Setting

X10029.doc Version 1.40 Page 1 FOSTERING SERVICE

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Lead Inspector Mr Rob Smith Announced Inspection 27 th February - 3 rd March & 7 th March 2006 09:30 Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 2 The Commission for Social Care Inspection aims to:

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• 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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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 Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 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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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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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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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. Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 4

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Name of service

Buckinghamshire County Council Fostering service

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Name of service

Address Buckinghamshire County Council Walton Street AYLESBURY Bucks HP20 1YU

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manager (if applicable)

Type of registration Local Auth Fostering Service

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of places

Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 5

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Conditions of registration:

Date of last inspection 7th February 2005

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Brief Description of the Service:

This was an annual announced inspection of the fostering service provided by Buckinghamshire County Council. The service provided emergency, short term and permanent fostering placements and respite care to children with disabilities. Following significant recent restructuring the service was primarily subdivided into a fostering team (covering support of emergency, short-term and long term placements), a recruitment team (covering recruitment and assessment of new carers), and a Take a Break team (which ran a respite service for children with disabilities). Within the main fostering operation sub teams were also focusing on assessment and support of family and friends placements and the setting up of a new scheme, Fostering XTRA, aimed at providing placements for more difficult to place young people.

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Brief Description of the Service:

Each of the three main teams had its own manager reporting to an overall fostering manager based in the Aylesbury area. The teams were located in various offices in Aylesbury, Wycombe, Amersham and Buckingham. Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 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 of the fostering services of Buckinghamshire County Council. The inspection took place over a total of six days and comprised the following activities:

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SUMMARY

¾ Submission of pre-inspection and self assessment information by the fostering manager;

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SUMMARY

¾ Visits to a sample of five foster placements to meet with carers and children in placement;

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SUMMARY

¾ Interviews with three further foster carers;

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SUMMARY

¾ Formal interviews with the fostering manager and other key managerial and frontline staff in the various parts of the fostering service;

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SUMMARY

¾ Scrutiny of a sample of child and carer files;

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SUMMARY

¾ Consideration of written responses from carers and children to invitation to submit their views of the fostering service.

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What the service does well:

The fostering service does well in the following areas of provision:

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What the service does well:

¾ Good support of children’s health and educational needs

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What the service does well:

¾ Good attention paid to the physical safety of children in placement and to any arising concerns about carers

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What the service does well:

¾ Good attention to the induction, training and personal development of staff

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What the service does well:

Effective panel involvement in the scrutiny of carer approvals and household reviews.

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What has improved since the last inspection?

Significant structural changes and improvements had been made to the structure of the fostering service since the last inspection with the introduction Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 7 of a separate recruitment service, the development of a family and friends placements specialist sub team and the development of a new Fostering XTRA scheme for more difficult to place children. Long term foster care assessment and placement responsibility had also been transferred wholly to the fostering team from the adoption and permanency team. There had also been significant additional staff changes at a variety of levels in the service, with for example the arrival of a new fostering manager, a new team manager for the Take a Break service and a new training co-ordinator.

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What has improved since the last inspection?

This inspection took place at time when these new structures and staff were still largely bedding down and so the impact of the changes could not yet be properly assessed. However the new structures and staffing arrangements held, in the view of the inspector, potential for provision of a much better organised and focused range of services to foster carers and placed children.

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What has improved since the last inspection?

The scale of organisational and senior staff changes since the last inspection had affected the pace at which requirements and recommendations made at the last inspection had been tackled. However to the credit of the fostering staff team all these areas had now been tackled or were in the final stages of completion.

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What has improved since the last inspection?

Particular effort had been put into revision of a range of significant policies and procedures (for example on investigation of concerns about carers), production of revised and updated carer handbooks and catching up with a backlog of household reviews. Much work had also been put into developing improved procedures for management of placements with friends and families under Regulation 38, which had been a major area of concern at the last inspection.

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What has improved since the last inspection?

As part of the new management and organisational structures the local authority was also introducing a broader range of quality monitoring to cover in particular processes for carer recruitment and assessment and for placement planning.

