3 P’s to Change the Pursuit of Placements to the Protection of Placements.

3 Ps? = Planning People Place – let’s explain…

Daily we read ‘there are not enough placements’, ‘not enough of the right type’.

Dispassionately, although the reality, it is also a collective abrogation of responsibility. No one involved in placement making escapes responsibility.

To abrogate is to evade. It’s uncomfortable to live with that realisation.

We see it. Children are living it.

We need to create a new reality.

The pursuit of placements, sufficiency, is to keep chasing numbers, not needs.  

We need to stop placement ‘shopping’, purchasing what is provided, look where we are, and implement the service and needs-led development that is really commissioning.

There’s a tornado that is children’s placements.

It doesn’t matter how many placements we create, if they are not meeting needs then we will always be chasing more placements.

We have to start from the other end.

How do we make the placements we have the best we can have?

By recognising where we are

The only thing that has stability is the prevalence of the instability of the system.

In England, Wales and Scotland the majority of looked after children remained in the same placement last year (70-84%). However, a significant minority (around 5-10%) had three or more placements in the last year. This measure is important because multiple care placements have been shown to have a significant impact on looked after children’s wellbeing (Hannon et al, 2010) and are associated with poor behavioural outcomes (Rubin et al, 2007)

Statistics briefing: children in care (nspcc.org.uk)

cco-stability-index-2020.pdf (childrenscommissioner.gov.uk)

Add to this number those who are placed in ‘other arrangements’ for whom a place has not been able to be found.

How do we address this and simultaneously address ‘there are not enough placements’, and ‘not enough of the right type’?

The focus of our discussion and development has to shift its priority to thinking about meeting needs.

#1. Planning

Thorough understanding of need and assessment result in stability and rich relationships.

There is no such thing as challenging behaviour only a child has been placed in a challenging situation. Behaviour is communication.  The child communicates very effectively that they are feeling challenged. At such moments the child experiences disorientation, dislocation, disconnection, falling forever, falling to bits.  As we have the responsibility for the situation, we have the responsibility to change it.

The needs of children for whom a residential solution is sought are frequently poorly understood, and as a result the assessment that accompany a Placement request Form are poorly conceptualised. As recent work in Australia shows this is not a uniquely English phenomena. In Australia they are seeking to do something about it. CETC-ACF-Submission-Special-Inquiry-Children-and-Young-People-in-ACAs-2023.pdf NCERCC knows of one such successful project in England. It could be transferred for sure.

Frequently the paperwork does not reflect the needs of the child. Being insufficiently detailed this adversely affects the planning and the placement search.

This is the result of an insufficiently developed social work/care workforce, few have had experience with higher level needs in their training or career. There is the additional factor that there are too few psychology, psychiatric, psychotherapy personnel to provide insights. Numerically there are too few, and they are used too sparingly, maybe as a matter of reducing cost.

Accurate identification of needs leads to accurate placement making. This is makes for effective care and efficiency of spending.

We will not get to stability if we do not attend to essentials.

#2 People

Children need a rich relational environment peopled by resourced and resourceful people. If needs are being met relationships and stability follow.

Though there is much badging of homes as trauma Informed or therapeutic this too infrequently translates into an understand of how the past is being manifested in the here and now. The focus is on the behaviour not what is behind, beneath and could be beyond with incisive assessment and planning. The work needed is highly structured. The result of knowing what to do and when supports workers, the work is stressful but if structured less so. Compassion fatigue can be reduced. Stability of placement increases and relationships deepen.

This comes from a well-developed workforce that have ‘know-how’ (NCERCC copyright), through having engaged in a thorough professional and personal development. Safety, consistency, and predictability can be achieved for a child. NCERCC has been developing a successful methodology and curriculum in its partnership RCC Academy with a local authority.

Focus on felt security/relational security.

Felt security is a subject NCERCC has written on over decades.

Relational security is contemporary learning from Australia as follows.

“Placement” and “relational stability” are often conflated by the system to mean the same thing but are distinct and differing needs.

“Relational stability can be contributed to through placement stability but requires consideration of the broader, enduring network of relationships that children need beyond the placement within which they can grow and live well. Relational stability has consistently been shown as a critical factor in the developmental trajectories of children in (care)…    Recovery comes from the relational network of ongoing important people who learn to tolerate, absorb, and ultimately reconfigure the trauma experiences that remain buried in the minds and bodies of children affected by abuse and neglect at such early infancy”.

Consider – every placement move is a re-traumatisation.

#3 Place

Children need homes that have a deep understanding and robust care practice delivering care that meets needs.

Insufficiently trained staff, inconsistent staffing, and places that are not directly attuned to the needs of the children in the home all contribute to instability. The Quality Standards say a child must feel safe and be safe.

To meet needs a local authority offer must be able to offer Supplemental, Substitute, Alternative places.

What is needed will be different in differing local authorities.

Local authorities can know what is needed through a needs audit, applying a needs profile to all children who need accommodation.

From here there can be planned provision.

In a market-led method providers create from their existing knowledge and experience rather than from what is needed. This results in the sector being insufficiently diverse with large gaps in provision. This results in challenges to matching. There is clearly some provision that needs to be there but is not because it has not been identified as needed.

With needs-led planned provision the gaps are lessened, and matching should be easier.

The range of needs identified in a needs analysis is different than exists currently.

You cannot 3-D print children’s homes.