Foster Parent Handbook

Vitamins and homeopathic remedies

Vitamin supplements and/or homeopathic remedies should, in the first instance, be discussed with your supervising social worker, who would consult with the child’s social worker. Medical advice can also be sought from the family GP or our own medical advisor. A discussion with the child’s social worker should always be a precursor to any action being taken in relation to a significant change in dietary supplements.

Physical activity

It is well recognised that children are less fit than in the past. This is due to a changed lifestyle. Regular exercise is essential for everyone. It can be running, jumping, bike riding, swimming or any other type of exercise the child enjoys. Simply walking to and from school or playgroup can be good for the children and their foster parents. The time can also be spent talking to the child. Getting children to walk everywhere rather than putting them in the ‘buggy’ or car because it is quicker is strongly recommended. Young people should exercise at least one hour each day to help stay healthy.

Foster parents can:

• Enable and encourage children to take up sports and help them to sustain their interest.
• Encourage free time outdoor play such as walking, running, informal games, cycling as well as formal clubs and teams.
• This might also include initiating physical activity, active travel, active play, sports and hobbies outside school particularly during weekends and school holidays.
• Take younger children to the park.
• Consider introducing a maximum time that children and young people can be in front of TV, computer or video games.
• Use the car less and walk more with them.
• Find out if the local authority gives free entry to their leisure facilities.

Leisure activities

Fostering services are required to ensure that foster parents promote the leisure interests of children and young people. It is important for looked after children to have access to a wide range of leisure activities which helps them to enjoy their interests, develop self-confidence and maintain good health. The activities from which children derive enjoyment will be varied and personal, but such experiences will be important in helping them to gain a sense of achievement and in helping them to develop skills that will prepare them for independence later on. Children will find life more fun if they have interests outside the home. Interests will:

• Help them build self-confidence.
• Give them a purpose, something to aim for and to achieve.
• Help them make new friends and develop their identity.
• Give them somewhere different to go.

Foster parents should encourage children to participate in normal leisure activities in the same way that any reasonable parent would. Supervising social workers can help foster parents to consider the full range of social, leisure and sporting opportunities available locally to foster children, including any with which the foster parents were not previously familiar. Foster children may need additional help and support from their foster parents to participate fully. Sometimes this may involve an element of informed risk taking, so that children are able to learn from their experiences. Foster parents need to be aware of the authority that they have to make decisions on activities, leisure interests and social events, and these must be included in arrangements in the placement plan.

Many fostered children will need a lot of help and encouragement to find interests they enjoy and there may be ‘false starts’ along the way. It is normal for children to try out several activities before they find one that really suits them, and it is important for foster parents to be patient. If any of these activities entail excessive expenditure, then foster parents should talk to their supervising social worker and child’s social worker about the possibility of getting assistance with this.

Vaccinations (Immunisations)

Immunisation helps protect against serious diseases such as flu, measles, mumps, whooping cough, meningitis, and polio. It is easy to protect most children against infection with a simple course of injections. Every year several children die unnecessarily from dangerous diseases. Permission for any vaccination programme must be included in the placement plan. If this is not the case, please discuss with your supervising social worker.

Here is a checklist of the vaccines that are routinely offered to children in the UK for free on the NHS, and the age at which children should ideally have them.

8 weeks:

• 5-in-1 vaccine – this single jab contains vaccines to protect against five separate diseases: diphtheria, tetanus, whooping cough (pertussis), polio and Haemophilus influenza type b (known as Hib – a bacterial infection that can cause severe pneumonia or meningitis in young children)
• Pneumococcal (PCV) vaccine

• Rotavirus vaccine

• Men B vaccine

12 weeks:

• 5-in-1 vaccine, second dose
• Rotavirus vaccine, second dose

16 weeks:

• 5-in-1 vaccine, third dose
• Pneumococcal (PCV) vaccine, second dose
• Men B vaccine second dose

One year:

• Hib/Men C vaccine, given as a single jab containing vaccines against meningitis C (first dose) and Hib (fourth dose)
• Measles, mumps and rubella (MMR) vaccine, given as a single jab
• Pneumococcal (PCV) vaccine, third dose
• Men B vaccine, third dose

2-7 years (including children in school years 1, 2 and 3):

• Children’s flu vaccine (annual)

3 years and 4 months:

• Measles, mumps and rubella (MMR) vaccine, second dose
• 4-in-1 pre-school booster, given as a single jab containing vaccines against diphtheria, tetanus, whooping cough (pertussis) and polio

12 – 13 years (girls only):

• HPV vaccine, which protects against cervical cancer – two injections given 6-12 months apart

14 years:

• 3-in-1 teenage booster, given as a single jab and contains vaccines against diphtheria, tetanus and polio
• Men ACWY vaccine, given as a single jab and contains vaccines against meningitis A, C, W and Y

Medication

Foster parents should keep medicines in a safe place that children cannot access, unless it has been specified in the placement plan that a child is capable of managing their own medication. Whilst children should be supported to keep and administer their own medication, care must be taken to ensure that they are responsible enough to do so, or will be able to do so with adequate support and supervision. Foster parents and social workers will need to make a judgement about whether children should manage their own medication, which is why it is best recorded in the placement plan.

When a child is first placed with them, foster parents ideally should be given written permission from a person with parental responsibility to administer first aid and non-prescription medication, and this should be clearly recorded in the placement plan. If it is unclear what permission has been given, please raise this with your supervising social worker.

Proper care must be taken to ensure prescribed medicines are only administered to the individual for whom they are prescribed. Foster parents should keep a written record of all medication, treatment and first aid given to children during their placement, using the progress action on CHARMS ‘Monitoring Event – Medication, medical treatment or first aid’ – you should record any medication administered and time given. This includes use of inhalers prescribed for asthma.

Infectious Diseases

HIV and AIDS

N.B. This information relating to a child should be confidential, as with any medical record.

HIV (Human Immunodeficiency Virus) is a virus which damages the body’s immune system and exposes it over time to the risk of severe infections (e.g. pneumonia, which affects the lungs) and certain cancers which affect the skin and various organs. AIDS (Acquired Immune Deficiency Syndrome) is the name given to a group of these diseases when caused by HIV.

There is as yet no cure for AIDS or vaccine against HIV infection. There are, however, anti-retroviral drugs that can improve the quality of life and extend the lifespan of people with HIV. However, such treatments may have debilitating side effects.

Children with HIV should be referred for assessment by an HIV specialist physician.

HIV infection is not spread by normal daily contact and activities e.g. coughing, sneezing, kissing, hugging, holding hands, sharing bathrooms and toilets or food, cups, cutlery and crockery.

Hepatitis A

Hepatitis A is less serious than hepatitis B, but also attacks the liver. It is transmitted in human faeces and contaminated food and drinking water. The incubation period is about three weeks. It causes sickness, diarrhoea and stomach pains but is not serious to otherwise healthy people. Sufferers usually recover completely in a few weeks and one attack usually gives full immunity. There is a vaccine available for hepatitis A.

Hepatitis B

Hepatitis B is a virus, which causes infection that may damage the liver. People with hepatitis B infection do not necessarily have symptoms or feel unwell, but some do get a short ‘flu-like’ illness, often with jaundice (yellowing of the skin and eyes and dark urine), nausea, vomiting and loss of appetite. Infection without symptoms and illness without jaundice occurs, particularly in children. Very rarely, hepatitis B infection may cause acute liver failure.

