Key facts on the needs of looked-after children

Looked-after children (LAC) are a vulnerable group who, compared with their peers, have significantly more educational and mental health problems, and on leaving care have worse outcomes as adults. Nationally, LAC and care leavers are between four and five times more likely to self-harm in adulthood. They are at five-fold increased risk of all childhood mental health, emotional and behavioural problems. Looked-after teenage girls are 2.5 times more likely to become pregnant than other teenagers.1

Looked After Children

The number of looked after children continues to rise. There were 157 looked after children as at 31st March 2015, an increase of 5% compared to March 2014 and an increase of 19% on 2011.

Table 1: Numbers and rate of children looked after compared to national averages as at 31st March 2015

 

Source: SSDA903 2011-2015

 

In the year 2014-15 there were 115 new admissions into care (relating to 107 children). A larger proportion of starters (28%) still in care at the 31st March 2015 were aged 16 and over. This is double the national proportion of starters in this age range.

Whilst Merton has seen a rise in its looked after child population in the past 4 years the rates per 10,000 population remains stable and we continue have one of the lowest LAC populations when compared to our statistical neighbours. Merton has the 3rd lowest rate amongst its Statistical Neighbours. There are only nine (four in London) local authorities with a rate per 10,000 less than Merton.

 

Figure 1: Rate per 10,000 population of Children Looked After 2015 against Merton's statistical neighbours 2015

The age profile of children looked after in Merton differs significantly from the national picture with Merton caring for a large number of older looked after children aged 16 and over. At 31 March 2015, 38% of our looked after children were aged 16 and 17 compared to 22% nationally. The inverse trend is reflected in the 0 to 9 year olds at 25% to the national 41%.

 

Figure 2: Percentage of Children Looked After by Age Group compared to National 2015

The table below shows the significant increase in the older population over the previous 5 years. Review of local information confirms that many of the 16 and 17 year olds come into care late in their adolescence and the reason for accommodation is often outside the control of the Local Authority (UASC, homelessness and LASPO).

 

Table 2: Age of children looked after by year as at the year end

Source: SSDA 903

 

Figure 3 below shows overall, 62% of the LAC population is male and 38% female. The breakdown of the gender/age data highlights the fact that our older LAC cohort is significantly over-represented by males. This reflects the fact that the majority of the UASC and LASPO referrals received relate to males.

Figure 3: Percentage of Children Looked After at 31st March 2015 by age and gender

 

The majority of children looked after in Merton are from a white background. This is a lower proportion than the general resident population (by 17%). There are fewer Asian or Asian British than the all persons Merton population, although numbers of looked after children have risen from 2014. Mixed ethnic backgrounds, Black or Black British heritage and ‘other ethnic groups’ have looked after children proportions greater than the resident population.

Figure 4: Difference in Ethnic Group of Looked after Children from the Merton resident population

Note: Other Ethnic Groups is a census defined category and represents a number of ethnic groups where ethnic heritage cannot be defined in the Asian, Black White or Mixed groups. The category includes Afghanistani, Arab, Egyptian, Filipino, Iranian, Iraqi, Japanese, Korean, Kurdish, Latin / South / Central American, Lebanese, Malay, Moroccan, Polynesian, Thai, Vietnamese, or Yemeni.

 

Children from some (not all) minority ethnic backgrounds are over-represented in our looked after child population.

 

The variable experiences of black and minority ethnic children in the looked after system indicates a need to develop social work understandings of the diverse population with whom we work. This is further evidenced by the peer audit programme in Merton which has identified ethnicity and diversity as an area for practice improvement with training planned for all social work practitioners in 2015-16.

 

The report demonstrates an increase in the category of ‘other ethnic groups’ from 2013 to 2015. In 2015 62% of these looked after children were known to the authority as Unaccompanied Asylum Seeking Children (UASC).

