evaluating parent and baby placements report...a total of 39 parent and baby placements were...

An evaluation of parent and baby placements in West Sussex

January 2007 Tim Martin and Susan Davies

Social Research Unit, West Sussex County Council January 2007

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Contents

Acknowledgements Summary

1 Introduction

1.1 Background 1.2 Aim of the evaluation

2 Methodology

2.1 Placements evaluated 2.2 Data collection 2.3 Response rate

3 Research findings

3.1 The placements 3.2 Quality of associated services 3.3 The responsible parents 3.4 The babies and their siblings 3.5 Issues affecting the placements 3.6 Quality of placements 3.7 Placement outcomes 3.8 Factors associated with placement outcomes

4 Conclusion

Related documentation Appendix 1: Comments from social workers

2 3

5 5 6

6 6 6 7

7 8

11 12 13 14 17 21 22

24

26 27

AN EVAL UATION OF PAR E NT AND BA BY PL AC EM ENTS IN WEST SUSSEX

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Acknowledgements We would like to thank Peter Crawhurst for the support and expertise he generously offered throughout the project. His input into the research design, the development of the questionnaire and interpretation of the research findings was particularly valuable and much appreciated. We would also like to thank Pat Rouse, Tracey Deyes and Jenny Boddington for their pertinent advice and comments on the development of the questionnaire. Finally, we would also like to acknowledge all the social workers who diligently completed and returned their questionnaires.


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Summary The aim of this study was to evaluate the quality and outcomes of parent and baby placements made by West Sussex Children and Young People’s Services. • A total of 39 parent and baby placements were identified that had been made

between 1 January 2005 and 31 August 2006. • The 39 placements were for 34 children (22 male, 12 female). • General information on these placements was gathered using existing information

systems and databases. Detailed information was sought from social workers involved in the cases using a questionnaire.

• Of the 39 questionnaires sent out, 31 were returned, equating to a response

rate of 79%. Key findings Placement options considered • In 68% of cases social workers reported that no in-house placement was

available (p.8). • In 86% of cases social workers said they had considered 1 or more foster

agency placements (p.9). • In 73% of cases social workers said they had not considered a residential

agency placement (p.9). The placements • 34 of the 39 placements were made with agencies: 29 with fostering agencies

and 5 with residential agencies. The other 5 placements were with in-house foster carers (p.10).

• The average weekly cost of agency placements was £1,398.62 (p.10). • For the 24 agency placements that had ended, the average total placement

cost (from start of placement to end) was £20,193.02 (p.11). The parents and children • All the responsible parents in the placements were female, were likely to be in

their late teens at the point of placement and of a white British ethnic background (p.12).

• The babies placed were likely to be male, between one and two months old at

placement, of a white British ethnic background and on the Child Protection Register (p.13).


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abies living together; > 1 baby living with father.

Issues and concerns about the parents • In all cases there were concerns about parents’ parenting abilities. In

particular, their knowledge of child care (100%), their emotional abilities (100%), and their intellectual abilities/learning difficulties (77%) (p.14).

• The most prominent issues associated with the mother were: child

protection (84%); own experience of being brought up (84%); lack of support networks (74%); accommodation/living conditions (58%); mental health issues (58%) (p.15).

• The most prominent issues associated with the father were: child protection

(67%); alcohol misuse (43%); father’s own experience of being brought up (43%); mental health issues (40%) (p.15).

Quality of the placements • In 78% of cases the quality of placements was considered to be either good or

very good (p.17). • In 55% of cases the aims and objectives of the placement were either fully or

mainly met (p.18). • In 64% of cases the placements were reported to have helped a lot in meeting

the stated aims and objectives (p.19). Parenting skills – prior to placement and currently • A small positive change was apparent in parenting skills from before the

placement to the current situation as shown in the table below (p.19).

Prior to placement

% Currently

%

good - 30

adequate 11 13

poor 89 57

• In 43% of cases the placement was thought to have been either beneficial or

very beneficial in developing parenting skills (p.20). Outcome of placements • At 31 August 2006, 25 parent and baby placements had ended. Living

arrangements at this date were (p.21): • Baby placed by him/herself (76%):

> 8 adopted/placed for adoption; > 6 in new foster placements (without parent); > 4 remaining in placement (without pare> 1 with family/friends (without parent).

nt);

• Pa ent and baby living together indeper ndently (24%):

> 3 mothers and babies living together; > 2 mothers, partners and b


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An evaluation of parent and baby placements in West Sussex 1 Introduction 1.1 Background Recent years have seen a trend in which increasing numbers of children have become looked after. Both nationally and locally, most of these additional placements have been provided by the independent sector. For West Sussex, this is illustrated in Charts 1 and 2 below. Chart 1: Number of children looked after in West Sussex 2003-2006

629 625 637 685

300

350

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450

500

550

600

650

700

2003

2004

2005

2006

Years - at March 31

Num

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f chi

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Chart 2: Number of children looked after in agency foster placements in West Sussex 2003-2006

1835

52

76

0

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20

30

40

50

60

70

80

2003

2004

2005

2006

Years - at March 31

Num

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In West Sussex most parent and baby placements have been provided by the independent sector. Although some of these placements have been residential, the majority have been with fostering agencies.


