Introduction
The aim of out-of-home care is to provide children with stable placements. Some of the most difficult and challenging times for a child in out-of-home care will occur when they must change placements.
The impact of placement changes
For many children placed in out-of-home care, the challenges confronting their parents and families are not resolved quickly. For some children this may mean further placements become necessary in order to ensure their safety and wellbeing.
The need for further placements occurs for a range of reasons such as availability of a carer or carers experiencing difficulties in managing behaviour. For others, a further placement will occur after the return home of the child and the report of further concerns. With every placement comes the possibility of the child experiencing further trauma. The care team is required to make every effort to minimise the number of placement changes a child may experience and ensure the child is supported where a placement change is required.
Disruptions
Where there are early indicators that a placement may be in trouble, for example, observation of carers having difficulty, child demonstrating difficult or escalating behaviour, the child protection practitioner needs to discuss this with their supervisor or more senior officer as early as possible. The issue must be raised with the CSO and a meeting scheduled if necessary to discuss what supports are available to enable the placement to continue. This may include increased support for the caregiver, a behaviour management plan, therapeutic intervention, and liaison with the school or a mentor for the child.
Sometimes the child's presenting behaviour may precipitate a change in placement. Practitioners need to consider a behaviour management plan. A meeting of all care team members should be arranged as quickly as possible with the aim of stabilising the placement or where this is not possible, to assist in the transition of the child to the new placement. Where a change of placement is required this must be endorsed by the team manager.
The child protection practitioner, as a member of the care team, must attend any meeting regarding potential placement changes.
Where there is no option other than a new placement, the care team can lessen the impact of the move upon the child by:
- clear, age appropriate explanations of the reasons for the change
- reassurance and support
- taking a planned and incremental approach to the move, so that the child is familiarised with the new setting and caregivers in advance of the placement occurring (this is particularly important for younger children).
Unless the placement is undisclosed, the child's parents must be informed of the address of the changed placement and carers must be aware that parents will be told this information. If the placement is undisclosed the parents should only be advised that a placement change has occurred. This must be accurately recorded on CRIS.
It is important that children understand the things that will stay the same or change once they have changed placement. For example, will contact arrangements stay the same or change, what will the changes be, will they remain at their current school, will they take a different route to school, who will show them how to get to and from placement to school? This information should be explained to the child, as soon as possible, as part of the case planning process.
Whilst placement of children in out-of-home care can occur without notice and time to plan, the need to change a child's placement should generally be known some time before the date of the move. This period provides care team members the opportunity to consider how best to prepare and support the child's move and minimise the resulting trauma.
Strategies for immediate placements changes
Even though immediate placement changes may be less than optimum, there are two essential aspects that the care team can do to lessen the stress of out-of-home care placements:
- it is vital children have an opportunity to express their feelings about the placement
- it is essential direct carers and case managers explain to children what is happening and why
The degree to which children are able to express how they feel will however be determined by a range of factors, including:
- their age and stage of development
- the degree of trauma they may have suffered as a result of abuse and neglect or previous placements.
Some children will be able and prepared to discuss their feelings in response to gentle prompts from the care team members. Others will simply be too young to talk about their feelings, or may demonstrate their distress via crying and stronger actions, including angry or aggressive outbursts or, in more extreme situations, by self harm or harming others.
Strong reactions are often an indication of the degree of attachment to parents. The care team needs to provide a safe environment where these angry outbursts can be managed. Where the child is harming their environment or themselves, their feelings should be acknowledge but the behaviour should be curtailed, for example, by saying, 'I know you are upset and that is OK, but I won't let you hurt yourself or others'.
Care team members should be careful about isolating the child in the early stages of placement, because it might be interpreted as punishment for the feelings that led to the behaviour. It is better for a carer to consider staying with the child in a quiet space if the child requires calming down. Child protection practitioners should liaise regularly with the CSO caseworker and carer as appropriate during the transition period to a new placement.
Planning
Care teams should develop a clear plan to assist and support the child to settle in to the new placement. Care should be taken to incorporate plans for carer support, crisis prevention, behaviour management and clear roles and responsibilities where the need to change placements is related to management of a child's presenting behaviour.
A note about young people in placement
Most children will be developing a sense of self identity and striving for independence and will be able to understand the reasons for placement or change of placement in out-of-home care, particularly if behaviour was a contributing factor.
Many of the children placed in care will have years of abuse and disrupted family life behind them, including a number of failed placements for some. These aspects will impact upon the resilience and independence of children, and many will require the nurturing, care and sensitivity we might normally equate with younger children.
Considerations for good practice
The child protection practitioner needs to develop good working relationships with other members of the care team. This will be particularly important for children in kinship care placements who do not have CSO workers. Below is a list of factors for consideration for all children who must change placement:
- placement change has the capacity to further traumatise children, it is important direct carers anticipate and identify the feelings associated with placement change for children
- the child’s response to placement will reflect previous abuse and trauma, their age and stage of development and the degree of attachment to their parent
- the degree of trauma associated with placement may reflect the degree and significance of the attachment
- where signs of trauma are demonstrated in behaviour, carers need sensitivity, patience and support
- children in care may suffer anxiety regarding their parent's welfare
- carers can lessen the impact of trauma by reassurance and support, age-appropriate explanations of the reason for placement and where possible, a planned and incremental introduction of the child to the placement
- behaviour will reflect the degree of attachment and loss, effects of abuse and neglect, inconsistent limit setting, and discipline and the effects of multiple placements
- behaviour management strategies should reflect an understanding and sensitivity to the origins of the individual child’s behaviour.
- in most out-of-home care placements, children will display challenging behaviours, this is the norm
- effective behaviour management results from a positive environment with an emphasis upon reward for positive behaviour rather than a focus upon rules and compliance
- carers should model behaviour that is positive and consistent with the rules
- sanctions must be achievable, immediate and clearly linked to the actions of the child
- planning for the management of crisis is best undertaken when things are calm
- carers need to be sensitive to the stigma of family violence, mental illness and substance abuse in caring for children from these backgrounds.