This is a post-peer-review, pre-copy edited version of a chapter published in The Future of Children’s Care Critical Perspectives on Children’s Services Reform. The definitive publisher-authenticated version: Radoux, J. (2023). "9: Caring for children and young people in state care in the 2020s". In The Future of Children’s Care. Bristol, UK: Policy Press is available online at: https://doi.org/10.51952/9781447368274.ch009
This blog version should not be used for citation.
I am grateful to Robin Sen and Christian Kerr for originally commissioning this piece.
Introduction
It would be remiss not to comment on personal experience – although this was all over 30 years ago – which included a few foster homes, a children’s home, kinship care and, through adolescence, a local authority boarding school for children with emotional and behavioural difficulties. The relationship between these experiences and my current ideas about the care system is peripheral, consciously at least, and I am much more influenced by the experiences I have had, and witnessed, over nearly two decades working in the care system. That said, to be care experienced gives any discussion about the care system an emotional resonance that is bound to affect thinking.
Much of my career, and therefore day-to-day involvement with children in care, has been spent working in residential children’s homes – for the most part as a care worker, often in senior/team leader roles, a brief period as a registered manger, developing staff training and so on. The nature of the role of children’s homes within the care system (the de facto ‘last resort’) means a significant majority of the children and young people I have been involved in caring for have had multiple foster homes, and sometimes a number of children’s homes too, before I knew them. Many, of course, went on to have other homes when my part in their lives ended. I have witnessed many ‘placement breakdowns’ - to use the rather cold jargon. Similarly, I have seen numerous young people leave care, but rarely to a situation or accommodation that I considered good enough. In short, the vast majority of children I have been involved with have not only had to contend with the very difficult experiences, sometimes horrific, that led to them coming into care, but they have been manifestly let down by the care system too.
More recently, my contact with children in care has been with those I see as a therapist and I have been involved, at one remove, with children in foster care who have experienced developmental trauma and disrupted attachment in a role supporting carers to think about the experiences and needs of their foster children. I have had no involvement in my career with children who are very settled where they are living and quietly getting on with their lives with no particular difficulties. This must skew my thinking – perhaps I see the care system as more inadequate than it is. However, it is ultimately the children and young adults that the care system is failing, that we as a society are failing, that are my concern in this chapter.
The Needs of Children in Care
In many ways, the needs of children in care do not differ from those of other children and could adequately be summarised by Maslow’s hierarchy of needs (Maslow, 1943): physiological, safety, social, esteem, and self-actualisation. Arguably, it is a flawed approach to place these needs in a hierarchy, because, for example, children are very unlikely to have a felt sense of safety unless their social – relational – needs are being met, for reasons described by Bowlby (1969) among many others. All models for understanding the human condition have their limitations and blind spots, but attachment theory - first developed by Bowlby and modified and expanded up on by developmental psychologists such as Crittenden (2008) - points to a basic relational need so often missing for children in care. Namely reliable, safe, and ongoing relationships with one or two key individuals. The MacAlister Review recognised this with its ‘Mission 1: No young person should leave care without at least two loving relationships, by 2027’ (The MacAlister Review, 2022, p. 151). A laudable objective, whether the recommendations of the MacAlister Review could create the conditions for this to happen will be discussed throughout this chapter.
Ongoing, trusting relationships in childhood that sustain into adulthood, play a crucial role in helping us navigate an interdependent society (Radoux, 2019). The MacAlister Review itself states, in the foreword from the Experts by Experience (EbE) Board: ‘A focus on ensuring young people leaving care have at least two loving relationships to support them, will help us reimagine leaving care as a time of ‘interdependence’, rather than ‘independence’.’ (The MacAlister Review, 2022, p. 9). It is disappointing, therefore, that this is the only use of the word ‘interdependence’ throughout the entire report, and the general thrust of the relevant chapters remains one of young people moving through care and becoming independent (a word used repeatedly) in adulthood. Had the MacAlister Review consistently promoted the concept of interdependence, and rejected the impossible expectation that children in care should be ‘prepared for independence’ and become independent by the time they leave care, this could have been genuinely radical.