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1.2 Aim of the evaluation Little is known about the outcome or quality of parent and baby placements. As far as can be ascertained, no published research currently exists which looks at any aspect of the topic1. Therefore the aim of this project was to evaluate the quality and outcomes of parent and baby placements made by West Sussex County Council. Part of this was to describe these placements with reference to the profiles of the parents and babies involved as well as other issues and factors associated with the placements and their outcomes. 2 Methodology 2.1 Placements evaluated All parent and baby placements made between 1 January 2005 and 31 August 2006 were included in the evaluation. Agency placements were identified from the placement database and Children’s Placement Panel reports. Additionally, family placement teams were approached to find parent and baby placements made with in-house foster carers. A total of 41 placements were discovered. Of these, two were not used: one was for respite only (under a week in duration); the other was, in fact, not a parent and baby placement. This left a total of 39 placements that had been made during the survey period. 2.2 Data collection Data were collected in two ways. Firstly, background information on placements was collected from the placement database and Children’s Placement Panel reports. Secondly, all social workers that had a case management responsibility for a parent and baby placement made over this period were targeted with a questionnaire. The database and report information provided the following: • names of parents, babies and social workers involved in cases; • locality; • type of placement; • placement costs; • the start and end dates of placements. This information was used to partially complete questionnaires before sending them out to the social worker involved in individual cases. This ensured that questionnaires were completed by the appropriate social worker for specific placements as, on occasion, parents and babies had more than one individual placement.

1 This was established by a literature search of national research and through contacting around 60 other local authorities to identify any research that they may have undertaken.


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The questionnaire itself collected the following information: • further background information on the placement including placement

provider, choices and costs; • assessment information relating to both the parent and baby including

issues involved, the parents’ parenting abilities, the age, sex, ethnicity, etc., of both parent and baby;

• social workers’ views on the quality of placements and any developments made;

• placement outcomes. A draft version of the questionnaire was piloted on three parent and baby placements. Feedback from the social workers completing the draft questionnaire was incorporated into the final version. 2.3 Response rate Questionnaires were sent out to the social workers involved with cases at the time that each parent and baby placement was made. A total of 39 questionnaires were sent out to individual social workers by email. In order to improve the response rate, those who had not retuned their questionnaires were sent a reminder email. This was then followed up with a combination of telephone calls and emails. Those who did not respond received at least four reminders. During this process it was discovered that a number of the original social workers had changed, moved office or left. In the absence of the original social workers being available, questionnaires were redirected to the person considered to have the best knowledge of the case. A total of 31 questionnaires were returned, giving a response rate of 79%. For the eight questionnaires that were not completed, further information was sought from the placement database, CIS and Children’s Placement Panel reports. 3 Research findings As noted above, although information on placements was obtained from the 31 questionnaires returned, some information was gained on all 39 placements from the placement database, CIS and Children’s Placement Panel reports. This section uses all these sources of information to present the most complete picture possible. Note: Discrepancies in percentages are due to rounding.

As a number of children had more than one placement, the figures in the report refer to either ‘placements’ or ‘children’ depending on which is the most appropriate in each particular instance. ‘Responsible parent’ is the term used to describe the parent with whom the baby is placed; ‘parent/s’ refers to birth parents.


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3.1 The placements Options considered prior to placement Social workers were asked what other options were considered prior to the parent and baby placement being made. Support for parent and baby living with family/friends was the option most frequently reported (shown in the table below). Table 1: options considered prior to placement

Options number

n=29 %

baby only foster home with parental contact 8 28

support for parent and baby living independently 5 17

support for parent and baby living with family/friends 12 41

baby with alternative carer with family centre assessment of parent 5 17

other option * 4 14

Total ** 34 117

* Includes: baby living independently with mother and father; mother already in parent and baby placement with older child when baby was born; residential parenting assessment. ** Some social workers considered more than one option. Placement options considered Social workers noted that there was a lack of options when considering in-house parent and baby placements. They were likely to have considered at least one agency family placement, but were unlikely to have considered a residential parent and baby placement: • in 17 of 25 (68%) cases social workers reported that no in-house

placement was available; • in 12 of 14 (86%) cases social workers said they had considered one or

more foster agency placements; • in eight of 11 (73%) cases social workers said they had not considered a

residential agency placement. This is illustrated in more detail in the following tables. Table 2: number of placement options considered: in-house family placement number %

one 6 24

two 1 4

not considered 1 4

none available 17 68

Total 25 100


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Table 3: number of placement options considered: agency parent and baby family placement

number %

one 9 64

two 3 21

not considered 2 14

none available - -

Total 14 100

Table 4: number of placement options considered: agency parent and baby residential placement

number %

one 2 18

two - -

not considered 8 73

none available 1 9

Total 11 100

Number of placements identified Although 39 parent and baby placements were identified, responses to the questionnaire revealed that an additional five placements had been made that were not on the placement database (giving 44 in total). For this reason, no data are available to describe these placements. Number of children and the number of placements they had been in A total of 34 children were placed: 31 had one placement; two had two placements; one had four placements. Length of placements Of the 29 placements that had ended and on which information was available, placement length was between two days and 62 weeks2. The average length of placements was 18.38 weeks.

2 A total of 33 placements had ended during the survey period. Some parents and babies had a number of placements during this time.


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Type of placement As Table 5 illustrates, most placements are made with independent agencies. The agency most frequently used was Families for Children (17 of the 34 agency placements made). Table 5: type of placement Placement options number %

in-house parent and baby family placement 5 13

agency parent and baby family placement 29 74

agency parent and baby residential placement 5 13

Total 39 100

Children’s locality The majority of children were from Adur, Arun, Chichester and Worthing. No placements were made for children from Mid Sussex. Table 6: children’s locality number %

Adur 6 18

Arun 7 21

Chichester 9 26

Crawley 3 9

Mid Sussex 0 0

Horsham 3 9

Worthing 6 18

Total 34 100

Costs of agency parent and baby placements Few social workers were able to give exact figures for the costs of the agency parent and baby placements used. They were able to provide details of the costs of eight placements in total. Of these, social workers indicated that four were jointly funded. As few social workers were able to provide this information, it was sought from the placement database. Using this source, information was available on the costs of 33 of the 34 agency placements made3. Weekly placement costs of all agency placements (both those finished and those ongoing) ranged from £450 per week to £3,000. The average weekly cost was £1,398.62. On the basis of this weekly cost, average yearly costs for these placements would be £72,728.24.