Hepatitis B carriers are infectious to other people, and about one in five infected in infancy or childhood may develop serious liver damage later in life such as cirrhosis (scarring of the liver) and primary liver cancer. Children with chronic hepatitis B infection should be referred for assessment by a specialist clinician, such as a hepatologist, gastro-enterologist or infectious disease physician. Drug treatments may be available, although they are not effective in every case.

Vaccination against hepatitis B is available, though not a necessary requirement. However, should foster parents or social workers feel worried or concerned about the risks to themselves or their families, they should discuss this with their GP.

Like HIV, hepatitis B infection is not spread by normal daily contact and activities e.g. Coughing, sneezing, kissing, hugging, holding hands, sharing bathrooms and toilets or food, cups, cutlery and crockery.

Hepatitis C

Like hepatitis B, hepatitis C is a virus, which causes infection that may damage the liver. Many people with hepatitis C infection have no symptoms and are often unaware that they have been infected. Some people will experience tiredness, nausea, loss of appetite, abdominal pain and ‘flu like’ symptoms. They may also develop jaundice (yellow eyes or skin and dark urine), but this is unusual.

Hepatitis C infection is not spread by normal daily contact and activities e.g. coughing, sneezing, kissing, hugging, holding hands, sharing bathrooms and toilets or food, cups, cutlery and crockery.

Meningitis

Meningitis is an inflammation of the membranes that surround and protect the brain and spinal cord. It can be caused by either a virus or bacteria. Viral meningitis is rarely life threatening, but can make people feel very unwell. Most people who get viral meningitis recover after a few weeks without any specific treatment.

Bacterial meningitis can be life threatening and needs urgent medical attention. Many different bacteria can cause meningitis but the three main types are hib, pneumococcus and meningococcus.

Common signs and symptoms

(Symptoms do not appear in any order and some may not appear at all).

Babies & Toddlers:

• Fever – cold hands and feet
• Refusing food or vomiting
• Fretful or dislike of being handled
• Pale, blotchy skin
• Blank staring expression
• Drowsy, difficult to wake
• Stiff neck, arched back
• High pitched cry

Children:

• Fever – cold hands and feet
• Vomiting
• Headache
• Stiff neck
• Dislike of bright light
• Joint or muscle pain
• Drowsy
• Confusion

As well as the above symptoms a sign of this disease can be a rash that does not fade under pressure. Do not wait for a number of symptoms to appear. Trust your instincts. Use a glass to press against the skin; if the rash does not fade this could be a sign of Meningococcal Disease. Meningococcal bacteria can cause both meningitis and septicaemia (blood poisoning). Together these are known as Meningococcal Disease.

Foster parents should always contact their GP immediately if they have any concerns; early medical intervention is critical to recovery. Do not wait for a number of symptoms to appear – trust your instincts!

Infection Prevention and Control and Hygiene Procedures

Within any household or environment where people share a living space, it can be easy to spread infection from person to person. Using methods of Infection Prevention and Control (IPC), we can help to prevent the spread of infection and maintain and promote good hygiene and health for all.

The “chain of infection” highlights how bacteria or viruses (the causation agent) can move from the source (the infection’s home environment e.g. person ) via a portal (exit) and is transmitted to a susceptible host when it gets into the person’s body via a portal of entry.

Breaking one of these links in this chain of infection can prevent the spread of infection. Bacteria can be killed. Sources can be isolated, removed or made less hospitable. Portals of exit and entry can be blocked. Therefore, transmission can be reduced or prevented.

Basic principles of environmental and personal hygiene will help to minimise or prevent the spread of common infections. These include

• Quarantine
• Good personal cleanliness, especially handwashing
• Using PPE where necessary
• Keeping environments clean
• Removing waste regularly
• Pest control policies where required

Smoking

The Smoking, Health and Social Care (Scotland) Act 2005 banned smoking in both the work place and indoor areas which are used by the public. All Fosterplus premises are subject to this legislation which applies to both staff and visitors. The legislation states that anyone who smokes in a smoke free place will be committing a criminal offence and could be subject to an instant fine of £50.

There is overwhelming evidence that children and young people are especially vulnerable to the effects of tobacco smoke which have serious long term effects on their health. Their entitlement to a healthy, smoke free environment is paramount and therefore foster parents are expected to ensure that all household members do not smoke in the home during fostering placements. This also means that Fosterplus staff should not smoke whilst visiting a foster parent. Equally, children and young people should be assured of a smoke free atmosphere whilst being transported by staff or foster parents.

Smoking in cars causes harm both to the smoker and to others in the vehicle, and children are particularly vulnerable to harm from second hand smoke (SHS).

Smoking Prohibition (Children in Motor Vehicles) (Scotland) Act 2016 came into force in January 2016. The penalty is £100 if caught smoking with a child in the car.

Fosterplus will not place the following with any foster family who have a smoker living in the household:

• Children under the age of 5 years.
• Parent and child.
• Child of any age with a respiratory illness which is known to be aggravated by smoke.

There is a lot of pressure on young people to smoke; from peers, television, film and advertising, and older people who they admire. Many young people who are looked after are smokers. Reducing or giving up smoking should be encouraged, for the financial as well as health benefits. It is illegal for young people under the age of 18 to buy cigarettes or tobacco. If a young person needs advice on giving up smoking, they should speak to their GP about various aids to giving up, such as nicorette gum and nicotine patches.

Fosterplus will respect the wishes of those foster parents who choose not to foster young people who are known to smoke and foster parents should inform their supervising social worker if they do not wish to be considered for such placements. Wherever possible, foster children who choose to smoke should be persuaded and supported to stop. Occasionally, a foster child will be determined to continue to smoke and in such circumstances the foster parent should insist the young person does not smoke within the foster parent’s home. Foster parents should inform any fostered child of the house rules on smoking before or at the beginning of the placement.

Where approved foster parents do smoke, the issue will be raised and reinforced through supervision and reviews. Support is crucial, particularly as smoking can be a response to stress, and consideration needs to be given to ways of minimising the level of stress experienced.

Supervising social workers will agree a smoke free plan with foster parents to include the following:

• Foster parents and other members of the household, including visitors, will not smoke in the company of children of any age, in the home or in the car and will promote non-smoking as the norm;
• Smoking will take place outside the home;
• Tobacco products, matches or lighters will not be left lying around or accessible to children.

Electronic Cigarettes

Fosterplus’s policy views e-smoking the same as conventional smoking.

E-cigarettes contain a number of toxic chemicals and ultrafine particles in addition to nicotine. However, because they are not currently licensed or regulated, it is not possible to be sure of their exact ingredients or how much nicotine they contain, although in general the content of nicotine is lower than in conventional cigarettes.

There is also concern that e-cigarettes may ‘renormalise’ smoking, thereby undermining the smoking bans which have helped to de-glamorise cigarettes.

The British Medical Association (BMA) has stated that the existing smoke free legislation in the UK should be extended to include the vapour from e-cigarettes.

Alcohol

Alcohol is generally accepted in our society as an aid to relaxing, socialising and enjoyment; but like tobacco, alcohol is a drug and people can fairly easily become addicted to it:

The Scottish Chief Medical Officer’s advice is that an alcohol-free childhood is the healthiest and best option.

Foster parents and supervising social workers have a responsibility to encourage positive health promotion through modelling the sensible use of alcohol. Therefore, Fosterplus expects foster parents to follow the Medical Officer’s guidance. The consumption of alcohol by fostered young people with the knowledge and approval of a foster parent can be a sensitive issue as foster parents are not the legal parents of the child. Some children will have experienced trauma associated with alcohol misuse. Some birth parents may have strong views about their child consuming alcohol. Therefore, foster parents should always discuss this issue with the young person and their local authority social worker and agree some rules about alcohol consumption.