 

The 5 year trend data indicates that the ethnic origin of our looked after children has remained relatively stable (Figure 5). An interesting shift in the demographic has seen a decrease in the number of Black/Black British children from 29% in 2011 to 20% in 2015.

Figure 5: Nationality of the Unaccompanied Asylum Seeking Children (UASC) population

Children ceasing care in 2014-15 to return home to live with parents/relatives has decreased to 37% (from 48% in 2014). Nationally one third ceased care and returned home. In 2015, 35% of Merton’s looked after children moved to independent living, an increase of 37% on 2014; this is above the national of 9% and reflects the higher proportion of older young people in our LAC cohort. This is further evidenced by the fact that in 2014-15 there was a 50% increase on 2013-14 of young people ceasing care turning 18, placing potential pressure on care leaving services.

 

Table 3: Reason for children leaving care during 2014/15*

*by number of children not number of episodes - if a child left care twice during the year the latest reason for care ceasing has been used

**for 2015 this excludes those who left care to live with parents or relatives with no parental responsibility. These have been grouped under 'other’

 

Placements

Children are looked after in a variety of settings; foster care, children’s homes, residential special schools, Youth Offending Institutes and a small number are in hospital settings. At 31 March 2015 68% of looked after children (106 children) were placed in foster care (this is just below the national figure of 75%). 58 children (59% of our looked after children) were placed with in house foster carers; this is a significant improvement on the 2014 figure of 49%. This continues to be an area of scrutiny for us due to the impact on budget, but also due the fact that agency placements are often outside of the borough.

The most common use of agency placements is for adolescents, as a number of our in house carers are only approved to take foster children up to the age of 10 years. The Access to Resources Service continues to undertake targeted recruitment of teenage carers, however there is a Pan London issue with many agencies and Local Authorities competing for a small number of carers.

18% of Merton’s looked after children are placed outside the local authority boundary and more than 20 miles from where they used to live, compared to 13% nationally (2014) and 18% for London. Merton is 6th amongst its 11 statistical neighbours (2014). 74% of all LAC placements made in 2014-15 were within a 10 mile radius of Merton and 60% of all LAC placements were within a 5 mile radius.

Figure 6: Percentage of Looked After Children placed outside Local Authority boundary and more than 20 miles from previous residence

 

For some young people placements away from their home community are a key part of the care plan as a result of anti-social behaviour/risk management. For some the needs of the young people are such that they require specialist placements which are not available in Merton or surrounding boroughs.

For all children being placed outside of the borough the Head of Service and DCS is required to sign off agreement for the placement. Care plans for these children and young people are reviewed to ensure that where possible young people are supported to return to their home community at the earliest opportunity. A more detailed analysis of these placements is available in Merton’s ‘Securing Sufficient Accommodation Statement for Looked After Children and Care Leavers’.

14% of Merton looked after children had three or more placement moves during 2014-15 compared to 10% nationally.

 

Table 4: Percentage of Children Looked After at 31st March with three or more placements during the year ending 31st March

Source: SSDA 903

Notes: From 2015, children missing from placement no longer count towards this indicator.

 

46% of Merton’s looked after children are in stable placements; the technical definition of stability is defined by the DfE as the percentage of looked after children aged under 16 who have been looked after continuously for at least 2.5 years who were living in the same placement for at least 2 years. Merton’s performance is significantly below the 2014 national average rate of 67%.

 

Table 5: Percentage of Looked After Children with Stability in their placement during 2014-15

Source: SSDA 903

Note: The percentage of Children Looked After aged under 16 at 31st March who had been looked after continuously for at least 2½ years, who were living in the same placement for at least 2 years, or are placed for adoption and their adoptive placement together with their previous placement last for at least 2 years

 

Placement stability has been an area of focus for Children’s Social Care and a detailed analysis of LAC stability was undertaken in April 2015. The resulting report identified key messages in relation to what we do well, what our challenges are and as such what we could do better. An improvement plan was put in place and our mid-year data is showing improvement in this area.