3 The costs presented here are taken from the placement database as agreed at the time placements were made. They do not take into account where costs have changed during the duration of placements or any other additional costs that may have been incurred.


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For the 24 agency placements that had ended (at 31 August 2006), the average total placement cost (from start of placement to end) was £20,193.02. The maximum total placement cost was £74,147.00. 3.2 Quality of associated services The most frequently used associated services for parent and baby placements were health visiting services and a family centre. Most of the services were rated highly as can be seen from the table below. Table 7: social workers’ ratings of the quality of the services provided by other professionals in respect of the parent and baby placement

Service

number of placements for

which the service was used

number rating the service as good or

very good

Health visiting services 29 28

Family centre 23 19

Learning disability services 2 1

Adult mental health services 2 1

CAMHS 1 1

Family resources team 2 1

In eleven cases other services were used. Four used Connexions. Others with one mention included (some used more than one): • Sure Start; • Priory mental health service; • leaving care team; • education – Camellia Botnar Centre; • health – [Dr]; • portage scheme; • expert physiological assessment of both parents as part of court process; • family aide; • midwifery service; • psychological and psychiatric assessments; • young persons’ drug abuse team.


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3.3 The responsible parents All the responsible parents in the placements were female, were likely to be in their late teens at the point of placement and of a white British ethnic background. This is described in more detail below. Age and sex of responsible parents At the point of placement, parents’ ages ranged from between 14 to 35 years. The mean age of parents at placement was 19.8; the median age was 17.5. All 34 parents were female. Ethnicity of responsible parents The ethnicity of 29 parents was established. A total of 26 (76%) were white British; one was ‘white other’; another one was white and black African; one other was ‘other mixed background’. Whether or not responsible parents were looked after Social workers were asked whether or not the responsible parents had been looked after either at the point of placement or previously4. Of the 27 parents on whom information was available, six had been looked after at the point of placement and eight previously (see Table 8). Of the six looked after at the point of placement, one was on a care order and the other five were voluntarily accommodated. Table 8: whether parent was looked after at the point of placement or at any time previously

number %

looked after at point of placement 6 18

previously looked after 8 24

never looked after 13 38

unknown/not stated 7 21

Total 34 100

4 It is possible that social workers may not have had detailed knowledge of whether or not parents had been looked after in the past due to parents’ ages (13 were 18 years of age or over).


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3.4 The babies and their siblings The babies placed were likely to be male, between one and two months old at placement, of a white British ethnic background and on the Child Protection Register. This is detailed below. Age and sex of babies The age of the children at the beginning of each placement ranged from between 30 weeks before birth to two years and ten months. The mean age of the children at the point of their first placement was 24 weeks; the median age was six and a half weeks5. Of the 34 children, 22 (65%) were male and 12 (35%) female. Ethnicity of babies The ethnicity of 29 of the 34 children was established: 25 (86%) were white British; two (7%) were ‘other white background’; the other two (7%) were ‘other mixed background’. Legal status of the babies at the point of first placement Most of the babies placed were accommodated at the point of their first placement as shown in the table below. Of the 21 who were accommodated, around half (10) were in legal proceedings at the point of their first placement. Thus for two thirds of the babies on whom information was available (22 of 33), legal proceedings were current or about to be initiated when the decision to place was taken. Table 9: Legal status of the babies at the point of first placement

Legal status number

Accommodated 21

Care order 2

Interim care order 9

Emergency placement order 1

Total * 33

* Information not available on one baby’s legal status at the point of first placement. Babies on the Child Protection Register Of the 30 babies on which information was available, 25 were on the Child Protection Register at the point of their first placement.

5 To avoid double counting those who had more than one placement, ‘age’ here refers to babies’ age at the point of their first placement. (Three babies had more than one placement: two had two placements; one had four.) Additionally, the median is used here as it provides a better description of central tendency than the mean.


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Siblings of the babies in placement Of the 29 children on whom information was available, 15 (52%) had one or more siblings. Six children had one sibling; three children had two siblings; one child had three siblings; another three children had four siblings; two children had five siblings. One other sibling was born whilst the current baby was in placement (not included in the following table). The majority of siblings were either adopted or placed for adoption as illustrated in the table below. Only four were currently with their mothers whilst three were with the fathers. Table 10: location of siblings

Location of siblings number

adopted 11

placed for adoption 8

with parent in current parent and baby placement 4

in another foster placement 7

with family 2

with father 3

baby in parent and baby placement without mother 1

not stated 1

Total * 37 * One other sibling was born during the placement, giving a total of 38 siblings. 3.5 Issues affecting the placements Attachment issues In more than half of all placements (16 of 29) there were at least some attachment issues between the parent and baby. Concerns regarding the responsible parent’s parenting abilities In all cases there was some level of concern about parents’ parenting abilities. In particular, their knowledge of child care (100%), their emotional abilities (100%), and their intellectual abilities/learning difficulties (77%). This is illustrated in Table 11. Table 11: concerns regarding the responsible parent’s parenting abilities

a lot %

some %

none %

knowledge of child care (n=31) 68 32 0

emotional abilities (n=31) 74 26 0

physical abilities (n=24) 8 33 58

intellectual abilities/learning difficulties (n=26) 27 50 23


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Issues that were a factor in the case and whether they were associated with the mother or father Social workers were asked whether or not any specific issues were a factor in individual cases and whether they were associated with the mother or father. The most prominent issues associated with the mother were: child protection concerns (84%); the mother’s own experience of being brought up (84%); a lack of support networks (74%). The most prominent issues associated with the father were: child protection concerns (67%); the father’s own experience of being brought up (43%); the father’s alcohol misuse (43%). These issues are detailed in Table 12. Table 12: issues that were a factor in the case and whether they were associated with the mother or father