However it is inevitable that many young people will use or experiment with alcohol or become involved through peer pressure. All young people come into contact with alcohol as they get older and they will receive mixed messages about its use from peers, adults and the media. Alcohol misuse by young people is more common than drug misuse. Most young people have their first alcoholic drink when they are teenagers, often in the company of their peers. At this age many young people will not appreciate the potential dangers of alcohol or of its effects. The risks include:

Aggressive behaviour – alcohol dis-inhibits people’s emotions, often leading to anger and violence.

Sex – unprotected sex can lead to unintended pregnancies or sexually transmitted infections.

Injuries – alcohol affects balance, co-ordination and the capacity to make decisions.

Alcohol poisoning – overdosing on alcohol is life threatening, as it can cause vomiting and choking whilst the child is unconscious. Foster parents should call an Ambulance if they are worried the young person has drunk excessively, whether or not causing unconsciousness. Place the child in the Recovery Position so that they won’t choke. If they vomit, stay with them and check their breathing regularly.

It may be that the young person needs additional help to manage this if their drinking has got out of control. This should be discussed openly with the young person and suitable services to help should be accessed, if necessary.

Drugs

Scotland has a long legacy of drug and alcohol misuse. This damages lives, families and communities, and contributes to violence and crime.

Many of those affected will have experienced difficult life circumstances, and are among the most vulnerable and marginalised in society, subject to stigma because of their addiction. Many of the young people we care for will have been exposed to some of the harshest effects of drug or alcohol misuse.

Common symptoms of drug misuse

There are many warning signs of drug use and abuse. The challenge for foster parents is to distinguish between the normal, sometimes volatile, ups and downs of puberty and the teenage years and the red flags of drug abuse.

Physical warning signs of drug abuse

• Bloodshot eyes or pupils that are larger or smaller than usual, or use of eye drops to mask this.
• Changes in appetite or sleep patterns. Sudden weight loss or weight gain.
• Deterioration of physical appearance and personal grooming habits.
• Unusual smells on breath, body, or clothing.
• Tremors, slurred speech, or impaired coordination.
• Using incense, perfume, or air freshener to hide the smell of smoke or drugs.

Behavioural warning signs of drug abuse

• Drop in attendance and performance at school or work.
• Unexplained need for money or financial problems.
• Missing money, valuables, or prescriptions.
• Being secretive about friends, possessions, and activities.
• Sudden change in friends, favourite hangouts, and hobbies.
• New interest in clothing, music, and other items that highlight drug use.
• Frequently getting into trouble (fights, accidents, illegal activities).

Psychological warning signs of drug abuse

• Unexplained change in personality or attitude.
• Sudden mood swings, irritability, or angry outbursts.
• Periods of unusual hyperactivity, agitation, or giddiness.
• Acting uncharacteristically isolated, withdrawn, or depressed.
• Demanding more privacy; locking doors; avoiding eye contact; sneaking around.
• Lack of motivation; appears lethargic or “spaced out.”
• Appears fearful, anxious, or paranoid, with no reason.

Sexual health

Foster parents and social workers can and should give young people, including under 16s, reliable information on sexual health and contraception and details of where and how to contact local services. Young people should be encouraged to contact health professionals for advice at the following centres where contraceptive advice and treatment is free:

• Family Planning Clinics.
• Brook Advisory Clinics.
• Their own GP.
• Some NHS walk-in centres/Young People’s Information Services.
• Pharmacies.
• Genito-urinary (G.U.M.) sexually transmitted infection centres.

Health professionals can give contraceptive advice and treatment to young people under 16 without parental consent, if they consider the young person to be ‘Gillick competent’. This term describes whether the young person has sufficient understanding to be able to consent to their own medical treatment without the consent of a parent.

Young people under care orders have the same right to confidentiality and treatment from health professionals as other young people. This means that they can ask for and access contraceptive advice from health professionals with the same degree of assurance about confidentiality as young people who are not subject to care orders.

Young people can also get information and advice about sexually transmitted infections from the centres listed above.

Consent and confidentiality

Promoting and safeguarding a young person’s sexual health should be discussed at the placement planning meeting (if age-appropriate) and at statutory reviews of the young person’s care plan. At these meetings, the Local Authority will set out their expectations of the foster parent, and issues of confidentiality and safeguarding can be discussed and agreed. In the absence of alternative instructions from the placing Local Authority, the agency will abide by the following principles and procedures:

• Young people under the age of 13 years cannot, in law, consent to sexual activity and consequently any incidents involving sexual activity must be reported to the Registered Manager and agency Safeguarding Manager.

• Sexual activity among young people over 13, but under 16 years of age is illegal, but law enforcement decisions are influenced by the age of the participants together with issues of coercion, exploitation and relative vulnerability of the young people concerned. If you are aware that a young person over 13, but under 16 years of age is involved in sexual activity you should inform your supervising social worker. They will initiate discussions about any risk factors and possible child sexual exploitation (CSE). Young people can be vulnerable to CSE as a result of mental ill health, psychological problems, emotional immaturity, physical disability, learning disability, substance misuse or low self-esteem and as many of our young people experience these problems it is important that you do not make decisions about their vulnerability in isolation from the agency’s social workers and the Local Authority.

A sexually active young person over 13, but under 16 years of age can access free and confidential sexual health advice and contraception from the NHS without you or their Local Authority being informed, subject to the health professional judging them to be “Gillick Competent” (according to Fraser Guidelines), and subject to the health professional being satisfied that there are no CSE factors involved.

• Young people who are over 16 years of age can consent in law to sexual activity and can access confidential sexual health advice and contraception from the NHS. Young people’s sexual health clinics will be alert to CSE factors and will take appropriate action to safeguard young people when they are concerned. If you are aware that a young person over 16 is involved in consensual, non-exploitative sexual activity you should encourage them to access NHS sexual health services and also encourage them to let you inform their social worker to increase support available to them. If a LAC Nurse conducts their annual health assessment, they are well-placed to give advice and support and young people should be encouraged to access this service. You are not obliged to breach their confidentiality should they ask you not to inform their social worker, unless you have concerns about CSE, or other wellbeing concerns. Please consider the following factors:

• The age of the young person and their sexual partner
• Number of sexual partners/frequency with which they change
• The level of maturity and understanding of the young person
• Aggression, coercion or bribery in the relationship
• Changes in the young person’s mood or behaviour, e.g. becoming withdrawn, secretive, anxious, aggressive
• Misuse of substances, which can act as a dis-inhibitor
• Young person’s ability to make informed decisions and accept advice

If you do feel it necessary to speak with your supervising social worker about your concerns, it is important that you discuss this with the young person first and let them know who you are going to tell, and the reasons why.

Sexuality

Puberty is the stage at which young people develop sexual characteristics and become sexually aware. The age at which this occurs is variable for boys and girls but usually takes place between 10 and 16 years. Children will need to be prepared for the changes that will occur in their bodies and helped to understand their feelings and emotions. Parents and foster parents often struggle to talk to young people about puberty and sex, but if a looked after young person has missed out on sex education at school because of absences then, without guidance, they are often left to pick up both facts and myths from friends. Remember, children who have been sexually abused may need particular help to accept and understand any form of sex education.

It is common for children and young people to masturbate and it does not automatically mean that they have been subject to abuse. Help them to understand that it is a private activity, but seek advice from your supervising social worker if you are unsure about what response to make.