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What they could do better:

The main areas requiring attention arising from this latest inspection were as follows:

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What they could do better:

¾ the inconsistent operation of systems for placement planning and the drawing up of detailed placement agreements;

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What they could do better:

¾ the inconsistent carrying out of checks on new persons joining carer households;

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What they could do better:

¾ inconsistencies in systems for the issuing of formal notices following carer reviews;

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What they could do better:

¾ the quality of case records for carers and children in relation to placement planning and agreement; Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 8 ¾ the effectiveness of working relationships between children’s social work teams and foster carers and children in placement.

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What they could do better:

Some additional, more minor areas for action were identified relating to the training needs of respite carers, recording of outcomes of carer investigations, processing of carer reimbursement, and household insurance arrangements for carers.

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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. Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 9

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CONTENTS

Statutory Requirements Identified During the Inspection Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 10

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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:

Satisfactory attention was paid by the fostering service and foster carers to the promotion of children’s health.

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EVIDENCE:

The evidence from children’s and carers’ files indicated that carers ensured children were appropriately and promptly registered with local health services such as GPs, dentists, opticians etc, and that appointments and courses of treatment were carried through appropriately.

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EVIDENCE:

Feedback from carers in interviews and written submissions did however indicate that receipt of adequately detailed medical information prior to, or immediately after the point of admission, to a foster home was inconsistent, even where children were already within the care system and their health care needs, presumably, already identified. This reflected a consistent theme of criticism from carers, supported by evidence from a variety of sources, that processes for detailed and effective placement planning and information sharing at the early stage of placements were not operating consistently. This issue is addressed more fully later in this report.

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EVIDENCE:

Carers had access to support and advice on a range of health and developmental issues from the Looked After Children (LAC) nursing service, which was aimed specifically at supporting and monitoring the health needs of children in the local care system. Ongoing monitoring of health and developmental needs was also maintained through children’s care review process.

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EVIDENCE:

Training on health and developmental issues and first aid was available as part of the foster carer initial and ongoing training schedule. Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 11 Carers for the Take a Break service for children with disabilities had to cope with a range of more complex personal care and health tasks. The difficulty faced by fostering staff in accessing relevant training was raised by staff and carers in discussion with the inspector. CSCI are aware this problem affects a range of services for children with more complex health care needs and would, as a matter of good practice, advise further discussion by the local authority with local health service colleagues on establishing a definitive range of approved training to cover such needs. Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 12

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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 fostering manager was an appropriate person to be managing the service

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

Assessment of the physical suitability and safety of foster carer households was satisfactory

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

Within current resources satisfactory attention was paid to matching considerations although placement planning processes were found to be unsatisfactory

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

Generally satisfactory systems were in place to safeguard children in placement from abuse and neglect

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

Satisfactory recruitment procedures were in place for staff

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

The fostering panel was operating in an effective and appropriate manner

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EVIDENCE:

The new fostering manager was appropriately experienced and qualified to manage the fostering service and required checks and references were seen to be in place. Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 13 Observation of fostering panel operations and additional scrutiny of a new carer assessment confirmed that, as part of initial assessment, household review and ongoing support and supervision of carer households, good attention was paid to ensuring foster placements were physically safe and free from avoidable risk. Detailed health and safety checklists were completed at assessment and review stages and health and safety matters were covered in the revised carer handbook and in initial and ongoing training schedules for carers . No obvious health and safety concerns emerged in the course of visits to carer households during this inspection.

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EVIDENCE:

The varying level and nature of placement demand meant that in some areas the fostering service lacked carers to make ideal placement matches, particularly in emergency or short- term placement contexts. However feedback from carers was that, overall, their terms of approval were well respected by the service and their allocated family placement workers. Discussion with fostering staff confirmed a real commitment to ensuring the right children were placed with the right carers.

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EVIDENCE:

The local authority continued to seek to extend its recruitment of carers from the major minority ethnic communities in the county to avoid wherever possible the need for transracial or cultural placements. A resource pack to support carers working with such placements was now said to be ready for implementation.

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EVIDENCE:

Recognised difficulties in finding appropriately matched placements for more challenging young people had led the local authority to set up a new scheme, Fostering XTRA, which was aimed at providing very experienced and skilled carers, remunerated at a higher level of allowance and provided with ready access to therapeutic consultation and support. This scheme was still in the process of being set up and will be more fully evaluated in subsequent inspections.