Issues in this case: mother

% father

% child protection concerns 84 67

victim of domestic abuse 52 23

substance misuse 19 30

alcohol misuse 32 43

physical health issues 10 7

mental health issues 58 40

offending 13 30

lack of support networks – family, social 74 37

accommodation/living conditions 58 30

parent’s own experience of being brought up 84 43

parent’s own experience of being a parent 36 30

employment/unemployment 23 23

non-resident parent’s contact with baby - 23

other issue associated with parent 19 10

Issues related to child that were a factor in the case In addition to the issues that were listed in the table above, social workers were also asked whether there were any issues that were associated specifically with the children themselves. This was an open-ended question. In general, the issues that were cited were related to children’s health and development. These included: • child developmental delay; • child is registered blind; • concerns about the baby's development and health; • historic concerns due to previous care proceedings; • [baby] was overweight; • [baby] born at 27 weeks with chronic lung disease; • poor development and health of the baby;


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• questionable as to whether [baby] would have drug withdrawal symptoms which could affect overall development, subsequently no concerns.

General issues that were a factor in the case In additional to the issues that were recorded in the list and table above (relating to the parents and babies), social workers were also asked whether there were any general issues that were a factor in placements. These tended to be case specific. The most frequently cited issues were related to court and care proceedings and expert opinion. For a full list of these issues, please refer to Appendix 1. The single most significant factor in the case Social workers were asked to identify the single most significant factor in each of the placements. As noted earlier, in all cases there was some level of concern about parents’ parenting abilities. In more than a quarter of cases (8 of 29) parents’ parenting abilities was the single most significant factor in the case. In five cases, parents’ mental health was the most significant factor and for four placements, child protection was the most significant factor. For a full list of these factors, please refer to Appendix 1. Table 13: the single most significant factor in the case Most significant factor in this case: number

parents’ parenting abilities 8

mental health issues 5

child protection concerns 4

parents’ own experience of being brought up 3

previous experience of parents’ older children 3

victim of domestic abuse 3

drugs/alcohol misuse 3

other * 5

* Includes: family history, learning difficulties, emotional difficulties, previous abuse of mother and the home environment. The extent to which the most significant factor was resolved by the parent and baby placement In the majority of cases the most significant factor in the placement remained either unresolved or only partially resolved. This illustrated in the following table.


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Table 14: the extent to which the most significant factor was resolved by the parent and baby placement

number %

fully resolved 3 10

mainly resolved 6 19

partially resolved 6 19

unresolved 16 52

Total 31 100

The extent to which the placement helped or hindered the resolution of the issue Social workers were asked an open-ended question concerning the extent to which placements had either helped or hindered the resolution of the most significant issue that was identified in individual cases. Comments tended to be positive, noting that, in general, placements had been helpful in providing an assessment of parenting capacity and support in respect of developing parenting abilities. One social worker commented, for example:

‘The placement helped by giving mother good advice, support and assistance in caring for the baby. It provided mother with security and stability of home life and an experience of warm loving care for herself that she had never experienced before.’

For a full list of comments, please see Appendix 1. 3.6 Quality of placements The overall rating of the quality of placements In general, placements were rated highly. In 78% (24 of 31) of cases the placement was rated as being either good or very good. This is illustrated in Table 15. Table 15: overall rating of the quality of placements

number %

very good 12 39

good 12 39

adequate 6 19

poor - -

very poor 1 3

Total 31 100


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The quality of Families for Children and in-house placements As noted earlier, 17 placements were made with Families for Children. Of these, ratings of the quality of placement were available on 14. Of the 14,13 were rated as being either good or very good. Of the five in-house parent and baby placements, ratings of the quality of placement were available on four. All four of these were considered to be either good or very good. Main aims and objectives of the placement The majority of parent and baby placements aimed to develop and support parents’ parenting skills (reported as part of the placement’s aims in 20 cases). One social worker, for example, stated the aim of the placement:

‘Nurturing of baby within an environment which would provide support and facilitate development of mother’s parenting abilities, skills and knowledge.’

In some cases assessment was allied to developing and supporting parenting skills, whilst for others it was the main aim. Assessment was reported as one of the aims in 13 cases. Other aims and objectives tended to be case specific, or as a part of supporting parenting and assessment, such as protecting the babies. This was illustrated in one case:

‘To assess mother’s ability to consistently and safely care for [baby] and to protect him from physical harm. To offer mother parenting advice and support.’

For a full list of the stated aims and objectives, please refer to Appendix 1. The extent to which the aims and objectives of the placement were met In just over a half of cases (55% or 17 of 31) the aims and objectives of the placements were either fully or mainly met. This is shown in the table below. Table 16: the extent to which these aims and objectives were met in the placement

number %

fully met 9 29

mainly met 8 26

partially met 6 19

not met 8 26

Total 31 100


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The extent to which the parent and baby placement helped in meeting the stated aims and objectives In 20 out of 31 cases the placement helped a lot in meeting the stated aims and objectives of the placement. Table 17: the extent to which the placement helped to meet the aims and objectives number %

helped a lot 20 64

helped to some extent 5 16

not helped at all - -

not applicable/not met 6 19

Total 31 100

Developments resulting from the placement Prior to the placement being made, none of the parents’ parenting skills were described by social workers as ‘good’; the majority were considered to be ‘poor’ (89%). Social workers were then asked to rate parenting skills ‘currently’. At this point in time, parenting skills graduated to being ‘good’ in three out of ten cases. Table 19: overall quality of the responsible parent’s parenting skills prior to placement and currently

Prior to placement

% Currently

%

good - 30

adequate 11 13

poor 89 57

As the positive change in parenting skills may have been due to factors outside the parent and baby placement, social workers were asked, in their opinion, the extent to which the placement itself was responsible for any development of parenting skills that had been observed. In 43% of cases (11 out of 28) the placement itself was thought to be either beneficial or very beneficial in this development.