Different families and cultures have their own sets of standards and rules about sex, and cultural and religious attitudes to puberty vary considerably. If you are caring for a child from a different culture or religion from your own, find out about attitudes to sex and puberty so that the child is adequately prepared for any changes.

Some children learn to use their sexuality to stimulate the interest of the opposite sex at an early age. Sometimes they are copying their parents’ behaviour and may not have experienced a normal parent/child relationship. Sometimes they will not know that their behaviour is inappropriate. Some children feel deprived of love and feel unsure of their attractiveness and so sexual relationships help them to feel wanted.

Sex should be a normal and healthy part of life. Children and young people need help in understanding the facts about all aspects of sexual behaviour and most importantly in understanding the issues about personal relationships and sex. You have a vital role in helping the child in your care to gain knowledge and in supporting the child in the journey to sexual maturity (physical and emotional).

Sexual Orientation

Happiness for all of us depends on being accepted for who we are, not living life according to the wishes of those who care about us. If a young person you are caring for thinks that they are lesbian or gay, or is not sure, then talking to somebody who understands, without feeling pressurised will help. Ideally, that person will be you, but could also be another significant family member or friend in their life, or another professional such as a social worker or counsellor.

Everyone needs the support, acceptance and understanding of those who are caring for them. Lots of people make different choices about their partners, often in the face of prejudice and hostility from those around them. Your supervising social worker and the child’s social worker will be able to advise and put you in contact with additional support services, groups or help lines that the young person can contact for advice.

Contraception

There are many complex issues to be considered in relation to young people and contraception. They include legal considerations relating to the age of consent; potentially different moral and religious views of young people, their parents, foster parents and social workers; ignorance of the facts of life and sexually transmitted diseases. There is need for clearly defined roles about who should be advising the young person in the light of the above. Foster parents can discuss this with their supervising social worker and decisions could be included in the placement plan, especially when there is particular concern about a young person’s sexual activity.

Foster parents are expected to discuss sexual matters with young people when appropriate and so need to be knowledgeable and confident about discussing contraception, sexual preference and identity and the consequences of unprotected sex. Foster parents will be advised and trained in this area. Supervising social workers and foster parents cannot give consent to contraception. If the young person is accommodated, the person with parental responsibility must give permission.

Foster parents are expected to take a health education approach, giving support and information. This may include information that young people can obtain confidential contraceptive advice from a GP or Family Planning Clinic or a Young People’s Clinic. If the young person is subject to a supervision order, the Director of Children’s Services/Social Work may give consent after taking into account the parents’ views

Pregnancy

Whether planned or unplanned, pregnancy needs to be dealt with sensitively. Local authority social workers, supervising social workers and foster parents should help the young woman through her pregnancy and support whatever decision she makes about her baby. She may need help to decide whether to keep her baby, ask her family’s support or consider adoption, but it is her decision to make. If a young man is about to father a child he will have feelings too. He must know that he can talk to you. He may also need professional advice on such matters as parental responsibility.

Abortion

The termination of a pregnancy requires careful counselling as it can have serious emotional and physical effects. Young women considering an abortion should be referred for professional counselling to an unbiased independent service. Foster parents should seek advice from their supervising social worker in such situations.

Mental health

What is mental health?

Mental health and wellbeing is an important part of overall health and wellbeing and can be affected by different factors, including life events such as relationship breakdowns, bereavement and work stress as well as mental health conditions such as depression or anxiety. Health Scotland has two definitions which are helpful in understanding what we mean by mental wellbeing and mental illness:

Mental wellbeing:

There are many different definitions of mental wellbeing but they generally include areas such as: life satisfaction, optimism, self-esteem, mastery and feeling in control, having a purpose in life, and a sense of belonging and support.

Mental illness:

Mental illness refers to a diagnosable condition that significantly interferes with an individual’s cognitive, emotional or social abilities e.g. depression, anxiety, schizophrenia.

It is also important to remember that it is natural to feel happy when something positive happens to you, to feel sad or angry when a bad event occurs, or scared and anxious if you are dealing with something worrying. Part of ensuring good mental health and wellbeing in children and young people is helping them recognise that it is natural to feel different emotions, but also knowing when they perhaps need some help in dealing with life events and mental health conditions.

What can foster parents do to promote mental health and emotional wellbeing?

The most important thing that all foster parents can do is to offer a secure base environment to children and young people, one in which they can begin to trust the adults who care for and are available to them, enhance their self-esteem through feeling accepted for who they are, begin to regulate and manage their feelings and behaviour through sensitive, reflective caregiving.

The DfE has identified a range of social, emotional and behavioural skills that contribute to children’s mental health and a sense of feeling good about themselves. They are to:

• Be an effective learner.
• Build and sustain friendships.
• Deal with and resolve conflicts.
• Be able to solve problems both with others and alone.
• Manage strong feelings such as frustration, anger and anxiety.
• Recover from setbacks.
• Work and play co-operatively.
• Compete fairly and lose with dignity.
• Respect the rights of others.

A nurturing, secure base foster placement, helping a child or young person to build a secure, trusting attachment with at least one adult, will assist them to develop the life skills and resilience referred to above and is the best preventative approach – providing children with available, sensitive and accepting parenting, with clear boundaries, and using co-operative parenting methods to help them feel effective in the world.

Practical things you could do:

• Provide a supportive and stable living environment with caring and consistent relationships.
• Encourage children and young people to join local clubs so they get a sense of achievement from doing something they enjoy as well as forming new social contacts.
• Celebrate achievements at school and support school work.
• Help them to feel included and to have a sense of belonging.
• Encourage children to express themselves and give them opportunities to talk about their feelings.
• Do things together that enhance a sense of achievement such as cook a meal, bake a cake, go on bike ride, and learn a new computer game.
• Do not overprotect children by avoiding challenging situations that may help them problem solve or develop emotional skills such as negotiating new friendships.
• Facilitate access to the mental health services that will help children and young people.

If you spot signs or symptoms that may lead you to be concerned that a child or young person has a mental health issue, observe, make notes and discuss with your supervising social worker. It is important to remember that, though you have a crucial role in helping children build resilience and good self-esteem, you are also working as part of a team alongside psychiatrists and psychologists who may prescribe drug treatment or one to one counselling sessions. Your role here is to be included and engaged in the therapeutic process by working in partnership with those delivering the service.

Eating disorders

Eating disorders are a common problem, yet they often go unnoticed, undiagnosed or untreated. Anorexia, binge eating and bulimia nervosa are types of eating disorder. They are characterised by an abnormal attitude towards food, difficulty controlling how much is eaten, and making unhealthy choices about food that damage the body.

Whilst it is true that eating disorders are most common in teenage girls, research suggests that 10% of cases affect males and the indication is that this percentage is rising. Eating disorders are often blamed on social pressure to be thin, as young people in particular feel they should look a certain way. However, the causes are usually more complex, and may reflect underlying mental or psychological issues.

Problems with food can begin when eating is used to cope with feelings of boredom, anxiety, anger, loneliness or guilt. Controlling what is eaten can become a way of controlling difficult emotions or coping with painful situations. There is unlikely to be a single cause, but a range of factors that leave people feeling unable to cope. These can include:

• Difficult family relationships.
• The death of someone special.
• Stress.
• Problems at work, school or university.
• Sexual or emotional abuse.

Low self-esteem can be a problem, as many people do not see themselves as being good enough, and blame this on being ‘too fat’. Recovering from an eating disorder can take a long time and it is important that the person wants to get better. The support of family and friends is very valuable. Specialist care will help to deal with underlying psychological causes and physical effects.