Both the MacAlister Review and the Duncan Review emphasise the need for children in care to have loving relationships and the, much harder to define, concept of ‘love in the system’. A possible way to describe a system that is loving is one where those making decisions for and about a child first imagine into that child’s world, consider how their decision/s will be experienced by the child and act with empathy. This is easy to suggest, it is much harder to do.
It is hard because it means professionals taking moments of pause during, often high pressure and busy, working days to think about a child’s age, stage of development, what they have experienced in their life so far and what impact these experiences have had on them – attempting, ultimately, to imagine what it would be like to be that child. This is necessary because this is the context for the decision that is being made. Those responsible for making and delivering policy may not have an individual child in mind, but they should nevertheless imagine into the lives of those they are designing policy for.
Those involved in the lives of children in care or care experienced adults, such as foster carers, social workers, teachers, commissioners, Secretaries of State or numerous others often, consciously or unconsciously, avoid this type of thinking and attunement – at least in part because it is emotionally uncomfortable. From a psychodynamic perspective, much of the children’s social care system seems designed, unconsciously, to be a ‘manic defence’ (Winnicott, 1975) – everyone too busy, rushing from one thing to the next, no one with time to stop and think or, as importantly, feel. While some level of dissociation is probably necessary – it would likely be intolerable for any individual to be fully in touch with the pain and distress they will come across during a career in the care system – the pendulum often appears to swing too far in this direction. If we do not allow the experiences of children in care, our role in their lives and the decisions we make to emotionally resonate with us, there will not be love in the system, however it is defined, and poor decisions, which lead to poor experiences for children in care, will continue to be made. ‘The system’ is an abstract construct, it is made up of people, the relationships, in all their different forms, between those people, and the decisions they make.
There is a considerable comment in the MacAlister Review regarding freeing up social workers to spend more time with children and families, often referred to – perhaps unhelpfully – as ‘direct work’. Certainly, it would be helpful if more children in care were able to have meaningful relationships with their social workers. To achieve this, social workers do need to be able to spend more time with these children, whether that is through a reduction in what the MacAlister Review calls ‘too much unnecessary bureaucracy’ (The MacAlister Review, 2022, p. 180) or the recruitment of more social workers. Few people would argue for more bureaucracy so this may be a popular line, but it is worth recalling the words of Mrs Justice Lieven in her judgement on the judicial review regarding Statutory Instrument 445 and the government’s argument that it simply removed some ‘administrative burdens’ on local authorities:
These are not administrative burdens, or minor matters, they are fundamental parts of a scheme of protecting vulnerable children. (R (Article 39) v Secretary of State for Education, 2020, Para. 76)
One risk of this emphasis on direct work is that it feeds an existing dynamic and tension common throughout children’s social care that could be described as ‘thinking vs doing’. ‘Thinking’ is already too often subordinate to ‘doing’, partly for the dissociative reasons explained above, and also, as the MacAlister Review states: ‘High workloads and a focus on compliance, too often means that supervision is focused on managerial oversight, processes and timescales, rather than meaningful reflection’ (The MacAlister Review, 2022, p. 70).
Perhaps it is indicative of the MacAlister Review’s primary focus being children and families social work, but the quotation above comes from its relatively brief discussion on reflective supervision in its chapter discussing child protection. What is required are many more opportunities to reflect, think and feel throughout the entire ecology of the care system from Secretaries of State and Directors of Children’s Services to foster carers and residential staff. This can only partly be achieved through the creation and protection of formal spaces such as supervision and reflective practice groups. There also needs to be time for the informal chat with a colleague or just to stop for a moment and reflect on one’s own. Of course, if individuals involved with children in care are to be asked to allow those children’s experiences to resonate, to notice their own emotional affect, then they must be provided with meaningful support beyond social media memes about ‘self-care’.