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Table 20: the extent to which the placement was beneficial in any development of parenting skills that were observed

number %

very beneficial 9 32

beneficial 3 11

adequate 4 14

of limited benefit 9 32

not at all beneficial 3 11

Total 28 100

The main areas of development observed Social workers were asked what the main areas of development were. Parents’ understanding of the children’s needs emerged as the most frequently reported area of development observed, followed by basic child care. One social worker noted, for example:

‘Mother is now able to put her children's needs before her own.’ For a full list of the main areas of development observed, please see Appendix 1. The single most significant area of development Social workers were asked what, in their opinion, had been the single most significant area of development. Although a range of specific areas was cited, it was the development of parents’ basic skills that was most frequently reported. This included a better understanding of needs and the development of practical child care skills to meet these needs. A full list is contained in Appendix 1. Areas in which development was expected that the placement was not effective in producing The main area in which development was expected in the parent and baby placements was the support and development of parenting skills. However, social workers reported that this was also one of the main areas in which many placements proved disappointing. Most often though, this was not the fault of the placement itself, it was due to parents’ own difficulties. The majority of these difficulties centred on parents’ learning difficulties. Typical comments included:

‘Mother did not accept her learning difficulty, found it difficult to take advice and put it into practice consistently to meet the child’s needs. This was not to do with the placement it was to do with the mother and her own needs.’

‘Mother showed lack of progress in her learning capacity because of her learning disability not because of the quality of [the] placement.’


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Other causes of problems in supporting parenting skills within the placement included the engagement and commitment of parents. One example was:

‘Mother cared for the baby well whilst in placement but she could not sustain her commitment and abandoned the placement on three occasions leaving [baby] with the foster carer. She eventually permanently abandoned the placement and requested [baby] be placed for adoption.’

For a full list of the areas in which development was expected, please refer to Appendix 1. 3.7 Placement outcomes This section shows where the parents and babies were at the end of the research’s timescale, the 31st of August 2006. Information was available on the whereabouts of 33 parents and babies. Eight parents and babies remained in parent and baby placements and 25 were elsewhere6. Of those no longer in parent and baby placements, the current living arrangements were as follows: Baby placed by him/herself (76%):

• 8 adopted/placed for adoption; • 6 in new foster placements (without parent); • 4 remaining in placement (without parent); • 1 with family/friends (without parent).

Parent and baby living together independently (24%):

• 3 mothers and babies living together independently; • 2 mothers, partners and babies living together; • 1 baby living with father.

6 This figure describes where parents and babies were at 31 August 2006; between 1 January 2005 and 31 August 2006 a total of 33 placements had ended as parents and babies moved through different placements. Placements in which the parent had left and the baby remained were considered to have ended, as they were no longer ‘parent and baby placements’ in a descriptive sense.


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3.8 Factors associated with placement outcomes This section looks at the factors associated with the outcome of individual placements. As these associations are based on small numbers, care should be taken when generalising from these findings. Number of placements The more parent and baby placements that the children had experienced, the more likely it was that the parent and baby would end up separated. In 71% (12 of 17) of cases where children had only had one placement the parent and baby ended up separated compared with 83% (5 of 6) of those who had two or more placements. Age of parents and babies There was a slight tendency for children who were younger when the placement started to end up separated from their mother: 80% (12 of 15) of placements in which the child was aged up to six weeks ended in separation compared with 70% (7 of 10) of placements in which the child was seven weeks or older. Where parents were older (18+) when the placement started, the child placed was more likely to be separated from the parent: 80% (8 of 10) of placements in which the parent was 18 or over ended in separation compared with 60% (3 of 5) of placements in which the parent was under 18. Placement outcomes for parents under 18 are detailed in Table 21. Table 21: parents aged under 18 at first placement, illustrating the first placements and the outcomes at 31 August 2006

age of parent at

first placement

first placement type where they were at 31 August 2006

14 in-house parent and baby second in-house parent and baby placement

14 IFA parent and baby in-house parent and baby placement

15 IFA parent and baby foster care with view to adoption

15 in-house parent and baby parent and baby living together independently

17 IFA parent and baby IFA parent and baby placement – parent left, baby remaining

17 IFA parent and baby IFA parent and baby placement – parent left, baby remaining

17 IFA parent and baby IFA parent and baby placement – ongoing

17 IFA parent and baby second IFA parent and baby placement

17 IFA parent and baby living with father


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Siblings and the current placement The outcome of a placement often followed a pattern associated with the children that parents had had prior to the current child. Where these older children were separated from the mother, the baby in the current placement was likely to follow the same route: in ten of the 12 cases in which older children were separated from the mother, the outcome for the current child was the same. Furthermore, in all cases where more than two older children had been separated from the mother, the outcome for the current baby was also separation. Whether or not the responsible parents were looked after There was a tendency for the parents and babies to be separated where the responsible parents had been looked after themselves. Separation happened in seven out of nine cases (78%) where the parent had been looked after compared with six of ten (60%) where they had not been looked after. Parents’ parenting skills Where parents’ parenting skills were considered to be either poor or very poor prior to the placement, the parent and baby were likely to be separated. This happened in 16 of the 19 cases in which parenting skills were reported as being poor or very poor. Specific areas in which there were concerns with the parents’ parenting skills that resulted in the parent and baby being separated are shown in Table 22. The intellectual abilities/learning difficulties of parents was the area of concern that was most likely to be associated with the later separation of the parent and baby. This happened in 83% of cases where intellectual abilities/ learning difficulties were highlighted. Table 22: areas in which there were concerns with parents’ parenting skills and how many ended up separated from their babies