If foster parents are concerned that a young person is taking their eating far too seriously, eating alone or only specific items or in tiny amounts, they should carry on as normal, but find an opportunity to talk with the young person alone and to try to get them to speak of how they are feeling. These disorders often go with very low self-esteem. They generally take a lot of care and counselling to help the young person back on to a sensible eating pattern. Foster parents must raise their concerns with their supervising social worker, with a view to consulting with their GP and/or accessing an assessment through CAMHS or other health service.

Therapy

If you think that a foster child in your care has mental health issues and is in need of specialist therapeutic input, you should first discuss this with your supervising social worker who can explore the options further with the child’s local authority. Referral to a CAMHS service may be an option.

CAMHS

CAMHS (Child and Adolescent Mental Health Service) is a multi-disciplinary NHS service commissioned to provide mental health assessment, treatment and intervention for children and young people, and their families, where there is concern about emotional or behavioural difficulties. CAMHS teams are generally made up of people trained as occupational therapists, child and family counsellors, specialist nurses, clinical psychologists, psychiatrists, social workers, family support workers and psychotherapists. Generic CAMHS services are locality based and open to the entire community, although referrals need to come from professionals from heath, education or social care. Those over 16 can contact CAMHS directly.

However, many locality CAMHS services have waiting lists – it can be several months before a child is seen. It is essential that referrals are made as early as possible and foster parents should discuss their concerns with their supervising social worker and the child’s social worker – the latter will usually make the referral to CAMHS.

Evidence shows that looked after children and young people share many of the same health risks and problems of their peers, but often at a greater degree.

Many local authorities now have their own looked after children’s CAMHS service which provides a designated or targeted service for looked after children and young people. However, there is variability as to the age range served, and whether the service is available to children living within the authority’s boundaries, but placed by another local authority, or to children placed by the authority outside of their own boundaries – as a consequence, some young people appear ‘to fall between two stools’. Some services work with care leavers up to age 25, whilst others have a cut-off age of 16. These specialist CAMHS teams tend to undertake some or all of the following:

• Assessment/consultation/therapeutic input in relation to a specific child’s needs and /or placement stability.
• Assessment of emotional, behavioural and therapeutic needs in preparation for permanence.
• Time limited direct therapeutic work with young people and/or their foster parents regarding mental health needs.
• Therapeutic parenting groups for foster parents.
• Monthly ‘drop ins’ for case holding social workers.

Again, referral to this looked after children (LAC) CAMHS would be via the child’s social worker.

Death of a child

In the event of the death of a foster child in their care, the foster parents will need to be clear about who they should inform and what action they should take. The following procedures are designed to help at a time when everyone may be confused and distressed:

Who to notify

• Contact the relevant emergency services: doctor, ambulance, and police. Dependent upon the action they take, ensure that you know where the child is being taken.
• Immediately notify the supervising social worker, if possible by speaking to them personally. If they are not available, speak to their service manager or another manager. Do not leave a message – insist on speaking to someone as a matter of urgency. If the death occurs out of normal hours you should immediately contact the out of hours duty worker on your local centre number.

• Fosterplus will tell the child’s social worker, and the local authority will take responsibility for informing the child’s parents and anyone with parental responsibility.

• Fosterplus is required to inform the Care Inspectorate about the death of a fostered child, within 24 hours. A report outlining the circumstances to Scottish Ministers in the Scottish Government is required to be submitted by the Local Authority within 28 days.

Funeral arrangements

• The child’s social worker will discuss with the parents the arrangements they wish to make about the funeral. Following the death of a child, any legal order on that child is no longer in place and the responsibility returns to the parents. This is a distressing time and sometimes parents and foster parents can disagree about funeral arrangements. It is the parents’ right to make decisions on these matters.
• Depending upon the parents’ wishes, you may be involved in the arrangements for the funeral.
• Fosterplus will make a worker available to offer you and your family support and keep you informed of the procedures and the arrangements. This will usually be your supervising social worker.

Fosterplus has a legal responsibility to inform the Care Inspectorate about the death of a fostered child, within 24 hours. We/they may request further information, and it may be necessary to conduct a formal review of events before the child’s death. In the event of a sudden death there is likely to be an inquest, which foster parents may be required to attend.

The duty and responsibilities of local authorities to promote educational achievement

The Education (Scotland) Act 2016 introduced legislation that stated it was a duty of local authorities to have due regard to the need to reduce inequalities of educational outcome experienced by pupils as a result of socio-economic disadvantage. The Scottish Ministers must fulfil this duty when exercising their powers in relation to the delivery of school education.

National Improvement Framework

The National Improvement Framework for Scottish Education was announced as the centrepiece of the Programme for Government in September 2015. Following a period of consultation on a draft Framework, the final publication was launched by the First Minister of Scotland, Nicola Sturgeon MSP, on 6 January 2016.

The publication sets out four key priorities that everyone in Scottish education should be working towards:

• Improvement in attainment, particularly in literacy and numeracy;
• Closing the attainment gap between the most and least disadvantaged children;
• Improvement in children and young people’s health and wellbeing; and
• Improvement in employability skills and sustained, positive school leaver destinations for all young people

The Framework builds on a strong record of improvement and will drive work to continually improve Scottish education and close the attainment gap, delivering both excellence and equity. Alongside the Scottish Attainment Challenge, the Framework aims to raise attainment and ensure equalities of outcomes for all children and young people. As part of the Education (Scotland) Act 2016, the reporting procedures for the Framework have been placed on a statutory footing.

The Framework identifies 6 key drivers of improvement – progress across all of these is needed to deliver the improvements we want to see for all children:

• School leadership
• Teacher professionalism
• Parental engagement
• Assessment of children’s progress
• School improvement
• Performance information

Curriculum for Excellence

Another key strategy within Scottish Education is Curriculum for Excellence (CfE) which is transforming all aspects of education in Scotland. It has been developed over a number of years in partnership with teachers, parents and the wider education and business community. The curriculum comprises a broad general education up to the end of S3 followed by a senior phase of learning from S4 to S6. Increased emphasis is placed on inter-disciplinary learning, skills development and encouraging personal achievement. CfE is intended to foster four capacities in all young people: successful learners, confident individuals, responsible citizens and effective contributors.

Children with Additional Support Needs

Through Getting it Right for Every Child and Curriculum for Excellence, the Scottish Government has set out its ambition for services provided to children and young people, and for their learning. An important part of their approach is the recognition that all children and young people are different. To enable them to reach their full potential some will need additional support.

The Education (Additional Support for Learning) (Scotland) Act 2004 was amended in 2009 and The Education (Additional Support for Learning) (Scotland) Act 2009 came into force on November 14th 2010. The main components of the act (as amended) are:

• It created the term ‘additional support needs’
• It places duties on local authorities to identify, meet and keep under review the needs of pupils for whom they are responsible
• It gives parents a number of rights, including the right to access mediation, dispute resolution and refer decisions to the Additional Support Needs Tribunals for matters concerned with a co-ordinated support plan.

Co-ordinated support plans (CSPs) are now prepared for children with additional support needs:

• arising from complex or multiple factors;
• requiring a range of support from different services; and
• enduring for one year or more

Children and young people who have complex needs which are likely to endure and which require significant input from a body other than the Education Authority should receive a coordinated support plan (CSP) to ensure their needs are met.

Principles of family time

• Parents are the most important people in the child’s life and children should be brought up in their families as far as possible.
• Children and Family Services are required by law to provide services to families to prevent the need for children to be looked after by the local authority.