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EVIDENCE:

Where there was a justified need to depart from existing approval terms, or to exceed the normal fostering limit, short term ‘exemptions’ were agreed by senior fostering management staff and any further extensions submitted for approval by the fostering panel. One such scenario arose during this inspection and confirmed that such situations were subject to appropriately rigorous challenge by panel.

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EVIDENCE:

For long term or permanent fostering placements formal, well considered matching processes were put in place and, until recently, had been subject to approval by the local authority adoption and permanency panel. This function was now in the process of transfer to the fostering panel.

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EVIDENCE:

Carers, in written feedback and discussion, raised repeated concerns about the effectiveness and timeliness of placement planning arrangements and the impact upon subsequent successful management of placements. These Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 14 observations were supported by scrutiny of a sample of carer and child files, which underlined the following concerns:

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EVIDENCE:

¾ Placement planning meetings appeared rarely, if ever, to take place prior to placements being made, even where placements were of a non- emergency nature;

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EVIDENCE:

¾ In some case placement planning meetings took place weeks, or even months, after placements had been made;

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EVIDENCE:

¾ On a number of children’s files, and the corresponding carer files, there was an absence of properly completed placement agreements and detailed placement planning arrangements (LAC PP1 and PP2 forms);

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EVIDENCE:

¾ Some children’s files seen contained all copies of the LAC documentation, raising concerns as to whether the information contained therein had been shared with the carers concerned;

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EVIDENCE:

¾ Where more complete placement planning documentation was in place there was still little formal identification of matching shortfalls and how they would be met;

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EVIDENCE:

¾ Carers indicated that often placing social workers or social worker assistants were unfamiliar with the range of information and documentation that needed to be provided at or prior to placement commencement.

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EVIDENCE:

The overall impression gained was therefore, that although good attention was paid to initial matching considerations, the subsequent attention paid to detailed placement planning procedures and expectations was not being applied in a consistent and effective manner. A number of carers and family placement staff indicated that this situation had deteriorated following transfer of responsibility for setting up and managing placement planning meetings from family placements to children social work team managers.

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EVIDENCE:

The weaknesses in these early stages of placement planning could be seen to play a significant contributing role to a range of other concerns expressed by carers, noted elsewhere in this report, in terms of inadequate sharing of key information, problems around contact management and differing interpretations of roles and expectations. While the inspector was aware of the plan shortly to introduce more formal documented monitoring and quality control of placement planning processes, the evidence of this inspection indicates this is an area of practice that needs urgent review and improvement to ensure the key early stages of placement are managed in ways that maximise the likelihood of sustainable placement matching and stability. A requirement has been made to address this shortfall. Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 15 The local authority had appropriate, recently revised and extended, policy

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EVIDENCE:

guidance and procedures in place governing the handling and investigation of child protection concerns arising in foster carer households. Clear guidance on child protection matters, acceptable behaviour management approaches, management of bullying and unauthorised absences etc, were included in the newly revised and extended foster carer handbook. Training on child protection and safe caring was incorporated in initial and ongoing carer training programmes. Examination of carer files indicated however that the production of safe caring policies for each individual carer household had not yet been fully implemented. This needed to be expedited as quickly as possible. A good practice recommendation has been made to address this shortfall.

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EVIDENCE:

Where issues of concern had arisen about the safety and welfare of children in foster households scrutiny of a sample of files and discussion with the manager, carers and other staff confirmed these had been investigated thoroughly. CSCI had also been notified of all significant concerns and their outcomes. As a point of good practice however it was noted that although carer files did note where concerns had been investigated, the record of outcome and assessed longer-term significance of the event, if any, was often very brief. Such incidents would benefit from a more structured summary outcome finding to be held on the relevant section of the carer file. A good practice recommendation has been to address this.

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EVIDENCE:

A sample of recent recruitment files for staff were seen. This indicated that recruitment procedures were satisfactory. Some minor inconsistencies were noted, namely unsigned interview notes, inconsistent recording of telephone follow-up of references and the absence of photo ID on one file. A good practice recommendation has been made to address this . Feedback from the manager confirmed that CRBs were now either in place or underway for all administrative staff working for the fostering service, addressing a shortfall noted at the last inspection.

