Care and Control in foster care

Background to the policy

NB This should be read in conjunction with the Behaviour Management Policy.

The Children Act 1989 (CA89) and the Care Standards Act 2000 (CSA 2000) provide the statutory framework for the care and protection of children and the regulations that accompany the Acts detail principles and standards that should be adhered to. The guidance and regulations that apply to foster carers in relation to care and control include the 2011 CA89 volume 3 Family Placements and volume 6 Children with Disabilities and the National Minimum Standards for Fostering Services 2011, together with the Fostering Services (England) Regulations 2011. All of the volumes of Children Act 1989 Guidance and Regulations were revised in 2011and you can find them all on the Department for Education website.

Aim of the policy

The aim of the policy is to provide a clear and useful policy on care and control for foster carers, which will ensure a consistent and effective response to children looked after by Brighton & Hove City Council. The policy will outline the principles of good practice and effective methods of care and control techniques. The policy aims to equip carers with the skills and awareness they need in order to provide children in their care with a safe, nurturing and encouraging environment that will enable them to reach their full potential and grow into responsible adults.

The principles of care and control

Children who are fostered have a right to expect that they will receive the care, encouragement, safety and security that good parents provide…They should also expect their carers….to respect them as individuals, listen to their views and help build their self esteem and identity. (Fostering Network)

The principles that should be followed are as follows:

  • Carers should seek to achieve a balance between care and control. The child should be offered a nurturing environment with firm boundaries. This should enable the child to develop a sense of care, security and personal responsibility that will allow them to become mature, sensible adults.
  • Through the use of effective care and control policies children are able to make choices about and take responsibility for their behaviour in the context of a caring and trusting relationship. Methods of care and control are applicable at all times when children are being looked after but there are certain methods that are particularly useful in dealing with challenging behaviour.
  • As all children are unique and have different life experiences, there is a need for foster carers to have maximum flexibility in the care they provide. Many children who are fostered have been victims of various forms of abuse and neglect and carers must have regard for these experiences at all times when they are caring for the young person and managing their behaviour.
  • Every child who is looked after has a right to have their needs in terms of gender, religion, ethnic origin, language, culture, disability and sexuality respected. This must be taken into account when exercising care and control.
  • For carers looking after children with disabilities, there are specific issues regarding care and control. Children’s impairments affect behaviour in different ways, for example, the difficulty adults may have in communicating non-verbally can cause frustration – which may lead to conflict and challenging behaviour.
  • All children have rights under the UN Convention on the Rights of the Child, some of which are specific to looked after children, for example Article 20 states:

    (1) A child temporarily or permanently deprived of his or her family environment, or in whose own best interests cannot be allowed to remain in that environment, shall be entitled to special protection and assistance provided by the state.

    (2) When considering solutions, due regard shall be paid to the desirability of continuity in a child’s upbringing and to the child’s ethnic, religious, cultural and linguistic background.

Challenging behaviour – a definition

Our policy aims to assist carers to manage difficult and challenging behaviour. An understanding of the term is gained from the following definition:

Challenging behaviour jeopardises the physical, emotional and psychological safety of the young person exhibiting the behaviour, of those who care for or are responsible for her or him, and of others who may be in the vicinity; it is behaviour of such intensity, frequency or duration, that its containment is especially difficult to manage. (Barnardo’s)

The care and control policy

Foster care is a difficult and demanding task and it is also a very isolated one in comparison with other types of placement. This policy aims to ensure that carers are equipped with the skills and techniques they need to manage difficult situations safely in relative isolation. As a result, carers should adopt a proposed method of care and control that does not allow for the use of restraint. The proposed model of care and control for foster carers is:

  • The Positive Interventions Model for Family Care Providers.
  • Techniques for the release from grabs, bites, hair pulls etc without harming the child.
  • Exemptions: for some children with disabilities they may be in a setting where a particular method is already being used, for example, in school. It is not expected that in these instances carers should adopt a different method to the one already in use. In these circumstances exemptions can be sought in consultation with the Head of Service and in the best interests of the child, with details documented in the care plan.
  • Training: all Children and Families carers must be trained in the proposed method of care and control.

Wherever possible, carers should try and manage behaviour by non-physical means before children become violent. For every child or young person whose behaviour is known to present a challenge, there should be an individual strategy for responding to violent behaviour, which will form part of the child’s care plan. Where appropriate, this will include specific directions for using physical interventions. In these circumstances it should be agreed by carers, parents and professionals what the appropriate strategies will be. This will be discussed at the introductory stage of the placement and will be included as a written part of the placement agreement.

In certain circumstances, (where the child’s safety or the safety of another child or person may be in question if the child leaves the room or premises), good practice involves communication to try and persuade the child on a different course of action. However where this is ineffective, the carer should reinforce dialogue with such actions as standing in the way of a child wishing to leave, or may place a hand on the child’s arm, or hold the child if they are highly distressed or in danger, for example if a child is trying to run out of the house onto the road in a distressed state. These methods should only be used for the minimum time needed and with the minimum force necessary to ensure the child’s safety.

These approaches are used in the context of engaging the child/young person in discussion about their behaviour, listening to them and showing empathy to their distress.

Holding discourages the child from harming themselves or others, whereas physical restraint uses an element of force which is not appropriate for foster carers working in isolation with the child.