• In a small number of cases, where the child’s safety cannot be promoted or protected with the family, removal of the child will be necessary and alternative family care sought.

• Fostering is a positive service to children and their families.

• When a foster placement is being considered, the wishes and feelings of the child, the parents, and other significant people must be sought and taken into consideration.

• Whether the child is with the parents or not, the parents retain parental responsibility for the child. If the parents are married they both have parental responsibility. If they are not married, parental responsibility lies with the mother unless the father has also acquired it through being named on the birth certificate, by agreement or by Court order.

• Parents are positively encouraged to be part of the planning process and to be actively involved in decision-making.

• All placements need to take into account the requirement for the child to be placed as near to the family as possible and siblings should be placed together.

• Whenever achievable, all work within the placement should be focused towards the child returning to the family as quickly as possible.

A good family time visit will leave a child feeling reassured that they are loved and missed by their parents and still belong to them. They will have heard about what has been going on in their family in detail and the bonds will be kept alive.

The birth parents (and others with parental responsibility)

Every parent will respond differently to their child being looked after. Many parents will wish to be involved in their child’s life while they are placed with foster parents, and some will not. Supervising social workers and foster parents should try to give them the opportunity to stay involved. Any separation will affect relationships. Family time can aid a speedy return of a child to their family.

Many parents experience feelings of shame or guilt if for some reason they are unable to look after their child. A parent’s inability to care for that child should not require them to forfeit respect as parents or people. Parents may be shattered, stunned, angry, depressed or feel powerless and guilty. Children’s social workers, supervising social workers and foster parents can be seen to be all-powerful and threatening. Anger is often the best defense:

• They may feel angry with the local authority because they blame it for bringing the problem to light.
• They may see the foster parent as an agent of the local authority and also someone who condemns them for failing their children.

• They may be angry with the child for not being ‘good’ and easy to look after.

• They may be afraid of losing their child, and confused about the legal processes.

• They may feel bitter and uncomfortable if foster parents have a better standard of living and seem able to cope.

• They may be afraid foster parents will replace them in their child’s affections.

As Fosterplus foster parents, your reactions to birth parents are vital. Birth parents need you to accept them for who they are. Foster parents should remember:

• That they are a responsible and professional adult in a very sensitive situation.
• The child in care is still the parents’ child.

• To be sensitive towards the parents’ and the child’s feelings.

• To be aware of their own feelings.

• Not to contradict the parents in front of the child.

• To involve the parents as much as possible in their child’s life.

• The child needs them to accept their parents because they are part of them.

• To let their own negative feelings out safely and away from the child.

A child’s parents will always be important to them. They may want to talk to the foster parent about their child and sort their feelings out about them. Foster parents need to be honest and truthful and gentle with birth parents. Children may feel loyalty to their parents even if they are angry with them.

The role of foster parents in family time

Subject to the child’s care plan, Fosterplus foster parents and staff must help to promote, support and encourage children to maintain positive and constructive contact with their parents and wider family, friends and others who are important to them. Most foster parents will routinely take on facilitating contact as part of the fostering role and do it well, but we recognise that it can be a difficult task and that some foster parents will struggle.

We aim to ensure that foster parents are clear from the placement plan what authority they have to make day to day decisions on family contact arrangements. The placement plan should specify the arrangements made for family time between the child and any parent and/or person who is not the child’s parent, but who has parental responsibility for them, and any other connected person – including the type, frequency, timing, venue, transport and supervision; restraining or other relevant Court orders; arrangements for notifying any changes in the arrangements for family time and any conditions of an order from the Children’s Hearing.

Visits should be natural and active occasions and, as appropriate, involve going out, playing, etc. Family time for the majority of children should take place at an agreed venue which is normally decided by the local authority. On occasion a foster parent may be asked to supervise this contact, unless there are good reasons for this not to happen. There will be practical implications and foster parents will understandably want to minimise disruption and intrusion to other members of their own family. This must be discussed at the placement planning stage.

Family time is one of the most emotional aspects of child care arrangements for children and their families who are separated. The management of family time is one of the toughest aspects of fostering. If a child is to go home, their links with their parents must be continued. For young children, where the plan is to return home, visits may be intensive and frequent e.g. several times a week. For older children, and where the plan is not rehabilitation, visits will be less frequent.

Family time can also mean letters or phone calls and children should not be prevented from writing to, e-mailing or phoning family members, unless restrictions on this are part of the placement plan.

Support to foster parents around family time

When deciding whether to offer a placement, Fosterplus will agree with the responsible authority how the child’s family time with family and significant others will be supported, particularly where a child is placed at a distance from home. Any proposed role for foster parents should be discussed with you at the matching stage.

Fosterplus can give foster parents practical help to set up appropriate family time arrangements, alongside support to manage any difficult emotional or other issues that the child and foster parent may have as a result of family time. The support should be discussed as part of the placement plan and any issues arising from family time brought by the foster parents to the attention of their supervising social worker. Foster parents should feel that they can talk to their supervising social worker. They should not be alone in picking up the pieces after difficult visits.

Restrictions on or termination of family time

We will only place emergency restrictions on family time to protect the child from significant risk to their safety or welfare, and the supervising social worker or service manager will communicate these to the responsible authority within 24 hours of being imposed. Any ongoing restriction on communication by the child must be agreed by the child’s responsible authority, take the child’s wishes and feelings into account and be regularly reviewed by Fosterplus in collaboration with the responsible authority.

If a decision is made that rehabilitation of a younger child back to their birth family is not in the child’s interest, the responsible authority will try to safeguard the child’s future with a permanent substitute family. This may mean terminating the parents’ family time with the child, although this will require a decision of the Children’s Hearing. When this occurs, the child still needs to know and be able to talk and ask questions about their parents. If the foster parent understands the parents’ situation, it is easier for them to explain kindly and truthfully to the child what is happening and why. In these circumstances, foster parents and social workers should discuss and agree what the children are told.

Recording family time

Fosterplus routinely feeds back to the child’s responsible authority any significant reactions a child or young person may have to family time arrangements or visits with any person. In addition, the supervising social worker or foster parent may need to give evidence in Court or information to a children’s hearing about the nature and quality of family time.

Foster parents should record all family time on the child’s CHARMS case record, using the carer log detailing type of contact, who with, where and how it went. Ideally, records should be made as soon after the family time as possible. Recording should be dated and, if appropriate, times recorded. It should be clear who has made the recording. This will help to ensure the accuracy of recording.

You should record details and observations of family time with birth family and other connected persons (including the child’s reactions). You should also note any failure to visit and the reasons, as well as telephone calls and letter box contact.

Preparation for independent living

Promoting independence

As young people approach adulthood, foster parents should increasingly support them to develop the skills they will need as they become more independent, working with the young person’s social worker to implement their pathway plan. Fosterplus offers foster parents training and support in this task.

The concept of a transition to adulthood is helpful in getting us to think about preparing young people for leaving care. Young people should be fully involved in all planning and decision making which affects them. We should be treating all young people as people in their own right, active partners in the care process. We should not treat young people as passive – they need to develop skills in independence, responsibility and decision making, in order to become successful adults.

Young people should be supported in developing life skills: self-care; practical skills; interpersonal skills. Many young people in the care system will have experienced challenges to their self-esteem and confidence and identity, either through abuse or deprivation. Foster parents and social workers have a responsibility to help young people build positive self-esteem. For many looked after young people there has not been gradual assimilation of skills throughout childhood. They may struggle with these skills and so need the support and assistance of their social workers and foster parents.