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EVIDENCE:

Appropriate checks were being carried out as part of carer household initial assessments and updated in line with BAAF and national minimum standards expectations. One instance was however identified of ambiguity about the obtaining of relevant check for an adult newly joining an established carer household, which had meant, in reality, that this person had been a substantive member of the household for some time before a CRB check had been initiated. While this matter was now in the process of resolution the local authority needed to ensure that expectations relating to checks of all household members were carried out properly. A requirement has been made to address this.

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EVIDENCE:

This inspection offered a further opportunity to observe the fostering panel and read minutes relating to recent meetings. The panel constitution remained largely unchanged, with an appropriately qualified and experienced chair. Panel meetings observed, or for which there were minutes available, indicated panels Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 16 were quorate when meeting, although the overall panel membership was currently not fully in line with regulatory expectations. A young person who had experience of being a foster child was in the process of induction into becoming a panel member and a new local authority councillor was also being sought following the death of the previous panel member. The panel was being advised and supported by a separate panel adviser, out of the immediate line management chain for fostering services, adding a more appropriate level of

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EVIDENCE:

arms length advice and comment on practice and quality development issues.

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EVIDENCE:

Panel was seen to operate efficiently and appropriately in assessing and challenging the quality of initial assessments and household reviews and providing feedback on various aspects of fostering service quality and provision.

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EVIDENCE:

Panel was administered efficiently and smoothly, although with the growing frequency of panel meetings the adequacy of the level of appropriately trained administrative support will need to be kept under close review by the local authority. New applicants, and carers having their first review, were routinely offered the opportunity to attend panel in person, as was observed during this inspection. Written guidance on attending panel had been produced for carers. Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 17

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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 sought to ensure diversity was appropriately supported and promoted

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

Good support was provided for young people’s educational achievement

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

Respite care fostering support services appropriately emphasised the ongoing key role of parents as main carers

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EVIDENCE:

Policy and practice principles as seen in written documentation for staff and carers appropriately emphasised issues of diversity. Foster carers had access to training on diversity issues and the panel had tightened up expectations in assessments and household reviews of the better addressing of these areas of consideration.

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EVIDENCE:

Wherever possible placement matching in terms of ethnicity and culture was sought, but sometimes difficult to achieve, particularly in emergency and short-term situations, in part due to the demography of current foster carer resources. As already noted the authority was looking to recruit carers from a more diverse range of backgrounds as part of the current recruitment drive. As also already noted a resource facility for carers working with transracially or transculturally placed children was being introduced. Access to interpreting services could be arranged as required. Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 18 Carers working with children with disabilities were encouraged and supported in providing relevant developmental and leisure opportunities within the more limited scope that respite provision offered. Training and equipment for carers

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EVIDENCE:

relevant to the needs of children with disabilities was provided as required on an individual basis.

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EVIDENCE:

The fostering service worked hard, in conjunction with other local authority services, to support the educational achievement of placed young people. Foster carer and child files confirmed that carers generally worked well in getting foster children into and staying at school and provided positive support for completion of homework and coursework. Files showed evidence of good foster carer liaison with schools and attendance, where relevant, at education review meetings. As looked after children the local authority provided access for foster children to computers in foster care households to support learning. The educational placement and progress of foster children was also supported and monitored by the local authority looked after children education team (ECPC) who were available to assist carers in any education related problem. A number of carers commented positively on the input from this team.

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EVIDENCE:

One issue raised by a number of carers was the problem posed by young people who were on prolonged or repeated exclusion from school, or who were in receipt of limited levels of home tutoring. Such situations, especially if not anticipated at placement planning stage, had significant impact on carer households that carers felt was not always fully appreciated by the local authority.

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EVIDENCE:

The primary service offering respite care to families was the Take a Break Service for children with disabilities. Although no feedback was received from families using this service, discussion with Take a Break staff and carers, and examination of a sample of Take a Break files showed that the role of parents was appropriately recognised in terms of placement planning and review and ongoing liaison about children’s needs and development. Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 19

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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):

Foster carers were seen to be supportive of contact arrangements although this was sometimes undermined by a lack of consistency in organisational arrangements and communication.

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

Young people had opportunities to express their views about their care and the fostering service they received.

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EVIDENCE:

Training and written guidance for foster carers emphasised the importance of sustaining family contact and a new contact policy was in the process of implementation . Scrutiny of files and discussion with young people and foster carers indicated that foster carers were committed to this aspect of their work and sought to support contact arrangements where these were in place.

