Tag: Health and wellbeing

• Independent Care Review wants ‘more care, less system’
• Says Scotland must ‘parent, not process’ children
• Human and economic cost of care published for first time

The Independent Care Review (Care Review) has called for a radical overhaul of  Scotland’s ‘care system’ and publishes, for the first time, the human and economic cost of the current provision and its failures.

Unprecedented in scope, methodology and model, the Care Review has listened to more than 5,500 experiences.

Over half of those were children and young people with experience of the ‘care system’, adults who have lived in care and their families. The rest came from the unpaid and paid workforce.

These experiences are the heart of the Care Review’s work and guided and shaped its conclusions.

The in-depth examination of all aspects of care in Scotland has revealed a system that is fractured, bureaucratic and unfeeling for far too many children and families. It also doesn’t adequately value the voices and experiences of those in it.

The Care Review has calculated that services which deliver and surround the ‘care system’ cost £1.2 billion annually – this includes children and families support services; Children’s Panels; Children’s Hearings Scotland; Scottish Children’s Reporters Administration as well as delivery of other universal services like education and mental health to children in care.

The Care Review also calculated the costs of the ‘care system’ letting down children and their families at £1.6 billion; a combination of £875 million in meeting the needs care experienced people have as a result of the ‘care system’ failing them and £732 million in lost income tax and national insurance.

Driven by an unwavering focus on the voice of care experience, the Care Review demands the following changes:

• The balance of power must be upended so that listening to children and young people is always the basis of all decisions made about their lives.
• There must be a focus on building and maintaining life-long relationships – that includes a broader understanding of the risk of not having long term, loving relationships.
• Scotland must parent, not process, children so there is no difference between the lives of children in care and their peers. Care experienced children must not miss out on the kind of childhood that many take for granted and the future that all our young people deserve.
• Families must be kept together wherever it is safe to do so. Families must get the support that is right for them at the earliest opportunity and it must be flexible, consistent, patient and free from stigma. This will mean that more children can live a safe, happy life at home with their families.

The report has identified five foundations for change, with over 80 specific changes that must be made to transform how Scotland cares for children and families as well as the unpaid and paid workforce.

Since 2018, the Care Review’s Stop:Go work with all 32 local authorities has already led to many important changes and ensured the review didn’t delay opportunities to improve the day-to-day experience of care received in Scotland today.

The Care Review has also published The Plan, an approach to implementation plotted out over 10 years whilst demanding urgency is maintained in the pace of change.

The five foundations are: 1) voice of the children must be heard at all stages; 2) what all families need to thrive; 3) care, that builds childhoods for children who Scotland has responsibility 4) people, with a relentless focus on the importance of relationships and 5) scaffolding, so that the structure is there to support children and families when needed.

Fiona Duncan, Chair of the Independent Care Review said: “I have heard countless stories of when the care system gets it wrong; separation, trauma, stigma and pain.  Too many childhoods have been lost to a system that serves its own convenience rather than those within it.

“The Care Review has listened to what care experienced people have said needs to change and those voices have driven its work and underpins its conclusions.

“It has sought to understand how the system feels to those who live and work in and around it. And it has produced the what, how, why and when of what needs to happen next.

“This is a radical blueprint for a country that loves, nurtures and cherishes its children. This is Scotland’s chance to care for its children, the way all good parents should.”

First Minister Nicola Sturgeon said: “I would like to extend my thanks to Fiona Duncan and the review members for the work they have put into their final report and supporting documents as well as the individuals who shared their often extremely personal stories with the team.

“In 2016 I accepted a challenge to listen to the experiences of 1,000 looked-after young people because I knew the care system needed a transformation and I wanted to hear first-hand what had to change. These early conversations inspired me to announce an independent root-and-branch review of the care system.

“So for the first time ever the voices of people with experience of the care sector have been, and will continue to be, at the heart of shaping care policy. Over 5,500 people, including care experienced individuals and their families, as well as paid and unpaid care workers, took the time to discuss their thoughts, feelings and experiences to highlight where things are going well and where we need to improve.

“I have had the privilege of meeting many young people with experience of care who are doing extremely well, I have also been given the chance to see the dedication, commitment and passion of those who work in the care sector.

“But I’ve also heard some extremely difficult stories which portray the care sector as bureaucratic and even unfeeling.

“It is clear that despite the efforts of those within the system, the actual experience of too many people in care is not what we want it to be.

“We will keep listening to and working with care experienced people because the case for transformational change is now unarguable and their voice must shape that change. We will work with them and with local authorities, care providers and others to deliver that change as quickly and as safely as possible.”

Fiona Aitken, Adoption UK’s Scotland director said: “This is an incredibly important piece of work – which will affect the lives of millions of children – so we’re delighted that the real-life experiences of care-experienced children and young people, as well as those of their families and carers, is at the very heart of this review.  

“Only by listening to their experiences can significant improvements be made to the care system.”

Joanna Barrett, Policy and Public Affairs Manager at NSPCC Scotland, said: “We are extremely heartened by this thorough and insightful analysis of our care system, with a wealth of important recommendations for its overhaul. 

“We have long had concerns that children are not being put at the centre of our Hearings System and are being let down, and believe changes to its operation are critical. 

“At NSPCC Scotland, we work with very young children in the care system and know that understanding early childhood development and behaviour is crucial to making the right decisions. And so, we are greatly encouraged that the Review recognises the focus needed on this age group, which makes up the greatest proportion of those entering care. 

“It is now vital that there is the will and the resources for us all to work together in implementing these changes.”

Stephen Finlayson, Head of Innovation and Improvement of leading mental health charity Penumbra said: “We know that change is required and it’s great to see this report calling on the transformation of the care system.  It is vital that those with lived experience are at the heart of change. 

“We are pleased to see the Independent Care Review put the voices of children and young people first and ensured their experience was central to the report and the recommendations within it.

“Despite good intentions, the care system in Scotland has too often placed children in care settings which have themselves contributed to poor mental health: it is time for Scotland to prioritise the mental wellbeing of all children and ensure that, when additional care is required,  this is the top priority.  Penumbra is committed to help realise the vision and ambition for Scotland’s children set out in the Independent Care Review.”

Duncan Dunlop, Chief Executive of Who Cares? Scotland said: “The first thing that we want to do is congratulate Fiona Duncan for her commitment and recognise the strength of every Care Experienced person who contributed their voice to the Review over the last three years.

“This was promised to be a Review like no other and that is why we believe its findings should provide a platform for the kind of change that Care Experienced people desperately need.

“Care Experienced people are capable, thoughtful and have enormous potential. What we have seen, unfortunately, are generations of people living with the consequences of a care system that focused on containing them then leaving them, rather than ensuring that they are loved and supported forever.

“We have also seen Scotland struggle to connect with how it can support Care Experienced people. With that in mind, we will now take the necessary time to reflect on the findings that have been published today and consider in what ways the recommendations realise our ambitions for change.

“In January this year, the Care Inspectorate published figures on the early deaths of Care Experienced people. They said that between 2012 and 2018, 36 people in the care of the state died unexpected or untimely death. We know from our own networks that this is an under-representation, with six young Care Experienced people in our network dying in December 2019 alone.

“The evidence shows that what the Scottish Government chooses to do next is literally a matter of life and death. We expect to see urgent action, in the next few weeks, that makes a tangible difference to young people’s lives. Any further delay would be unacceptable.”

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