What is the role of foster parents?

Foster parents have key formal and informal roles in preparing young people for independent or semi-independent living. Formal roles include contributing to care plans and pathway plans, and attending reviews and other planning meetings. Fosterplus expects foster parents to prepare for and attend all relevant meetings and to take a pro-active approach to developing and implementing plans.

The informal role of foster parents is less easy to define, but is just as important. In the years leading up to the young person’s 18th birthday they need to be prepared for independent living, and foster parents are the best placed people to help them on a day-to-day basis. For many young people this will be about supporting them to complete practical tasks, such as making job or housing applications, preparing a budget or notifying relevant agencies such as energy companies of an impending move. It may include remaining in contact and offering continuing support, as any good parent would, once the young person has moved on to their own accommodation.

Skills required for independence

The checklists below give an indication of the sorts of skills all young people need to acquire for independent living. Preparation should be seen as a process that occurs throughout the care experience of the young person. Many of these skills can be developed in an age and developmentally appropriate way through living alongside foster parents and their families, and taking part in ordinary family activities, such as preparing meals, shopping, travelling to places and discussions. Other skills directly relate to the pathway plan and will require a more focused approach.

Practical Daily Living Skills

Young people need to know about:

• How to shop for, prepare and cook food;
• Eating a balanced diet;
• Laundry, sewing and mending and other housekeeping skills;
• How to carry out basic household jobs such as mending fuses (which will involve basic electrical and other knowledge);
• Safety in the home and first aid;
• Household budgeting, including the matching of expenditure to income, the regular payment of bills and avoidance of the excessive use of credit;
• Applying for and being interviewed for a job;
• The rights and responsibilities of being an employee;
• Applying for a course of education or training;
• Applying for social security benefits;
• Applying for housing and locating and maintaining it;
• Registering with a doctor, dentist and optician;
• Contacting emergency services (fire, police, ambulance);
• Finding and using community services and resources;
• Contacting Children’s Services Departments and other caring agencies;
• Contacting organisations and groups set up to help young people who are, or have been, in care;
• The role of agencies such as the Citizens Advice Bureau, local councillors, and MPs;
• How to write a letter of (a) complaint; (b) to obtain advice;
• How to socialise, where to go, how to relate to others.

Self-care and Emotional Skills

Young people need help with:

• Health education, including personal hygiene;
• Sexual education, including contraception and preparation for parenthood;
• Assertiveness;
• Management of stress;
• General coping mechanisms;
• Exploring feelings about moving on – positive and negative;
• Feelings about identity;
• Feelings about transition from being a young person dependent on others to being more responsible for their actions;
• Feelings about family and relationships and support networks;
• Where can they go/where can they receive support in times of crisis?
• Continuation of therapy/counselling if applicable;
• Recognition of ongoing unresolved issues.

Parenting Skills

Some young people may be pregnant or already have a child when they move in to independent living. All young people should be adequately prepared for the reality of having a dependent child:

• Can this young person provide adequate care for a dependent child whilst living on their own in a flat?
• Do they understand and practice basic childcare to aid the child’s physical development?
• What support networks do they have to provide continual emotional and practical support?
• What support networks do they have to provide assistance in times of crisis?
• Is there someone who can help with child minding?

By the age of 16, every eligible child should receive an assessment of their needs by their local authority, which will form the basis for their pathway plan (which should be completed within three months of their 16th birthday). The assessment of need should identify the young person’s independence skills which will decide their accommodation needs when they leave care. The pathway plan, which contains the same core elements as a care plan, will include:

• Nature and level of contact and personal support to be provided.
• Plans for education (the personal education plan) or training.
• Plans to assist in relation to employment or other occupation.
• Contingency plans if things do not work out as planned.
• Details of accommodation.
• Support for relationships with family and friends.
• Practical skills needed and a programme to develop them.
• Financial needs and arrangements.
• Health needs and how they will be met.
• Arrangements to meet needs in relation to identity.
• Details of their personal advisor and anyone else involved in supporting the plan.

Each young person will be central to drawing up their own plan, setting out goals and identifying with their social worker how the local authority will help them. The role of their foster parent/s should be included within this. While they are still living with their foster parent/s, their foster parent/s’ role and any staying put arrangements – including financial and other support available – should be summarised in the placement plan.

The pathway plan should be regularly reviewed and updated as part of the case review process up until the young person’s 18th birthday. Once a young person reaches the age of 18 they are no longer a looked after child and are therefore no longer subject to the looked after child review systems. However local authorities have a duty to regularly review the young adult’s pathway plan. The personal advisor is primarily responsible for co-ordinating this process, which would normally be undertaken by regular review meetings.

Some young people who are continuing their education may remain with their foster parents until this is completed. See Staying Put.

Throughcare and After Care

Some local authorities will have specialised throughcare and after care teams who will work with young people who are moving towards independence and leaving care. This may mean that a young person is allocated a throughcare and after care worker. However in many authorities this work will be carried out by the child’s social worker. Some young people may not be in a place that they feel able to use this help at that time but will need it later. The Children and Young Person’s (Scotland) Act 2014 enables a local authority to assist a young person who was in care on their 16th birthday or subsequently to assist them up to the age of 26 years.

Staying Put

What is a Staying Put arrangement?

Each local authority is required to have their own Staying Put Policy, which sets out the arrangements whereby the authority can fulfil their duty to facilitate and support young people to remain with their former foster parents from the age of 18, where this is the wish of both the young person and the foster parent.

Effect on the usual fostering limit

As the young person is no longer a foster child, the young person is not included in the number of children who can be fostered. This means that, if the foster parent continues to foster, in addition to any young adult living with them under a Staying Put Arrangement they can foster up to the limit of their fostering approval. The young person would be regarded as another adult in the household. Such factors as the number of bedrooms available, the capacities of the foster parents and the needs of other fostered children will determine the foster parents’ approval criteria if they also care for a former foster child.

Financial arrangements for Staying Put Arrangements

Where young people turn 18 and remain with their former foster parents on a Staying Put Arrangement, the basis for any payments will change. Staying Put should have been explored as part of Pathway Planning for young people. The foster parents and the Agency both need to be involved in discussions with the placing local authority. Young people aged 18 or over are no longer fostered and the financial aspects of Staying Put Arrangements need to be agreed in writing before they turn 18.

Payments to foster parents for Staying Put Arrangements are not standard – they depend on each local authority’s policy. If there is no written agreement in place, Agency payments to the former foster parents will automatically cease when the young person turns 18, so it is essential that discussions take place at an early stage. The service manager and the Polaris Contracts and Partnerships Team will play a key role in this negotiation. The arrangements that are agreed should be regularly reviewed. The Finance Team will be informed of the arrangements and any subsequent changes.

Why do children with disabilities need foster care?

Children with disabilities ranging in age from babies to teenagers may be placed in foster care. Sometimes their parents are unable to care for them and these children often need to be placed in long-term or permanent foster care… For other families of children with disabilities, or children with life limiting conditions there might be a need for the child or young person to be placed regularly with foster parents for a few days each week, or each month, to help them and their family. Supporting both the family of a disabled child as well as the child can be hugely rewarding and is often referred to as short breaks foster care.

Some children have learning difficulties, such as those with Down’s syndrome, whilst others may have been physically disabled from birth or have suffered an accident or injury that has resulted in them being disabled. A child may have severe and complex health problems arising from a disability. The use of the term ‘child with disabilities’ is actually quite vague and often describes a child with a lot of abilities, which can get forgotten in our attempts to classify what a child can’t, or is less able to do.