number separated

%

knowledge of child care 17 of 23 74

emotional abilities 17 of 23 74

physical abilities 8 of 10 80

intellectual abilities/learning difficulties 15 of 18 83


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Attachment issues Unsurprisingly, in cases where there were attachment issues the babies tended to be separated from their parents. This happened in nine out of 11 cases in which attachment issues were apparent. Resolution of significant factors in individual cases Social workers were asked to identify the single most significant factor in individual cases. Whether or not this issue was resolved was reflected in whether or not the parent and baby ended up together. In 16 of 17 cases where the identified issues were only partially resolved or remained unresolved, the parent and baby were separated. 4 Conclusion This evaluation found that social workers had few options when considering in-house parent and baby placements. However, they were likely to have considered at least one agency parent and baby foster placement. This was reflected in the number and proportion of parent and baby placements made with the independent sector, reflecting the trend in West Sussex for the increasing use of agency foster placements. On average, agency placements cost more than £20,000 from start to finish. The average length of all placements was around four and a half months. Other options had been considered by social workers outside parent and baby placements. In particular, support for the parents living with their family or friends. All parents involved were female and tended to be in their late teens at the point of the first placement that was made. Ages ranged from between 14 to 35. More than half of the parents on whom information was available were themselves looked after at some point. The babies were likely to be between one and two months old at the point of placement. Around half of the babies had siblings. Most of these were either adopted or placed for adoption. Of the 37 siblings that were identified, only four were still with their mothers. More than eight out of ten of the babies were on the Child Protection Register at the point of their first placement. For two thirds of those on whom information was available, legal proceedings were either current or in the process of being initiated when the decision to place was made. Child protection issues, experiences of being brought up and mental health issues were common concerns with both the mother and father. Concerns were also expressed with all parents’ parenting abilities. In particular their knowledge of child care, their emotional abilities and to a slightly lesser extent their intellectual abilities/learning difficulties. Although this latter area was a slightly lesser concern than other areas, it was more closely associated with later separation of the parent and baby.


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The main aim of placements was reported by social workers as being to develop and support parenting skills. In more than half of the cases this aim was fully met whilst in two thirds of cases placements were thought to have helped a lot in meeting placement aims. In fact, some development in parenting skills was reported by social workers when a comparison was made between the parenting skills parents possessed prior to the placement and ‘currently’. In more than four out of ten cases the placement itself was thought to have been beneficial in the development of parenting skills. Although this positive development was apparent in a number of cases, and was the key aim in most placements, it was also the area in which many proved disappointing. This, however, was likely to be linked with parents’ own difficulties rather than the quality of the placement itself. Often this was thought to be to do with the learning difficulties of the parents. Three quarters of placements examined ended with the parent and baby being separated. For parents, separation was associated with: • cases where attachment issues were prominent; • parents’ parenting skills being poor, in particular their intellectual

abilities/learning difficulties; • the parent having been looked after themselves; • being older (18+). For children, separation was associated with: • the number of placements already experienced; • being younger (under six weeks); • where a sibling had been separated from the parent previously, in

particular where more than two siblings had been separated from the parent.


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Related documentation Crawhurst, P. (2006). Parent and baby foster care: policy, procedure and practice guidance. West Sussex County Council. Crawhurst, P. (2006). Parent and baby foster care: proposals for development. West Sussex County Council.


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Appendix 1: Comments from social workers General issues that were a factor in the case • Six months after placement, legal proceedings were underway, child

currently on ICO. Children's guardian involved. Expert assessments used. • Already in care proceedings with older siblings. • Court, expert and GAL involvement. • Mother has history of relationships with schedule 1 offenders (sexual

abuse). • Mother on ABSO, multiple inappropriate carers, alcohol issues. • Mother’s ability to protect child from father and to protect herself from

father. • Mother’s learning difficulty and questions asked by mother’s advocates as

to whether the placement was suitable for parent with learning difficulties.

• Previous children all removed and adoption care plans in place [father]. • Previous court reports and expert opinions of mother's ability to care for

previous children. • [Baby] subject of an Interim Care Order - expert identified to address

long-term parenting of mother and father (not logical) concerning drug misuse as well.

• There had been many issues of concern with the mother over the years she had been in care, and before.

Single most important factor in the placement • Parent’s own experience of being bought up. • All other children placed for adoption due to level of concerns. • All relevant, lots of issues surrounding family history to do with mother’s

own parents’ upbringing. • All the factors were significant as is identified including mother’s mental

health. • Child protection and serious neglect. • Child protection concerns. • Domestic violence. • Domestic violence and substance misuse. • Domestic violence towards mother. • Drug and alcohol misuse. • GP concerns. • Learning disability and their inability to improve their parenting skills. • Mental health issues. • Mother's emotional unavailability and lack of understanding of parenting

and child’s development. • Mother's history of being sexually abused as a young child, coupled with

the death of a sibling from injuries sustained in the home. • Mother's mental health problems. • Mother’s ability to care for the baby in a safe and consistent manner. • Mother’s home environment and young age. • Mother’s inability to provide safe care for baby. • Mother’s inability to put her children’s needs above her own. • Mother’s lack of parenting skills and dependence on her own mother. • Mother only 16 years old. • Mother’s mental health and availability for her child.


