVIDENCE:

It was good to note the imminent confirmation of a dedicated administrative support team for the fostering service, which was raised as an issue at the last inspection.

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EVIDENCE:

The fostering service had a good overall strategy in place for carer support as highlighted at the last inspection. This incorporated elements such as generally regular supervision and telephone contact, duty desk support in and out of office hours, foster carer forum, input from local CAMHS therapists and advisers on a group or individual basis, membership of the Fostering Network, carer awards, input for birth children of carers etc. Confirmation of overall Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 24 good levels of support was received in carer questionnaires, in carer interviews and in the evidence of support and supervision contained in carer files.

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EVIDENCE:

Carer feedback in interviews and questionnaires did however indicate occasional lapses in the continuity of support and supervision for a small number of carers as a result of the unsettled staffing situation over the last year. The more settled staffing situation that is anticipated in the near future ought to rectify this situation.

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EVIDENCE:

Carers were generally very positive about the range and quality of training on offer and this was confirmed by sight of the carer training programme for the coming year.

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EVIDENCE:

Although not specifically the focus of this inspection carers and young people did provide feedback on their dissatisfaction with the poor quality of input and support offered by some children’s social workers in the local authority, which was often contrasted with the quality of support from fostering team staff. While carers did acknowledge the pressure children’s social workers were under, the following points were consistent themes expressed by carers and young people.

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EVIDENCE:

They noted the high turnover of allocated social workers, inconsistent communication, limited visiting and engagement with young people in placement and occasional but significant failures to provide or sign key paperwork in a timely fashion (which in one instance led to disruption of holiday plans). A number of carers commented on not being treated as a respected member of the ‘team’ caring for young people and felt some children’s social workers did not appreciate the significant impact that small actions or inactions on their part had on their family and foster children. These points were raised in verbal feedback to the local authority to consider in the overall context of their support for looked after young people.

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EVIDENCE:

A sample of case records for children were checked during this inspection. These were maintained by children’s social work teams, rather than the fostering service staff. While they were mostly in good order and contained the relevant information on ongoing developments and contacts there were repeated gaps in Looked After Children (LAC) documentation. Examples were seen of files with no signed placement agreement (PP1), essential information forms (EIR 1 & 2) or details of day-to-day placement planning arrangements (PP2). On one file there were also no contact or diary entries made since September, despite the child still being in placement until early November. This shortfalls reinforce the points made earlier in this report about aspects of initial placement planning and information provision. A requirement has been made to address this issue. Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 25

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EVIDENCE:

Carer files seen were well maintained, containing all relevant information about carers and up to date records relating to carer contacts, supervision unannounced visits etc.

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EVIDENCE:

Other central records such as the carer register, monitoring records for complaints and concerns, child protection incidents and carer investigations were in good order. The sample of staff files seen contained the required information.

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EVIDENCE:

In relation to recognition of the role of family and friends as carers this was a central plank of the local authority’s strategy for supporting families where there was a risk of breakdown and/or reception into local authority care. As already noted in this report family and friends assessments and placements were as a consequence a burgeoning aspect of the service’s work.

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EVIDENCE:

Feedback in questionnaires and from carer visits confirmed assessments and placement support for such placements were sensitive to the complexities of family situations and the team was developing considerable experience and skill in the complex judgements involved, balancing potential risks against the benefits of continuity of care within the extended family. Evidence of this was seen in carer initial assessments and ongoing monitoring of placements by fostering staff. Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 26

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SCORING OF OUTCOMES

This page summarises the assessment of the extent to which the National Minimum Standards for Fostering Services have been met and uses the following scale.

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SCORING OF OUTCOMES

4 Standard Exceeded (Commendable) 3 Standard Met (No Shortfalls) 2 Standard Almost Met (Minor Shortfalls) 1 Standard Not Met (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable

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SCORING OF OUTCOMES

BEING HEALTHY ACHIEVING ECONOMIC Standard No Score WELLBEING 12 4 Standard No Score 14 x STAYING SAFE 29 3 Standard No Score 3 3 MANAGEMENT 6 3 Standard No Score 8 2 1 3 9 3 2 X 15 3 4 X 30 4 5 X 16 4 ENJOYING AND ACHIEVING 17 3 Standard No Score 18 X 7 4 19 X 13 3 20 X 31 3 21 3 22 X MAKING A POSITIVE 23 X CONTRIBUTION 24 2 Standard No Score 25 3 10 3 26 X 11 3 27 N/A 28 N/A 32 4 Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No

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STATUTORY REQUIREMENTS

This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Fostering Services Regulations 2002 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales.

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STATUTORY REQUIREMENTS

No. Standard Regulation Requirement Timescale for action 1 FS8 34(1) That the fostering service ensures all placements are supported by fully completed placement agreements drawn up with foster carers. 30/04/07

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STATUTORY REQUIREMENTS

2 FS24 34(1) That the local authority ensures all required information is consistently held on young people’s files and, where available, promptly shared with carers as part of placement planning processes. 30/04/07

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RECOMMENDATIONS

These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out.

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RECOMMENDATIONS

No. Refer to Standard Good Practice Recommendations

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RECOMMENDATIONS

1 FS17 That the fostering service continues to work at establishing a broader range of placement availability to support more options for placement choice and matching. 2 FS8 That the fostering service ensures that more consistent attention is paid to evidencing and recording of matching considerations when short-term and emergency Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 28 placements are made 3 FS9 That the fostering service ensures safe caring guidelines are introduced for individual care households 4 FS17 That the local authority keeps the adequacy of established staffing levels in the fostering team under close review. 5 FS30 That the local authority establishes a suitable and consistent venue for the Fostering Panel to operate from. Milton Keynes Council Fostering Service DS0000053806.V311070.R01.S.doc Version 5.2 Page 29

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Commission for Social Care Inspection

Burgner House 4630 Kingsgate Cascade Way Oxford Business Park South Cowley Oxford, OX4 2SU

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Commission for Social Care Inspection

National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI

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