Positive Interventions for foster carers

An outline of training provided to support care and control policy

Brighton and Hove carers who are caring for children or young people who display challenging behaviour should receive training in Positive Interventions to support the implementation of the care and control policy. Preferably this training should be provided before carers have to handle challenging behaviour. This training provides a range of non-contact techniques for managing difficult behaviour and to help carers to respond positively to difficult and challenging behaviour.

Positive Interventions emphasises a therapeutic response to challenging behaviour including a range of practical skills such as de-escalation and counselling techniques but does not teach a method of restraint.

However there will be instances, particularly for carers looking after children with specially challenging behaviour, when they need to release themselves from grabs, bites, hair pulls and chokes. This training for residential staff includes methods of escaping these holds, which do not cause harm to the young person. These should be included in training for foster carers.

The focus of Positive Interventions for foster carers is on conflict resolution and communication with the child and does not advocate the use of restraint techniques because of the family orientated nature of foster care. These methods should be used in conjunction with general guidance on setting appropriate boundaries and positive control. The ethos behind this method is summed up in the following statement:

Our ability to relate to children and their families in an open, sensitive, consistent and caring way is the single most important contribution. It is our actions – and reactions – that so strongly shape and influence the subsequent behaviours and growth of the young people we care for.

The thinking behind the model is to encourage the carer to approach a crisis situation, when challenging behaviour is being demonstrated, as a learning opportunity from which the young person can grow through an understanding of their behaviour and experience, therefore:

Carers’ skills, knowledge and professional judgement are critical in helping children learn constructive and adaptive ways to deal with frustration, failure, anger, rejection, hurt and depression.

Positive control and the use of sanctions

At times, emergency action will be required to prevent the risk of immediate danger to the child/young person or others, or to prevent the risk of serious damage to property. The intention behind any action must be to care for and safeguard the child and their welfare as the carer’s paramount consideration.

Whilst there is an expectation that carers will provide a warm and nurturing environment at all times whilst setting appropriate boundaries around behaviour, it is acknowledged that there will be times when some form of sanction and control will be necessary because of unacceptable behaviour.

Any sanction or control used in the foster home must be:

  • Compatible with what is recognised as good practice in the care of children
  • Related to the individual’s care plan, age and circumstances
  • Realistic and sensitive
  • Enforceable
  • Consistent.

Sanctions which may be considered are as follows (though there is no implication that carers should be using sanctions nor that this list is exhaustive):

  • Reparation (the act or process of making amends)
  • Restitution (the act of giving back something that has been stolen)
  • Time out (giving space and privacy when it is safe to give the young person time to calm down and think things through) or a cooling off period.
  • Early to bed
  • Grounding
  • Delaying treats
  • Increased supervision
  • Extra tasks.

Acceptable sanctions should be relevant, used sparingly and follow the unacceptable behaviour as quickly as possible.

Unacceptable Sanctions

Sanctions which are unacceptable include:

  • Those that intentionally or unintentionally humiliate a child/young person, cause them to be ridiculed, or which have been experienced previously under different circumstances, for example in their previous home(s)
  • Corporal punishment
  • Deprivation of food or drink
  • Restriction of visits to or by any child, or any restriction or delay in agreed levels of communication by telephone or post with:
    • a parent
    • any person who is not a parent but who has parental responsibility
    • relatives or friends (there may be exceptions with peers, for example
    • when a child is grounded)
    • any social worker assigned to the child by a responsible authority
    • a guardian or advocate for the child
    • any solicitor acting for the child
  • use of , or withholding of medication, medical or dental treatment
  • use of accommodation to physically restrict the liberty of any child – except in situations when the child is in danger
  • the use of a wheelchair, high chair, buggy, playpen, cot or safety gate as a punishment. Some children with disabilities are strapped in to equipment for their own safety and this is not the same as a punishment
  • intentional deprivation of sleep
  • imposition of fines or permanent withholding of pocket money or savings
  • intimate physical examination of the child. This occurs in the care of some children with disabilities but clearly not as a sanction
  • no child must be kept in any form of isolation in consequence of his/her behaviour. If it is necessary for isolation to be used for other reasons, then it must only be with close adult supervision i.e. time out
  • No excessive use of sending a child to bed early as a punishment

Recording the use of sanctions

 

Foster carers should record significant sanctions that have been used, why they were used, and the child/young person’s reaction.

Where carers have used sanctions which were not previously agreed, due to unforeseen circumstances, it is particularly important that they should record the events and the sanctions used for discussion later with the child’s social worker, their supervising social worker, the young person, and where appropriate, their parent. Any incident where there has been physical contact i.e. holding, release from grabs etc need to be recorded.

The supervising social worker needs to give direction to foster carers on the recording and reporting of incidents, and support carers who have behaved in the interests of the child’s welfare when complaints are received from parents about the sanctions used.

All sanctions should be monitored as to their usefulness and effectiveness.

If it is thought that an inappropriate sanction has been used then the supervising social worker should talk this through with the carer and look at alternative strategies which might have been used in the circumstances. Continued use of inappropriate sanction(s) would need to be addressed through a review of the carer(s) but where the use of inappropriate sanctions places a child at harm or risk of harm it may be deemed to be a child protection issue and referred to the appropriate officer.

Foster care agreement

The care and control policy must be explained to, and discussed with, prospective carers as part of the assessment process. After approval, the supervising social worker will discuss the policy with carers and any queries should be jointly clarified. In training and in contact with their supervising social worker carers should demonstrate that they have understood and accept the principles and methods of the agency’s Care and Control Policy.

 

 

 

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