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• Parents’ inability to prioritise child’s needs over and above their own. • Parent’s own experience of being parented. • Parent’s own experiences of being parented. • Previous child protection concerns relating to [mother’s] four other

children. • Previous children removed and mother’s learning difficulty. • Risk of neglect both physical and emotional. • Substance misuse abstention and ability to parent young baby. How the placement has helped or hindered in the resolution of the issue • It was possible to complete assessments in a shorter time scale than

when parents and babies are placed together and avoid delay for baby. • Allowed mother to reflect on past behaviours and to focus on baby's

needs. • Being supportive to mother in learning basic skills and how to care for

baby appropriately. • Foster carers have managed to get counselling for mother to address

past issues. • Helped by providing assessment of the mother and her ability to parent. • Helped to identify very clearly that mother was unable to meet child’s

needs. • Helped with the assessment of mother’s parenting capacity. • If offered a safe place for mother/baby. • Made her decide the longer term plan for her child. • Mother continues to be unable to prioritise children’s needs. • Mother has left placement. Baby remained in the placement but is due to

be moved to a LA foster placement. • Mother left placement after two days, leaving children in placement.

Therefore assessment of mother unable to take place. • Mother left placement and child was subsequently accommodated at an

alternative placement. • Mother’s perspective is that the foster carer responded to mother’s

limitations and motivation to provide adequate care by 'taking over' the care of the child. This led to mother leaving the placement without the baby. The guardian in this case agreed with the mother’s perspective and was very critical of the placement - arguing that the foster carer had attached to the child and forced the mother away from placement. This led to court directing a residential parenting assessment for both mother and father with some criticism of WSCC for not offering a parents and baby placement in the first instance (gender discrimination). Both parents attended the R.P.A with St Michael’s Fellowship and completed 9 weeks of a 12 week programme before the assessment was terminated due to poor care afforded the child by parents. A subsequent viability assessment focusing on each parent's ability to care for baby individually was then agreed by court. All assessments completed concluded that neither parent were capable of providing 'good enough' care to baby. Baby was placed in pre-adoptive placement soon after final hearing in January 2006. It is with some interest to me that if an in-house parent and baby placement had been available, then considerable time, money and human resources would have been saved and delay to the Final Hearing would have been avoided - with permanence for [baby] being achieved far sooner. The parents had their second child on [date of birth]


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and Care Application has been made in regard to this child with the LA care plan being for no further assessment processes to be undertaken.

• Placement helped local authority to assess mother's ability to care for baby and helped mother to assess her own abilities in caring for her newborn in a supportive and safe environment.

• Placement helped provide supervision, modelling and structure to mother and baby and allowed for a full accurate assessment of mother’s ability to care for a child. However, the placement also needed close monitoring to ensure carer was complying with the care plan. There were occasions when foster carer was collaborating with the family and not considering the best interests and safety of the child.

• Placement worked hard to resolve these issues but mother was unable to recognise concerns.

• Protection for [baby]. • Providing mother with structure and guidance. • Residential assessment and treatment program. Mother was unable to

fully engage in the treatment process and was assessed as not being able to care for her children either now or in the future.

• The placement afforded the mother the opportunity to learn how to parent her child successfully. The placement safeguarded the child from neglect. However, mother abandoned the baby and the placement after a few weeks.

• The placement did not help as the mother was needing more input in order to parent.

• The placement helped by giving mother good advice, support and assistance in caring for the baby. It provided mother with security and stability of home life and an experience of warm, loving care for herself that she had never experienced before.

• The placement helped in identifying mother’s inability to provide consistent care for her baby.

• The placement really helped; the child is now placed in the community with mother.

• The placement was disappointing at best, at worst neglectful; also impossible to work with.

• There has been no violence between the parents while mother and baby have been in the placement. This is because they are having no contact with each other.

• This placement offered stability and good parental modelling. • Type of placement helped mother to mature and time on her own

identity. • With the support and guidance, mother was able to grow in confidence

regarding parenting skills, supported in her methadone intake and abstention from illicit drugs.

Main aims and objectives of the placements • Nurturing of baby, within an environment, which would provide support

and facilitate development of mother’s parenting abilities, skills and knowledge. Contact was set at five hours per day five times per week to include father in the care of his child.

• Assess mother’s ability to learn and to sustain changes in order to establish whether she could safely parent her child.

• Assessment of mother's ability to care for baby. • Assessment of mother by previous SW.


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• Assessment of mother/baby; protection of mother/baby. • Attachment, mental health, self-esteem, trusting adults, self harm,

domestic violence. • For [mother] to parent [baby]. For [mother] to ensure that all [baby]

needs are met consistently. • Foster carer to supervise, support and model appropriate parenting,

stimulation, play, boundaries, routines, communication, health and basic care needs of the child. To enable the mother to understand and manage child's needs appropriately.

• [Mother] to be offered guidance and assistance with managing the care of [baby]. The foster carer to supervise all interaction between mother and baby and produce weekly reports. To provide evidence for court. To give [mother] the opportunity of being cared for by a birth parent in a safe and stable environment.

• Make sure that baby is safe and is developing well, show mother by example how to parent her child, observe if mother is capable to retain information and to improve her parenting.

• Monitor and assess parenting skills and attachment regarding mother and baby.

• Mother to establish structure and routines which respond to the baby's needs.

• To assess and support mother and baby, to maintain CP supervision and to alert and report concerns.

• To assess and support mother’s parenting abilities. • To assess mother's ability to safely care for her [baby]. • To assess mother’s ability to consistently and safely care for [baby] and

to protect him from physical harm. To offer mother parenting advice and support.

• To enable parent and child to live together whilst mother developed parenting skills.