As well as ‘imagining in’ to a child’s world, if we want to understand a children’s experiences, and what they need and want, we must ask them. Ideally, this can be done in a relatively informal, ordinary, way via a professional’s or carer’s relationship with a child, but it is also necessary, not least because of how often children have been abused in the care system, to have formal structures for consulting children in care. The MacAlister Review (pp. 140- 142) argues for a presumption that children in care have an advocate unless they choose to opt-out. It confused the issue by suggesting advocates should also replace Independent Reviewing Officers and Regulation 44 inspections of children’s home but, setting aside this misguided thinking, the argument that all children in care should have an advocate is compelling. The recommendation should go further – even children who ‘opt-out’ should continue to have a named advocate, so if they choose to ‘opt-in’ again the process for doing so is straightforward.
How much weight is given to a child’s views will depend on numerous factors, including: a child’s age and stage of development, their immediate emotional/psychological state, the significance of the decision, the risks involved and so on. Often this is an ordinary part of day-to-day care, on other occasions it might require discussion with a child’s wider network. Many would argue for the importance of a child’s agency, including Bowlby when discussing the role of primary carers: ‘In essence this role is one of being available, ready to respond when called up to encourage or perhaps assist, but to intervene actively only when clearly necessary’ (Bowlby, 1988, p11).
Arguably, it is perhaps even more important to regularly consult children in care than children growing up in ordinary families – from the moment a child is taken from the care of his or her parents and transported, in a blur, to the care of a stranger, in a strange house, often in a strange town, a feeling of abject powerlessness and being ‘done to’ can be engendered. This feeling, increasingly entrenched through a child’s experience of being buffeted over his or her years in the care system, can become a pervasive sense of not mattering and not being able to affect change in, or impact on, the world or other people. This can have consequences for psychological and emotional health, and material well-being, long into adulthood. Nevertheless, caution is required when emphasising a child’s agency, otherwise these arguments can easily lead to a sexually exploited 15-year-old girl being described as making ‘a lifestyle choice’ or a 16-year-old, having been seduced by the notion of ‘independence’, making distressed late night phone calls to his former children's home asking if he can move back in. Taking the latter example, if we are going to be serious about allowing young people to make choices, even ones we might consider ill-advised, surely this must include the right to change their mind? The circumstances in which children come into the care of the state vary a great deal, but there is often a common theme - those (usually the parents) who were meant to be caring for them were unable or unwilling to take up adult responsibility. The care system, and individuals working in it, must be very careful not to replicate this.
It is worth noting too that for children to feel safe they need to have a strong sense that the grownups know what they are doing and, while a child can be given appropriate levels of autonomy, ultimately, the adult/s caring for them have responsibility for their welfare. This is especially true of traumatised children who are likely to have experienced unsafe and non-boundaried adults. Ensuring this entirely necessary power imbalance is not used in an abusive, coercive or punitive way involves recognising that any professional or carer could be capable of doing so in certain circumstances or under particular kinds of psychological pressure, and considering it as a regular topic of supervision and reflective practice.
It appears axiomatic to say that children in care need to be loved. Would anyone attempt to argue that children in care should not be loved? But we should not deny complexity here. Even in the best of circumstances, love - whether that be between parent/child, romantic, friendship or any other kind – is never static and almost invariably includes feelings of ambivalence from time-to-time. Whether love can, or should, ever be unconditional is a philosophical question beyond the scope of this chapter, but one worth bearing in mind. We must also remember that the word ‘love’ and similar language can be used coercively or by those who abuse children – indeed as a justification for doing so. Certainly, carers must consider carefully what they mean, and the impact it might have, on a child in their care before they tell them they love them. What is the carer communicating? ‘I love you in this moment’? Or, ‘I will love you forever?’ Or, ‘I love you irrespective of how you behave towards me’? and so on. It is also vital to consider whose need is being met by this declaration – the child or the adult? Is the carer, or worker, hoping the child will say it back to them? It is advisable for any carer or social care worker experiencing an entirely human and powerful urge to tell a child in care that they love them to think this through with someone else in the child’s professional network. All this said, squeamishness regarding the issue of love and use of the word has meant children spending entire childhoods in care without feeling loved or being told they are loved – this is deeply problematic too.