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EVIDENCE:

Feedback from carers did however identify a number of recurrent problems in the management of contact. Some carers indicated that contact expectations were not made clear enough at the point of placement, a situation exacerbated when effective and prompt placement planning did not take place. Repeated criticism was also received from carers about poor communication from children’s social workers when contact arrangements were changed or postponed. A number said that they felt children’s social workers did not always appreciate the difficulties of accommodating such changes, especially if they had a number of children in placement. These were again dimensions to broader problems noted elsewhere in this report relating to effective and clear placement planning and expectations and the quality of relationships and communication between foster carers and some children’s social workers. Buckinghamshire County Council Fostering

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EVIDENCE:

service DS0000058771.V272800.R01.S.doc Version 5.1 Page 20 Young people had opportunities to express their views about their care in foster homes through their care reviews, through contact with their social workers and through their contribution to carer household reviews. There were also clear systems in place for young people to make formal complaints if they wished through the ‘Your Shout’ complaints system for looked after children. Based on the evidence seen of the prompt and thorough response to any concerns raised by young people about their care it was evident their concerns were taken seriously by the fostering service. On a less formal basis young people were also able to access advocacy services provided for the local authority by an external childcare organisation. There was currently no formal local forum for young people in foster care.

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EVIDENCE:

Training for carers on hearing the views of young people was available and in the sample of cases seen during this inspection there were examples of carers ensuring children’s views and wishes were heard on subjects such as contact arrangements and clarifying permanency of placements. Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 21

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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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The Commission considers Standards 29 the key standard 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):

Improved attention was being paid to preparation of young people for adulthood

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

Foster carers received appropriate allowances and expenses

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EVIDENCE:

The fostering service had provided specific training input and developed helpful workbooks for use by carers working with older young people and preparing them for leaving care and adulthood, alongside their allocated social workers. Due to the sample of carers and young people seen during this inspection no specific examples of this work were seen on this occasion.

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EVIDENCE:

A number of carers expressed concerns, that were also raised in the context of the last inspection, about difficulties in effective co-working with the Leaving Care team, who had primary responsibility for working with prospective care leavers. The concerns again appeared to centre on a lack of clarity about mutual roles, responsibilities and expectations.

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EVIDENCE:

The local authority had established levels of allowances and expenses payable to care that were laid out in the foster care handbook and related information. Apart from some specific and complex queries to do with the relationship between benefits and allowances, carers spoken with were generally satisfied with the system for payments for regular allowances. The allowance level was subject to regular review by the local authority to ensure a reasonable degree of competitiveness with other local providers. Enhanced payments were planned for carers achieving higher levels of competence through training or qualification and the planned Fostering XTRA service offered higher levels Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 22 again in recognition of the more complex and demanding placements likely to be made through this scheme.

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EVIDENCE:

Criticism was received from carers about delays in reimbursement of unexpected or emergency expenditure incurred by some placements, which in some cases were said to take several months, potentially placing less well–off carers in difficult situations. It appeared these were typically payments that might need to be processed through children’s social work teams rather than through the fostering service itself. A good practice recommendation has been made to address this issue.

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EVIDENCE:

Some carers also expressed concern that the enhanced cost of household contents insurance premiums to cover their status as foster carers was proving prohibitive, to the extent that at least one carer had resolved not to take out cover and simply replace any items damaged or stolen by foster children. A good practice recommendation has been made to address this issue. Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 23

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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, and 24 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):

1, 2, 4, 5, 16, 17, 19, 20, 21, 22, 23, 24, 25, 26 & 32

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

The fostering service provided good clear information on its aims, objectives and services provided.

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

The fostering service was managed by staff with appropriate skills, qualification and experience. Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 24 Appropriate systems for monitoring the quality of the service were in place or planned

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

Appropriate and improved management structures and systems were in place to secure the day-to-day running of the service (Stds 5, 7, 16)

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

Staffing levels had improved and appeared adequate to the meet the current needs of the service. Foster carer assessments covered required areas and a recruitment drive for new carers was underway.

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

Fostering staff had good access to relevant training and development opportunities and were well supported through regular supervision.

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

An appropriate structure of support and supervision was in place for foster carers although working relationships with some children’s social workers were a source of concern for some carers (Stds 21 & 22).