Training and guidance

Fosterplus has a number of foster families with experience, skills and an interest in fostering children with disabilities. If foster parents have not offered this type of care, but think they might be interested, they should speak with their supervising social worker. We can offer specialist and targeted training and support to help foster parents acquire and develop the skills to care for children with complex disabilities and health care needs. There is much evidence within our own agency of the ability to provide good quality life experiences for these children notwithstanding the huge obstacles they face.

Equipment and accommodation

Placements for children with disabilities will be planned and matching discussions between Fosterplus and the referring local authority will include consideration of accommodation and equipment needs.

Children with disabilities and child abuse

Safeguarding children with disabilities

Children with disabilities have the same rights to be safe from abuse and neglect and to be protected from harm as non-disabled children. Disabled children do, however, require additional action. This is because they experience greater vulnerability as a result of negative attitudes about disabled children, unequal access to services and resources and because they have additional needs relating to physical, sensory, cognitive and/or communication impairments. Such additional factors include:

• Disabled children are at an increased likelihood of being socially isolated with fewer outside contacts than non-disabled children.
• Their dependency on parents and foster parents for practical assistance in daily living, including intimate personal care, increases their risk of exposure to abusive behaviour.
• They have impaired capacity to resist or avoid abuse.
• They may have speech, language, and communication needs which may make it difficult for them to tell others what is happening.
• They often do not have access to someone they can trust to disclose that they have been abused.
• They are especially vulnerable to bullying and intimidation.

Research has established that proportionately higher numbers of children with disabilities are subject to abuse than non-disabled children, yet professionals involved in their care may be reluctant to act on concerns for such reasons as:

• Over identifying with the child’s parents or foster parents and being reluctant to accept that abuse or neglect is taking place, seeing it as being attributable to the stress and difficulties of caring for a disabled child.
• A lack of knowledge about the impact of disability on the child.
• A lack of knowledge about the child e.g. not knowing the child’s usual behaviour.
• Not being able to understand the child’s method of communication.
• Confusing behaviours that may indicate the child is being abused with those associated with the child’s disability. Sexually harmful behaviour and self- harming may be indicative of abuse and not linked to the child’s disability.
• Denial of the child’s sexuality.

If foster parents have any concerns that a child they have care of may have been abused, they should contact their supervising social worker urgently.

Applying for benefits

Some children and their foster parents may be able to receive state benefits in recognition of additional living costs. These benefits are financed and administered by central government and not by Fosterplus or the child’s responsible local authority. Any benefits paid do not affect the fostering fees paid to the foster parent by Fosterplus. Where a child is eligible for benefits as a result of a disability, foster parents are encouraged to apply for those benefits. This must be done with the knowledge and agreement of Fosterplus and the local authority for the child. Your supervising social worker can provide advice and help about how to go about this.

Accountability for disability benefits relating to a fostered child

Fosterplus expects that there will be regular recorded discussions between the foster parent/s and the supervising social worker about how any additional benefits are being spent to promote the best interests of the child.

Any complaint that the allowance was being misspent would be made to the Department for Work and Pensions (DWP) for investigation. The criteria for entitlement to disability benefits are complicated and cannot be fully addressed within the Foster Parent Finances Handbook.

Disability Living Allowance

Disability Living Allowance (DLA) is a weekly benefit paid in recognition of the additional direct and indirect living costs incurred by young people with disabilities. Foster parents must make the claim for the child. The amount of the benefit depends on the nature and extent of the child’s disability. There are two components: namely mobility and care. Once a child is awarded the assessed level of the allowance, the foster parent acts as the ‘Appointee’ and is responsible for administering the allowance.

Who is accountable for the Disability Living Allowance?

Although the foster parent is legally accountable to the DWP for how the allowance is spent and not to Fosterplus (or the child’s social worker), it is expected that, when entitlement to the allowance has been confirmed, the use of the DLA will be discussed with both parties and that the Fosterplus supervising social worker will regularly monitor expenditure with the foster parents. Foster parents are expected to demonstrate to the Agency that they are managing this allowance appropriately.

N.B. Once a young person reaches the age of 16 years their DLA will stop and they will have to apply for Personal Independence Payment (PIP). The rate received is dependent on how the condition affects the individual, not the condition itself. The rate will be regularly reassessed. This should be applied for before the DLA is due to stop to avoid any gap in benefit.

Who are unaccompanied asylum seeking children?

Unaccompanied asylum seeking children are young people who are not UK citizens and who arrive at a point of entry to the UK from abroad without having an identified and available adult to care for them or where there is uncertainty regarding the suitability of any identified carer. Such children are likely to have, for example, different cultural, religious, social, familial and language experiences which foster parents will need to understand, value and maintain along with facilitating the young person’s integration.

Matching with foster parents

Our aim is to access and obtain the best possible care and support for these children and young people – many of whom have already suffered significant personal hardship and loss.

As for any child or young person placed with Fosterplus, we will seek to provide an appropriate match of family who will offer the stability and opportunity for development necessary for them to thrive and overcome their early experiences. We will only place unaccompanied asylum seeking young people with foster parents who have attended a Fostering Unaccompanied Asylum Seeking Children training course.

Clearly there are specific aspects of care that must be addressed for this group of children and young people. These will include ensuring that there is appropriate provision to reflect the young person’s culture, religion and language. There are mosques and also Catholic and other denomination churches in most cities and towns. Dates of festivals, Ramadan etc. can be obtained from a variety of sources (e.g. publications; internet). We expect dietary needs and requirements, as well as preferences, to be respected and catered for by foster parents. A major concern will be the possibility that the child is trafficked and therefore at risk. See Trafficked Children.

Support to foster parents and young people

The supervising social worker will assist foster parents in liaison with the school, family, church, mosque etc. as well as the placing authority. Where possible, and with due regard to the cultural and religious differences that exist in each country of origin, Fosterplus will endeavour to introduce children and young people of similar background who are placed with Fosterplus and who live in proximity.

Fosterplus can identify solicitors who have been approved by the Legal Aid Commission to undertake applications for asylum.

Education and translators

Fosterplus will work with the relevant local education departments to provide adequate support for children in schools. TESOL trained teachers are also available according to the location of the foster parents. Local authorities also provide intensive language courses. There are many other similar private language tuition centres available and several trained specialist teachers can be engaged on a sessional basis.

Where translation is required for legislation/application purposes, this is covered by legal aid. Translators for interviews, meetings and reviews are normally provided by the placing authority, but there are many local contacts if required.

Health care

Unaccompanied asylum seeking children may have complex and varied health needs. They may have experienced malnourishment or subject to infections or diseases unfamiliar to UK residents. Children from war zones may have been subject to violence and sexual assaults. They may have witnessed such actions and be emotionally traumatised by their experiences. Simply by being separated from family and friends may cause depression and anxiety. Foster parents and professionals will need to manage and support such children with great sensitivity.

Health care services will be accessed by the foster parents as appropriate. If immediate or specific attention is required, Fosterplus employs the service of a Medical Advisor.

As previously mentioned, some children may be traumatised and distressed by things they have witnessed or experienced in the past. Such children may need specialist and expert psychiatric intervention from CAMHS or other mental health services.

Family time

Fosterplus will encourage and support a child or young person’s family time with relatives and friends in this country where appropriate and as agreed with the placing authority. Where a child is able to contact relatives in their country of origin, Fosterplus will enable phone contact to take place regularly as part of the placement plan.