‘Love’ is subjective and incredibly difficult to define and measure, which means it does not lend itself to legislation or policy, but that does not make it wrong to state, as an aspiration, that children in care should be loved, or leave the care system with long-term loving relationships – to name it as something to strive for, even if this is largely symbolic.
The question is, how do we provide children in care with a genuine experience of being loved? Cleary, it is not possible to simply instruct someone to love another human being. If we are going to get anywhere close to achieving this aim, we must consider why it is so difficult – including why some children in care appear to reject love and care – and we cannot afford to be sentimental. Many children in care, due to their early experiences and, often, because of experiences within the care system, find relationships both with other people and themselves difficult. They need more than, what might be called, ‘ordinary’ childcare or parenting. To acknowledge the impact of early years trauma, ruptured attachments, abuse and neglect on a child’s psychological and emotional health is not to pathologize or stigmatise children in care. Nor is it to suggest they cannot go on to have ordinary and fulfilling lives – indeed it is to help make this more likely. That said, harms experienced in childhood can be so profound that some individuals may continue to need significant support throughout adulthood – this should not be a matter of shame or judgement – and wealthy, industrialised nations such as the UK should have no difficulty in providing it.
Types of Care
When children cannot live with one or both parents, the options available are: residential children’s homes or schools, kinship care, foster care and adoption. It can often seem as if there is an implied hierarchy in provision or routes to ‘permanence’, but none is intended by the order of the list here. The MacAlister Review appeared to have a preference for kinship care: ‘many children should and could safely – with the right help – remain within their family network rather than enter care’ (The MacAlister Review, 2022, p. 94). The MacAlister Review is in no position to assert this, but perhaps this ambition is why it had relatively little to say about other forms of care. Both kinship care and adoption are considered more thoroughly in other chapters, therefore the focus of this chapter is residential and foster care.
Prior to the MacAlister Review, there were separate reviews, in England, of foster care and residential care led by Martin Narey (National Fostering Stock Take, 2018 & Independent Review of Children’s Residential Care 2016). This siloed approach did not reflect the experience of children as they live and move through the care system, nor did it offer an opportunity to consider how these types of care might dovetail in ways that might better meet the needs of some children. This is one of the reasons some called for a whole system review and it was hoped the MacAlister Review might better consider this. That said, for coherence, the sections below will consider foster care and residential care in isolation, before discussing how they might work together. Secure care will be discussed separately.
Foster Care
The majority of children who cannot live with parents or family members will continue to live with foster carers. For many this will be appropriate and, in most cases, these children would ideally have one foster home until either they return to the care of their birth family, or they are genuinely ready to live interdependently, but with less need for day-to-day care and support – probably in early adulthood. Ideally too, those that want to will continue to have a relationship with their foster carers long into adulthood (in line with the MacAlister Review’s ‘Mission one’ discussed previously).
Unfortunately, there is a shortage of foster carers, the MacAlister Review calls for the recruitment of 9000 new carers. It correctly states that foster carers need ‘…the right parenting skills to meet the varying and complex needs of children…’ (The MacAlister Review, 2022, p. 12). However, implicit here is that not everyone has ‘the right parenting skills’. In other words, not everyone who wants to be a foster carer, however well intentioned, should become one. It is almost contradictory for the MacAlister Review to later speculate about teachers, or other adults in a child’s wider network, fostering specific children. There would need to be a process to ensure they had ‘the right parenting skills’ (and, it will be argued here, other necessary attributes required to foster traumatised children). The impact of a breakdown in the relationship between a child and a teacher or other known adult (experienced, almost inevitably, by the child as a rejection) could be more harmful and problematic than with an otherwise unconnected foster carer. That is not to say it would never be appropriate for a child to be fostered by a teacher, or maybe a family friend, for a period, but it is unlikely to prove the solution to the shortage of foster carers the MacAlister Review appears to imagine.
