David Lane interviews the Earl of Listowel

Which are the services for children most in need of improvement? Ask people involved in child care, and many would answer, “Residential child care”. Whether the services deserve the poor image which they have is a matter for debate, but it is a fact that residential care is widely criticised, - by the public, in inquiry reports and within the social professions. Residential care has its advocates, but they are a small band.

Despite all the reports over the last thirty years, with all their recommendations for action, standards are still not satisfactory. So, when Francis, 6th Earl of Listowel, took his seat in the House of Lords in 1998, he decided that concern for the children in greatest need, and in particular those in residential care, should be the focus of his activity in the House. It was a worthy cause, in need of a champion.

The Level of Need

In laying out the case for action, Lord Listowel first points to the level of need. In 2002, 68% of children in residential care were identified as having mental disorders, 56% had conduct disorders and 11% less common disorders such as autism. These figures derive from the first national survey for England and the methods used to gather them may require refinement. They figures are worse than those for children in foster care and well above the ordinary population; the needs being met in residential care are severe.

The attainments of children in residential care are also poor, with only 1% reaching university. They are unhappily also over-represented in the prison population.

Meeting the Children’s Needs

If such acute needs are to be met, the staff should be well trained, well supported and well managed, but as Lord Listowel notes, training levels are inadequate and the quality of management and support often leave much to be desired.

In 1998, 70 – 80% of staff were unqualified. The Government set a target that by January 2005, 80% of staff should have achieved NVQ awards, but this has not been met. The figure is over 50%, but there is still some way to go.

Similarly, Lord Listowel’s view is that staff teams should have the support of specialists, -whether psychiatrists, psychologists or psychotherapists – to advise them on the care of the children and the management of the impact of the work on the personnel. The Warner Report recommended that this sort of expert help should be available, and without it, Lord Listowel feels that the staff are high and dry, and he has pressed the Minister for homes to have this sort of support provided.

Worryingly, he has found in visiting some homes that there are staff who do not want expert support, despite the intensity of the children’s needs they are having to cope with. He feels that perhaps the workers sometimes do not appreciate the complexity of their task.

He is keen, though, not to blame the staff for the failings of the system or the weaknesses of managerial and support systems. He sees the staff generally as being committed and determined to win through. It would be easy to “shoot the messenger” and blame the staff for the shortfalls of residential care, but that would be unjust.

Clearly, despite the criticisms, not all residential child care is poor, and Lord Listowel himself has seen both good and bad practice. He has a good record for getting to see the services, both in the residential sector and in services for homeless young people, in schools, in school holiday play schemes, in intermediate treatment and in psychiatric care. He undertakes voluntary work, and knows about the issues at first hand. Indeed, it was while undertaking voluntary work that he noted the high proportion of rough sleepers who had been in care and turned his attention to the cause.

International Comparisons

In the recent House of Lords debate, Lord Listowel quoted research by Pat Petrie of the Thomas Coram Foundation, in which standards of residential child care in England were compared with other countries in continental Europe. In general these showed England up in an unfavourable light – workers in the other countries were better trained and more professional.

Was this a reflection on British culture, he wondered. Are the British better at training engineers, soldiers and scientists, where the subjects are empirical. Do we like matters simplified and do we reduce complex issues to something we can manage? Are we less effective with matters pertaining to emotions? And yet there has been a sound tradition of therapeutic care in this country.

While we measure outcomes better in British child care, the actual outcomes appear to be better in continental Europe, for example in terms of the educational attainments of children in residential care.

The Causes of the Predicament

Obviously, there have been many attempts over the years to improve the quality of residential child care.
* The Castle Priory Report advocated good staffing levels in the 1960s, followed shortly by the Williams Report, which looked at residential care across the board.
* The Central Council for Education and Training in Social Work produced its report Residential Work is a Part of Social Work, introducing new qualifications for residential staff.
* The short-lived Personal Social Services Council inquired into residential child care.
* The Wagner Report tried to establish a positive image for residential care.
* The Warner Report looked at recruitment, management and other matters.
* The Support Force, set up by the Department of Health, produced guidance for three or four years and toured the country supporting local authorities in improving standards.
* Alan Levy and Barbara Kahan caused a stir with the Pindown Report.
* Sir Ronald Waterhouse reported in detail on the situation in Wales after the child care scandals in North Wales.
* Sir Bill Utting’s reports have laid out the predicament once again in England, with the Skinner Report doing the same for Scotland.
* In England the Residential Child Care Initiative attempted to improve training for residential child care workers for some time, while in Scotland the Scottish Institute for Residential Child Care was set up.
* Following the failure of the RCCI, the Residential Forum published A Golden Opportunity, advocating better training.
* The Blueprint Project focused on children’s views.
* Most recently there has been the proposal to set up an English counterpart to SIRCC, which is still awaiting ministerial decision.

Between all these well-intentioned, well-researched and well-written reports, there must have been several hundred recommendations for action, often with common messages, but the predicament remains. The question is : why?

Lord Listowel suggests that one cause may have been that, at the time of the Seebohm reorganisation, good staff were promoted and moved out of direct work with children. The loss of expert practitioners damaged the services.

Another problem is that no-one is prepared to own the services. Central Government says that service provision is the responsibility of local government, which is true, while local authorities, in Lord Listowel’s view, do not have the power to make the difference. Furthermore, he suggests, the number of children involved – about 6,000 – is too small for the Government to make it a political priority. To solve the problems of residential care requires long-term investment, and politicians are under pressure to think in terms of short-term targets.

Lord Listowel is critical of heavy inspection regimes and the impact of excessive bureaucracy. The danger with these systems is that they identify the wrong solutions to the problems, supplying sticking plasters for broken bones, when we need a more fundamental consideration of what residential child care is trying to achieve.

Action

Lord Listowel is concerned that the Government’s track record should be recognised. Over the last seven years it has done an enormous amount for children. Among current examples, it had tried to reduce bureaucracy in the Education Bill, and teachers were now being trained better. The Children’s Workforce Plan should be out soon, and hopefully that would lead to improved care.

Residential workers’ task is hard, says Lord Listowel, and they need to be courageous. Where they underfunction, it is often because they need better support and management and have picked up poor methods of work, discriminatory attitudes and poor values. With the right support, they could improve.

He supports the proposal for a centre of excellence to promote residential child care, not least because the number of sound practitioners and knowledgeable academics in this field has dwindled seriously and the corpus of experience needs to be built up again.

Lord Listowel advocates identifying children’s needs in developing the right types of services, and he supports the Blueprint Project’s findings – starting with the child and staying with the child.

It was concern about the complex range of issues surrounding residential care which led the Earl of Listowel to champion its cause, and he has made his mark. In the recent House of Lords debate (reported elsewhere in this issue) he was praised by his peers for raising the subject. He has done so not only in the debate he triggered but also in meetings with Ministers and in the corridors of the House. As a cross-bencher, he has been able to speak out and ask awkward questions, while of course tempering advocacy to retain the goodwill of Ministers.

What are his solutions to the problems facing residential care? The first, he says, is that the extent and reality of the problems has to be acknowledged, and this has not yet really been achieved. There is still work for the champion to do. We only hope that hereditary peers retain their seats in the Lords long enough for the Earl of Listowel to achieve his aims.