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

The training needs of carers were being appropriately evaluated and met.

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

Case records for children did not consistently contain the required information.

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

Other records were generally appropriately maintained although carer files had some shortfalls.

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

The role of family and friends as carers was appropriately recognised and considered by the local authority.

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EVIDENCE:

The fostering service had a satisfactory statement of purpose in place, supported by additional information provided for young people in placement. It was confirmed to the inspector that this information would be provided in different formats and languages as required on a case-by-case basis. A broader range of information for looked after children in general, in written and CD ROM format, was also available for young people in foster placements; this was usually provided by their placing social worker at commencement of placement

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EVIDENCE:

The re-organisation of the fostering services into the various teams and sub teams indicated at the start of this report, although very much in its early days, appeared an important step forward in providing more coherent subdivision and accountable management of the various strands of fostering operations. The impact and effectiveness of the new arrangements will be Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 25 more accurately judged in subsequent inspections. The staff in the various management posts in the new structure were appropriately experienced and qualified to carry out those roles, and there was a clear understanding of lines of accountability and responsibility with all staff spoken with. Deployment and management of staff on a day to day basis to deal with the various, and sometimes conflicting, demands of the service appeared to be effectively

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EVIDENCE:

More detailed and rigorous systems for monitoring the quality of the various strands of the service were being introduced by the new fostering manager. For example a quality monitoring process tracking management of new applicants’ assessment and approval and also the process of placement planning and matching were in the process of implementation. These new systems supplemented existing quality information supplied via carer and child reviews, complaints and investigations, panel oversight and staff and carer supervision.

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EVIDENCE:

Newly appointed staff spoken with were very positive about their process of induction to the authority and the phased introduction to their work responsibilities. More established staff confirmed the picture gained at the last inspection of good ongoing support, supervision and guidance from their immediate managers. They also confirmed good access to training and further formal qualification in both practitioner and management roles.

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EVIDENCE:

Clear procedures and systems were in place for the conducting of carer household reviews in line with regulatory expectations. The last inspection had identified shortfalls in the regularity of these reviews and it was evident that, in the recent transfer of work from the permanency team to the fostering team, a significant number of additional overdue annual reviews had been identified. As of the date of this inspection all overdue reviews had now been completed, according to figures provided by the fostering manager, but this is clearly an area of practice the local authority will need to monitor closely to ensure no further lapses in the future.

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EVIDENCE:

Foster carers were, as at the previous inspection, very complimentary about the consistency and quality of direct support they received from the fostering team. Regular formal recorded supervision provided by allocated fostering workers place at monthly to six weekly intervals, longer in the case of respite carers who had infrequent placements. Additional visits and telephone support were available as required.

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EVIDENCE:

A duty system was in place to deal with immediate day-to-day issues with out of hours support offered by the emergency duty team backed up by on-call senior family placement staff if required. Other support elements included membership of the Fostering Network, opportunities to attend the regular Carer’s Forum and local or specialist support groups, and provision of a revised and updated carer handbook. Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 26 The level of unannounced visits to carers was improving, although judging from carer files was not yet fully in line with the expectations of at least one in each year. The inspector acknowledged the particular difficulties of managing such visits to irregular respite carers.

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EVIDENCE:

More specialist ongoing support structures were being planned for the Fostering XTRA scheme in recognition of the additional demands these more complex placement might place on carers. This included ready access to advice, guidance and sessional input from child psychiatric services.

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EVIDENCE:

Despite the above level of support from the fostering service the inspector was in receipt of repeated concerns from carers and young people in writing and in person about aspects of the children’s social work team input to the planning and support of placements. Similar concerns were seen expressed in carer feedback in forums, in household reviews and children’s care reviews and so were not isolated comments on this occasion. Although these concerns largely fall outside the responsibility of the fostering service, and therefore the strict remit of this inspection, the impact on some foster carers and their morale was significant and therefore warrants summary mention here. The concerns will also be shared with CSCI staff carrying out broader assessments of the quality of the local authority’s services for children.