A key consideration when recruiting, and for any applicant themselves, is what need is the potential foster carer trying to meet? This is beyond discussion regarding overt motive – such as wanting to make a positive difference to a child’s life, income, or a combination – but the applicant’s own psychological and emotional needs, which they might not be fully conscious of. One example, which, from this writer’s observations, appears common not just to foster carers but many in what might be called ‘helping’ roles and professions, is the need to be needed.
Of course, this ‘need’ does not preclude someone from becoming a foster carer, but if it is unrecognised and unthought about – then it is likely to be very difficult for the carer when a foster child does not meet this need. At best the foster child, certainly in the early months, will be ambivalent, but just as likely rejecting and actively hostile. Typically, just at the point when a child appears to be settling, is gradually accepting care and beginning to trust the carer, she will experience the greatest anxiety (essentially that she will be rejected) and the cycle will start again. Even the most robust, committed and psychologically informed foster carer will feel buffeted by this – intellectually the carer might understand it is neither fair or realistic to expect the child to be ‘grateful’ but, emotionally, resentment can start to build. Mixed with these resentful feelings is guilt (perhaps even more so if lip service is given to unsophisticated notions of ‘love’). What does the carer do with these feelings? Unacknowledged, unthought about, unexpressed feelings are usually acted out in some way – this is the psychological pressure mentioned previously, under which someone may act abusively or punitively. Frequently, the response from the carer will be to inform the local authority, or fostering service, they are no longer able to care for the child – sometimes even unable to see through a 28-day notice period. This picture is bleak, but versions of it are common place within the care system.
To help avoid this, or other equally fraught dynamics, fosters carers should really be supported to undertake in-depth personal reflective work prior to becoming carers. There is an argument for a robust assessment, similar to an adult attachment interview, which could also be used, later, for matching purposes. This process should continue via ongoing reflective spaces throughout their time as foster carers – facilitated by psychologically informed practitioners. A space where not just feelings of ‘love’ towards foster children are voiced, but less benign feelings such as resentment and anger, can be heard, thought about and contained.
Of course, foster carers need substantial ongoing training and learning – not least because a framework for understanding what is happening for a foster child, and the carers internal responses, is vital. There is not the space for detailed descriptions of therapeutic parenting models here, but those devised and described by attachment and trauma influenced clinical psychologists such as Dan Hughes (2006) or Kim Golding (2007) have much to recommend them. However, without meaningful ongoing support, simply learning these models is unlikely to be sufficient. Additionally, specialist intervention maybe needed – either a dyadic form of psychotherapy designed to encourage the attachment between child and carer, individual psychotherapy for the child or both. In some cases, counselling or psychotherapy for the foster carer might be more productive.
It is to be noted that many foster carers would argue they do not require this level of support and they, and their foster children, would experience it as intrusive. Perhaps for many fostering families this might be true, but caution is urged before taking all such protestations at face value. It is, understandably, more emotionally comfortable for some carers to believe that the stress and tension is not caused by the foster child, and their relationship with them, but all the external ‘interference’ and ‘noises off’ – the fantasy that everything would be okay if they, and the child, were left alone is alluring, but often it is not grounded in reality.
Perhaps it is unreasonable to expect a government policy review to speak to these kinds of complexities, but given the MacAlister Review stated: ‘…for a child in care, our obsession must be putting relationships around them that are loving and lasting’ (The MacAlister Review, 2022, p.12), it is a shame it did not give more thought to what is required to make that happen, beyond recommending an off-the-shelf model of foster care – Mockingbird (The MacAlister Review, 2022, p. 138). Mockingbird, which attempts to mirror the support network an extended family provides by creating a constellation of foster carers, is not without merit, but nor is it a panacea. The fact that this was the only recommendation on foster care directly related to supporting foster carers and foster children suggests a lack of practitioner expertise within the Review team and, again, illustrates the MacAlister Review’s primary focus was children and families social work, not the experiences of children in the care of the state.