• To ensure [baby’s] safety and overall well being whilst being cared for by his mother. To provide mother with the opportunity to improve her ability to care for [baby].

• To monitor the care of the baby and enable mother to gain the necessary skills to be able to care for her child independently. Observations and feedback to be provided.

• To provide good care for the baby; to help improve mother’s parenting; to facilitate contact with key family members.

• To support and assist mother to be the main carer for the child. • To support and monitor the mother and her ability to safely protect her

baby. • To support mother in caring for her new born baby and learn and develop

skills. • To support mother in parenting [baby] and enable her to learn and

develop parenting skills. • To support mother to improve on her parent skills and to maintain her

focus on the needs of her children in order for her to have sole care of [baby].

• To support mother with gaining her independence and stability prior to the birth of her child. Mother having had child, placement initially would support mother in the day-to-day care of her child until mother felt she was able to cope on her own.

• To support [mother] parent [baby] and to give the opportunity to continue her education.

• To support, assess and supervise mother in the placement.


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Main areas of development observed

• We did not have any prior knowledge of her parenting skills so all areas have been observed and all developed.

• An understanding of her child's needs and her own limitations. • Attachment, basic care. • Basic care and handling of baby. • Basic care of baby. • Basic child care skills. • Commitment from mother in attempting to learn and understand the

skills required for her to provide appropriate care. • Confidence, competence and knowledge of appropriate care for a

dependant child. • Following a routine for the baby, basic care skills (feeding, bathing

etc). • His speech. • How good could mother care for her baby. • It helped mother understand she could not parent without help. • [Baby] is thriving in the care of the mother. [Parent] has surprised

herself at how capable she is of being a parent and her confidence has grown enormously. [Baby] has benefited from being in a safe and nurturing environment and has been able to recognise what an unsuitable environment she and [baby’s] father provided previously.

• More consistency, better understanding, clarity to work with professionals.

• Mother's gaining confidence in caring for child - having the protective and nurturing skills to enhance baby’s overall development.

• Mother able to provide physical care. • Mother cared for baby adequately when she was at the placement

and asked the foster carer for advice with care of baby. • Mother did not fully engage and did not make good use of, or access

the help and treatment offered to her, limited progress observed. • Mother has been unable to show she can maintain any progress. • Mother is now able to put her children's needs before her own. • Mother more confident - her abilities prior to placement were

unknown. • Mother was asked to leave the placement due to negative behaviours. • Practicalities of caring for a child i.e. feeding, bathing, stimulation etc. • Self esteem, insight, trusting the professional network. • There was not any development in parenting. The mother and baby

placement was a safe place in which to place [baby] with his mother to assess whether she could parent [baby], as she had stated to the court.

Most significant area of development

• Basic care and handling of baby. • Basic practical child care skills. • Being placed within the extended family. • Better understanding of child’s needs. • Confidence in spite of this very poor placement. • Confidence, competence and knowledge of appropriate care for a

dependant child. • Day to day care of the baby.


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• His speech. • How good mother was able to care for her child. As a result, child was

able to form a positive attachment to mother. • [Mother] has bonded with [baby] and now prioritises her above all

else. • Meeting baby's needs – feeding, carrying, bathing. • Mother did not fully engage and did not make good use of, or access,

the help and treatment offered to her, limited progress observed. • Mother has been able to maintain a reasonable relationship with the

carer. • Mother is now able to put her children's needs before her own. • Mother understanding and coming to terms with the realisation that

she is unable to care for her son without full supervision. • Mother was asked to leave the placement due to negative behaviours. • Mother’s bond and attachment to child. • No assessment due to end of placement. • On mother coming to the decision that she needed help. • Practicalities of caring for a child i.e. feeding, bathing, stimulation etc. • Protective skills. • Self-esteem.

Areas in which development was expected that the placement was not effective in producing

• Cared for baby and this continued in placement with FC caring for baby. This highlighted her own parenting inadequacies.

• Engagement of the parents in order to achieve the desired outcome. • For mother to prioritise baby's needs over her own. No fault of the

carers and nothing more that either placement could do to help achieve this.

• In enabling [parent] as parent, but given that she moved out this was not possible.

• It was not possible to improve mother's parenting skills efficiently due to her learning disability.

• It’s the parenting skills that are so poor. • More needs to be done around bonding and attachment between

mother and baby, and mother and foster carers. Due to contact with birth family and foster carers. Due to contact with birth family and baby's father this has been difficult to achieve as [baby] has spent substantial time away from her foster carers.

• Mother cared for the baby well whilst in placement but she could not sustain her commitment and abandoned the placement on three occasions leaving [baby] with the foster carer. She eventually permanently abandoned the placement and requested [baby] be placed for adoption.

• Mother did not accept her learning difficulty, found it hard to take advice and put it into practice consistently to meet child's needs. This was not because of the placement but to do with mother and her own needs.

• Mother showed lack of progress in her parenting capacity because of her learning disability not because of the quality of placement.

• Mother was asked to leave the placement due to negative behaviours. • Mother’s ability to protect child or separate from violent abuser.


January 2007

33 AN EVAL UATION OF PAR E NT AND BA BY PL AC EM ENTS IN WEST SUSSEX

January 2007

• [Parent] chose to leave in the early stages of her foster placement. [Baby] was moved to an in-house foster placement on his own whilst care proceedings progressed. Parenting skills work was undertaken at the Family Centre.

• No - mother was unable to maintain any significant changes due to her learning abilities and not a reflection on the placement.

• Not applicable to current situation. • Placement provided no support whatever; YP was ignored. YP was

stoical in placement; and survived the ordeal. • Placement was primarily for assessment of parenting abilities.

evaluating parent and baby placements report...a total of 39 parent and baby placements were...

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