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EVIDENCE:

The key issues foster carers and young people were concerned about were

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EVIDENCE:

¾ Instances of poor communication, both at the point of, and subsequent to placement, and repeated failures to respond promptly to messages left;

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EVIDENCE:

¾ Delays in effective placement planning and the arrangements of meetings to achieve this along with failures to provide sufficient information or correct documentation prior to placement;

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EVIDENCE:

¾ Not being regarded and respected by some social workers as part of the professional network working with young people in placements;

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EVIDENCE:

¾ Lack of consideration by some children’s social workers of the impact, for example, of unplanned or short notice changes to contact arrangements;

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EVIDENCE:

¾ High turnover of children’s social workers meaning that children in placement often did not know, or had little meaningful relationship with their social workers;

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EVIDENCE:

¾ Unacceptably long delays in getting formal permission for young people to undertake activities or in getting documents such as passports sorted out; Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 27 Carers were clear that family placement staff were extremely helpful in trying to sort out problems arising in relation to children’s social work teams, but recognised that this was not their primary responsibility. Although carers acknowledged that they had also had good experiences of children’s social work input, and realised social workers were often under considerable pressure with other emergency cases, they nonetheless felt the children in more stable placement were getting a raw deal in some circumstances and they, as carers, were at times frustrated and undermined by poor joint working relationships. Some of the comments received also reflect the findings elsewhere in this

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EVIDENCE:

report of insufficient attention being paid to detailed and clear placement planning and agreement processes.

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EVIDENCE:

The local authority clearly needs to explore strategies for developing more consistent and effective working relationships between carers and children’s social work teams to avoid any further disillusionment, and potential loss of carers, and to ensure children’s needs in placement are appropriately met.

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EVIDENCE:

A new foster carer training co-ordinator had recently been appointed following the retirement of the previous postholder. The period between the two postholders had led to a partial loss of momentum on developing appropriate training packages for carers. However the evident energy and enthusiasm of the new co-ordinator, coupled with the plans for training seen at this inspection reassured the inspector that matters were now well in hand. An appropriate range of training was proposed covering both mandatory and additional more specialist areas of interest. Good consideration was also being given to delivering this training in flexible ways to take account of carers’ individual circumstances and learning styles. Carers were also offered the opportunity to achieve NVQ 3 qualification.

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EVIDENCE:

Particular points raised with the co-ordinator were the need to develop a clearer ongoing record of training undertaken by carers, as this did not appear to held in a consistent and readily accessible way, and the need to ensure that where two members of the household were approved as carers that both parties completed at least the minimum mandatory range of training. As the co-coordinator was aware of the need to address these issues no requirements or recommendations have been made on this occasion.

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EVIDENCE:

Staffing establishment levels in the fostering service had improved as part of the significant reorganisations that had taken place and now appeared satisfactory to meet current levels of demand. Senior managers were also aware that the possible growth in family and friend placements, and possible increased take up as a result of more sustained and targeted recruitment drives, might prompt the need for higher staffing in these areas at a later point. Some current posts had yet to be recruited to, but on an interim basis a small number of agency staff were being employed to get the range of services underway. Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 28 Additional administrative staffing resources had also been put in place since the last inspection but as noted earlier the specific needs of the fostering panel for more administrative support will need to be kept under review.

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EVIDENCE:

As noted earlier a new separate recruitment team was now in place to manage the whole process of attracting, training, and assessing new carers. Responsibilities for this process had previously been shared throughout the fostering team and had sometimes been subject to a loss of focus when other, more urgent, work demands arose. The discrete role of the new team should therefore provide a more consistent and focused approach. The team sought to combine expertise and experience from both social work and marketing fields to maximise the likelihood of increasing carer numbers. A new round of advertising and campaigning to attract new carers was currently underway. Some of the posts in this team were being filled on an agency basis pending recruitment of permanent staff.

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EVIDENCE:

Assessments for carers seen at this inspection made use of the established BAAF competency framework and covered the areas expected under the standards. Assessments were seen to be thorough and generally well evidenced. The first assessment produced by the new recruitment team was seen to be of a good standard.

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EVIDENCE:

The sample of case records for children seen during this inspection, although generally satisfactory, had particular weaknesses, as already noted, in relation to the presence and adequacy of the range of LAC documentation. This was confirmed in the authority own recorded audits of the files seen. Written placement agreements and detailed placement plans were either not in place or not fully completed on a number of files; conversely some files had all copies of the LAC forms suggesting that other parties such as foster carers had not received their copy; care plans were sometimes not in place or had not been updated in the light of changes to original intentions; receipt of review minutes was also often very delayed. These are shortfalls that should be largely addressed as part of overall review of placement planning processes highlighted as necessary earlier in this report.