Residential Care
The lack of practitioner expertise at the heart of the MacAlister Review (and perhaps policy making more generally) was most noticeable in it’s almost complete dismissal of residential care – foster care is given a chapter subheading, residential care is not, and none of the reviews 81 recommendations are specifically about residential care. This is negligent for a review described by its own EbE Board as: ‘…the most wide ranging rethink of children’s social care in more than a generation’ (The MacAlister Review, 2022, p. 8). The MacAlister Review’s position appears to be, if enough foster carers are recruited there will be little, if any, need for residential care, claiming: ‘There are many children living in children’s homes today who would be better suited to living in a family environment with a foster carer if we had enough foster carers…’ (The MacAlister Review, 2022, p.12). It later cites Ofsted research, which: ‘…highlighted that one third of children living in children’s residential homes had originally had foster care on their care plan…’ (The MacAlister Review, 2022, p.122). That still equates to over 6000 children, currently, with residential home on their care plan (potentially tens of thousands over the next generation) and ‘originally had foster care on their care plan’ does not mean it was not in the child’s interests for the care plan to change.
Many of the reasons residential care maybe a better option for some children and young people have been described by this writer previously:
Perhaps living with a substitute family is simply too painful – too stark a reminder of what they have lost or never had – or perhaps a child might feel that if they attach or bond with another family, they will be betraying their own. It could also be a child’s early experience of a family home was frightening and abusive – so they just do not feel safe in that environment. (Radoux, 2019)
Another, more straightforward, reason is some young people state it as a clear preference. For those with a well-intentioned desire to end or significantly reduce the use of residential children’s homes, who, understandably, wish to see children grow up in family environments, what would they say to a young person who told them clearly he does not want to? Further, imagine a child who has lived in 10 foster homes, possibly because of repeated cycles of the rejection/resentment dynamic with foster carers described above. What is it that foster carer 11 might be able to provide that the previous 10 could not? If this question cannot be answered, it is surely time to try something else.
Further, even if the long-term aim is for a child to have a positive experience of living in a family environment, she could be more able to emotionally and psychologically bear this following a period of specialist help in a genuinely therapeutic children’s home such as a children’s therapeutic community similar to those described by Ward et al (2003). For example, The Mulberry Bush school, a residential therapeutic community for children in Oxford, which offers 38- or 52-week boarding, has an upper age limit of 13 – the intention being to have sufficiently helped children with their social and emotional needs for them to be able to live in a family environment. Some of the children who board for 38 weeks live with foster carers in the holidays and will be cared for them full-time when they leave the school. The advantage of these types of provision (usually influenced by psychodynamic models of thinking), although not necessarily helpful for all children, is that reflective thinking both with and about a child, and staff members internal responses, can be built into the day-to-day culture and structures of the environment. It is not that the types of feelings and dynamics described previously do not occur, but that they can be recognised quickly, thought about and understood – the child can be helped to understand too. More prosaically, if an interaction between a child and a carer is becoming too fraught, another carer can step in. Although it is likely, and to be hoped, that a child living in a residential setting will form particularly significant relationships with two or three key staff members, what can at first seem a disadvantage of residential care – too many primary carers, shift handovers and so on – could, counterintuitively, be helpful for some children, taking some of the painful intensity out of relationships that can be experienced with just one or two carers in a foster home.
