Nursery World - Well looked after

Children in care have complex needs. Jackie Cosh reviews the
guidance and legislation relevant to nurseries, plus training
options.

The number of children in care is at a 20-year high. There are nearly 70,000 children in care in the UK, of which a significant proportion - 17 per cent - are between one and four years old.

These children often have some of the most complex needs nursery staff will come across. Challenging behaviour, learning difficulties and disabilities, and behavioural and mental health needs are all common. Many of them come from the poorest backgrounds and more than 60 per cent of children are taken into care because of neglect or abuse. Others are there because their parents have died or cannot look after them. Most live in foster homes.

Thus the issue of children in care is a health problem as well as a societal one. National Institute for Heath and Care Excellence (NICE) guidance from 2010 on looked-after children states that for very young children in particular, the absence of a permanent carer 'can jeopardise children's chances of developing meaningful attachments and have adverse consequences for their long-term well-being'. NICE adds that this means it may be difficult for children to settle in nurseries and other early years settings.

According to the guidance, 'The majority (of children in care) are from families where parents are struggling with issues such as domestic violence, substance abuse, alcohol abuse and mental health problems, often in combinations. While some parents succeed in overcoming their difficulties during a child's formative years, not all are able to do so.'

NICE recommendations from 2012 on well-being in the early years state that social and emotional well-being should be considered 'as the foundation for the healthy development of vulnerable children' and as a means to 'offset the risks relating to disadvantage'.

Over the past 30 years a number of laws have formalised the duty of the local authority towards looked-after children. They must now accommodate 'children in need' and be their legal parent if required. The 2004 Children Act also placed a responsibility on children's services departments to prepare and publish a Children and Young People's Plan, setting out a strategy for improving the lives of looked-after children in their area. All looked-after children must also have an individual care plan.

As with many systems, standards and practice vary through the country, says Natasha Finlayson, chief executive of care charity The Who Cares? Trust: 'On the whole we think the legislation and regulation and guidance is pretty solid in that it says what it needs to say.

'Where there are problems is in terms of local authority practice. Where you start to get an issue, particularly in terms of care planning, is the speed of getting children into the care system and the extent to which local authorities can find a permanent place for them.'

Children's outcomes are one of the central planks of safeguarding ('taking action to enable all children to have the best outcomes' is part of the Government definition of safeguarding, along with 'ensuring children are growing up in circumstances consistent with the provision of safe and effective care'). Yet outcomes for looked-after children generally are dire: a third leave school with no GCSEs while just 6 per cent go on to university, compared with 38 per cent of all young people.

Ms Finlayson says, 'The difference between outcomes for children in care and those for other children are enormous. Then you look at the number of people in prison who have been in care.' The current figures stand at nearly 40 per cent of prisoners under 21.

Yet despite the severity of the issue and the 'phenomenal' importance of the early years, she adds, there is still is a 'huge gap' in the training of many staff.

CASE STUDY: YMCA FAIRTHORNE GROUP, GOSPORT

Jo Currass is nursery manager at the YMCA Fairthorne Group's Gosport nursery. It currently has one looked-after child, but has on occasions had several.

The staff have safeguarding training in-house and NSPCC safeguarding training.

'We don't tend to give looked-after children the same key person,' says Ms Currass. 'We have three age settings, so it wouldn't be appropriate for a child in pre-school to have the same key worker as a one-year-old.

'The key person and I attend social services meetings every three months. From that we work out children's needs.

'Specialist training is not necessarily about safeguarding; it is about what that child needs. Our current looked-after child needed Makaton and we were able to put that in place.

'When our foster child is in we have to be careful who we let visit the nursery. We have to be aware of the names of the parents who aren't supposed to see their children so that they don't try to gain access.

'We duplicate things like accident reports because we need a copy and the foster carer needs a copy. We can't put photographs up of looked-after children. They can only go in private books or to the children.

'It is also key to build up a relationship with the foster carer because they need support as well. If they need to sit and have a cup of tea and talk things through, we offer a listening ear.'

TRAINING

Local authorities across the country run courses on children in care, though many do not focus on the early years sector.

Some local authorities also provide useful guidance on children in care for early years settings.

Hampshire County Council provides a checklist (www3.hants.gov.uk/childrens-services/childcare/providers/sfyc-cic.htm) that includes reminders about:

awareness of the importance of outside play
awareness that there is a probable lack of familiar extended family members such as grandparents, uncles and aunts, etc
awareness of milestones that may have been reached but may not have been 'seen'
the need to identify peers/buddies who can invite/be invited for play dates
to recognise that separation anxiety, birth trauma and attachment difficulties may all show themselves in challenging behaviour
to remember that unstructured times can be very stressful so provide lots of visual and aural support
to always remember to ask yourself 'would this be good enough for my child?'

National courses

Tavistock and Portman NHS Foundation Trust

The trust has set up the International Training School for Infancy and early years, a joint enterprise between the Anna Freud clinic, the Tavistock clinic and Yale University, Child Studies Centre in the USA. The centre focuses on the 0-3 age group and many of the issues that affect mental health and well-being of young children, families and carers. The course aims to help develop a deep understanding of attachment or behavioural problems. See www.tavistockandportman.nhs.uk/training/courses/ international-training-school-infancy-and-early-years-itsiey.

The Drive Network

Looked-After Children and Education is run by a teacher and social worker and aims to consider how poor outcomes for children in care can be redressed and how self-esteem can be restored.

See www.drivenetwork.co.uk.

The National Children's Bureau (NCB)

The NCB runs a course called Communicating with Children in Care Aged 11 and Under about 'practical child-centred approaches to listening, involving and consulting with children about their care plans and reviews'. www.ncb.org.uk.

Osiris training

Courses in attachment theory. See www.osiris-training.co.uk/new_page_6.htm.

Books

See Maybe Days by Jennifer Wilgocki and Marcia Kahn Wright, A Family for Sammy by Kate Gaynor and Murphy's Three Homes by Jan Levinson Gilman.

Other resources