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EVIDENCE:

Foster carers were provided with clear guidance on the range of recording they were expected to maintain and this was checked as part of ongoing supervision.

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EVIDENCE:

Carer files were generally in good order but again often lacked properly completed placement agreements and placement plans for current placements. It was also noted that on a number of carer files there was no formal notification of approval following the latest household review, where reviews had not gone through the panel process. Senior managers were also made aware that copies of notices following review or termination of approval had not, to date, been sent to area authorities for carers located outside of Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 29 Buckinghamshire, as required by regulation. A requirement has been made to address these shortfalls.

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EVIDENCE:

More general administrative records, such as records of complaints, concerns and investigations and the foster carer register were satisfactory and the inspector was made aware that further work on adapting the local authority’s IT systems to better serve the needs of the fostering service was underway, headed up by the new fostering manager. Clear policies procedures and guidance were in place governing overall record keeping expectations, confidentiality and records access.

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EVIDENCE:

The overall standard of the premises used in the different offices by different parts of the fostering service was generally satisfactory, although there were still some marked disparities. The office accommodation in Wycombe for the Take a Break staff for example was more spacious and welcoming that that in the main Aylesbury fostering office, which, as noted at the last inspection, despite some marginal improvement in filing space, was still quite cramped and lacked adequate and readily accessible equipment storage areas.

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EVIDENCE:

The local authority continued to support an expansion of family and friends placements and had now identified a sub team, headed by a senior practitioner, to focus on developing this area of work. Considerable work had also been put in by the local authority to address the serious concerns raised at the last inspection about the identification and management of immediate placements made under Regulation 38. Policies, procedures and guidance for staff had been revised and, where appropriate, simplified to ensure a common understanding of the nature of these placements and how they should be assessed and progressed. A programme of practice workshops on this issue was still underway. A sample file relating to a recent Regulation 38 placement was checked at this inspection and evidenced much improved practice and documentation. Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 30

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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 3 Standard No Score 14 3 STAYING SAFE 29 2 Standard No Score 3 3 MANAGEMENT 6 3 Standard No Score 8 2 1 3 9 2 2 3 15 3 4 3 30 3 5 3 16 3 ENJOYING AND ACHIEVING 17 3 Standard No Score 18 3 7 3 19 3 13 3 20 3 31 3 21 2 22 3 MAKING A POSITIVE 23 3 CONTRIBUTION 24 2 Standard No Score 25 2 10 3 26 2 11 3 27 X 28 X 32 3 Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 31 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 That the local authority urgently reviews the effectiveness of current arrangements for placement planning and the drawing up of appropriately detailed written placement agreements and placement plans. 30/06/06

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STATUTORY REQUIREMENTS

2 FS15 30 That the local authority ensures that appropriate checks are consistently carried out before new persons join approved carer households. 31/05/06

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STATUTORY REQUIREMENTS

3 FS25 29(12) That the local authority ensures formal notices following review of foster care households are produced consistently and sent to all parties as required under regulation. 31/05/06

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STATUTORY REQUIREMENTS

4 FS25 34 That the local authority ensures both foster carer and children’s files contain the information required by regulation with specific regard to placement agreement documentation and children’s LAC documentation. 31/05/06 Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 32

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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 FS12 That the local authority engages in further discussion with area health colleagues on the provision of suitable training for carers coping with more complex children’s health care needs. 2 FS9 That the local authority introduces clearer recording of the outcome and implications of any investigations into concerns raised about carers. 3 FS15 That the local authority ensures all aspects of documentation and recording in relation to staff recruitment procedures are maintained consistently. 4 FS29 That the local authority ensures reimbursement to carers for unexpected or emergency expenditure is processed promptly and explores carer concerns expressed about household insurance arrangements. 5 FS8 That the local authority looks at ways of improving the consistency of good working relationships between foster carers and children’s social work teams. Buckinghamshire County Council Fostering service DS0000058771.V272800.R01.S.doc Version 5.1 Page 33

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Commission for Social Care Inspection

Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR

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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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