Much more consideration should be given to how children can transition, where it is right for them, from residential homes to foster care. One difficult dilemma is that just as a child is settled and, perhaps, appears ‘ready’ to live in a family environment, moving him from all he knows and relationships he trusts is likely to significantly unsettle him. An option would be for transitions to take place over a much longer period than is currently the norm – not a couple of dinners and an overnight stay, but several months. There should also be the possibility of ongoing relationships with key adults from the residential home. Organisations and businesses who run both residential and fostering provision are in a position to offer options similar to this, but there is no evidence currently of a genuinely joined up approach.
Residential homes are perhaps better placed than foster carer to help facilitate relatively quick reunifications home – trained staff potentially providing support to parents or outreach for young people. North Yorkshire’s No Wrong Door is a version of this and there are some indications of positive outcomes (Lushey et al, 2017). Curiously, although the MacAlister Review includes this research in its list of references, it does not discuss No Wrong Door or other possible uses for residential care in the body of the report.
Not all residential care is, or necessarily needs to be, highly specialist but currently much of it is mediocre. This is not helped by increasingly large chains of children’s homes – where the owners or shareholders and decision makers have no relationship at all with the children they are paid to care for. Specialist or not, it remains the case that it is possible to start work in a children’s home with no prior training or experience. This is not adequate for a role caring for children who often have significant social, emotional and mental health needs. Many children’s home staff will start with substantially less training than a foster carer will be expected to undertake prior to having a child placed with them – this is not coherent.
The University of Strathclyde offers an MSc in Advanced Residential Child Care, and although it does not follow those individuals working in residential homes should all be graduates or post graduates, this points to taking the role of children’s homes and those who work in them seriously. It is a specific and complex task that requires substantial and psychologically informed study and understanding. Residential child care should be professionalised, and residential child care workers should have status (and remuneration) similar to teachers, nurses or social workers. It is hard to see how there will be an improvement in the overall quality of residential care now that the children who will continue to live in, and need, residential homes have been abandoned by the MacAlister Review.
There is a cohort of young people, often traumatised, often with mental health issues, who are very distressed and at significant risk to themselves. They do not meet the criteria for admission to an inpatient mental health ward, nor would this likely be a helpful environment. Currently, there is no provision adequately meeting the needs of these young people. Too often, as evidenced by a number of court cases, they live in unregulated settings, subject to Deprivation of Liberty (DoL) orders and cared for by a revolving group of staff who are neither appropriately experienced or qualified. Too often, nothing will happen during the period of the DoL order to meaningfully address the young person’s distress or behaviours which cause them harm. To address this issue, meaningfully therapeutic secure provision must be created. Although the MacAlister Review rightly describes the need for an increase in the number of secure homes, and a greater geographical spread, it does not describe the type of care they should offer.
Conclusion
Inevitably, this chapter has only touched on a small number of the issues involved in caring for children and young people in state care, but hopefully it has given a flavour of the complexity. This complexity makes developing review recommendations or policies, which need to have clarity, difficult. For this reason, it is understandable that policy makers and, indeed, campaigners can be seduced by ideas that appear unarguable - children should be loved, children should live with a family member or, if not, a substitute family – or ideas that are superficially attractive: what if children were fostered by their teachers? And so on. These ideas feel pleasing and emotionally comfortable, but we do many children in care a disservice if we do not confront realities. Any honest policy recommendation would come with a number of caveats. For example, this writer is strongly of the view that children should have as few ‘placements’ as possible throughout their childhoods, but there are clearly a number of reasons why it might be in the best interests of children (or other children they live with) to move them.
Finally, many of the ideas suggested in this chapter would come with a cost burden, but if we are serious that ‘our obsession must be putting relationships around them that are loving and lasting’ (The MacAlister Review, 2022, p.12) then this is a cost that must be borne. It might be that investing in the care system now could mean saving money on services later, but this should not be the motivation for doing it. It is a moral imperative - if, as a society, we are to remove children from the care of their parents then we must be certain we are doing all we can to ensure they are receiving better care than they would at home – ideally helping them to recover from their original trauma, but as a bare minimum not causing any more harm.
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