 

Health outcomes for looked after children

LAC Health outcomes in 2015 are above national average in dental checks and annual health assessments. Immunisations are in line with national (2014).

Merton has the lowest proportion of children looked after identified as having a substance misuse problem for the last five years at 6%. This is above the percentage of children and young people nationally (2014). Of the children and young people offered an intervention, 60% accepted and received an intervention.

 

Table 6: Health Care of Children Looked After (LAC continuously for at least 12 months, ending 31 March)

Source: SSDA903

 

Please also see LAC Health Needs assessment JSNA chapter 2015.

 

Care Leavers

Merton has 93, 19, 20 and 21 year old care leavers (2014/15). This increase has a direct relationship with the increasing number profile of 16 and 17 year old looked after children in previous years

In 2013-2014 the DfE amended the cohort of Care Leavers considered in the SSD903 to include young people aged 20 and 21 from the traditional care leavers aged 19, and this should be taken into account when considering the year on year comparator data.

Table 7: Numbers of care leavers 2011 to 2015

 

2011 (31st March)

2012 (31st march

2013 (31st March)

2014 (31st March)

2015 (31st March

Merton

13

17

20

96

93

Source: SSDA 903

 

Table 8: Age and gender of Care Leavers

Source: SSDA 903

Percentage of Care Leavers in Suitable Accommodation

Merton has a smaller proportion of care leavers in suitable accommodation (76%) than national (81%), it is however noted that local performance has improved by 10% over the past 12 months.

Table 9: The percentage of care leavers who were in suitable accommodation 2011 to 2015

 

Source: SSDA 903

Note: In 2014 the DfE extended the care leaver cohort to include 20 and 21 year olds. As a result the figures for 2011-2013 include only to 19 year olds whilst the figures for 2014 and 2015 include Care Leavers of all ages.

 

Percentage of Care Leavers in Education, Employment or Training

Over half of former care leavers are Not in Education, Employment or Training (NEET). This has become an area of focus for us as we have seen a year on year decline in performance.

 

Table 10: The percentage of care leavers who were in education, employment or training 2011 to 2015

 

Source: SSDA 903

Note: In 2014 the DfE extended the care leaver cohort to include 20 and 21 year olds. As a result the figures for 2011-2013 include only to 19 year olds whilst the figures for 2014 and 2015 include Care Leavers of all ages.

 

A deeper analysis of this data identifies that 19% (10 young people) are NEET due to illness/disability and pregnancy/parenthood and therefore may not be in a position to take up an ETE opportunity. As part of the Care Leaver Task Force we have reviewed the intervention resource in this area and have now agreed the additional resource of an ETE worker to work solely with the care leaver cohort.

 

11% of Merton young people aged 19-21 were in higher education (2014), this compares favourably with the National 2014 return of 6%. Further data is provided in the Virtual School Annual Report.

Figure 7: Percentage of former care leavers aged 19 to 21 who were in higher education in 2014

 

Evidence about what works to improve the health and wellbeing of looked-after children

National Institute for Health and Care Excellence (NICE) has produced guidance on the health and wellbeing of looked-after children and young people (NICE PH29 2010) and more recent quality standards (NICE QS31 2013), which define best practice and describe high-priority areas for quality improvements. These focus on promoting resilience, including warm nurturing care, a sense of belonging and emotional support.

The Chief Medical Officer’s Annual Report 2012 outlines recent evidence on the risk factors associated with entering care and outcomes.

Key commissioning recommendations

  • There are increasing numbers of LAC who require timely health assessments and other services.
  • There is a local and national emphasis on increasing the numbers of foster carers and speeding up the permanency process for prospective foster carers and adopters in relation to LAC requiring timely health assessments.

References

1.^ Department of Health (2013). Chief Medical Officer’s annual report 2012: Our Children Deserve Better: Prevention Pays – Chapter 11: Looked-after Children and Young People.