_________________________________________________________________________Swansea University E-Theses Exploring outcomes of children and young people in kinship care in South Wales Pratchett, Rebecca How to cite: _________________________________________________________________________ Pratchett, Rebecca (2018) Exploring outcomes of children and young people in kinship care in South Wales. Doctoral thesis, Swansea University. http://cronfa.swan.ac.uk/Record/cronfa45015 Use policy: _________________________________________________________________________ This item is brought to you by Swansea University. Any person downloading material is agreeing to abide by the terms of the repository licence: copies of full text items may be used or reproduced in any format or medium, without prior permission for personal research or study, educational or non-commercial purposes only. The copyright for any work remains with the original author unless otherwise specified. The full-text must not be sold in any format or medium without the formal permission of the copyright holder. Permission for multiple reproductions should be obtained from the original author. Authors are personally responsible for adhering to copyright and publisher restrictions when uploading content to the repository. Please link to the metadata record in the Swansea University repository, Cronfa (link given in the citation reference above.) http://www.swansea.ac.uk/library/researchsupport/ris-support/ Exploring outcomes of children and young people in kinship care in South Wales. Rebecca Pratchett Submitted to Swansea University in fulfilment of the requirements for the programme of Doctor of Philosophy. Swansea University 2017 i Abstract Around 30,000 young people enter care every year, with more than a fifth of those being placed with a relative or close family friend in kinship care. Literature has suggested that kinship care may be a positive avenue for providing alternative out-of-home care to young people in a cost-effective manner. However, some studies have pointed to systematic challenges in formalising kinship care, which threatens to undermine the benefits of a family-based placement. These include permanency options such as Special Guardianship Orders (SGOs). This study will explore some of the outcomes of formal kinship care placements. The objective of this thesis is to explore the implications of a theoretical shift from formal care toward a kinship model via three study aims: to explore factors affecting stability within kinship care; to assess the relative wellbeing of young people in kinship care who are looked after; and to assess the educational achievement of looked after young people in kinship care. The study employs a mixed design comprised of two phases. Phase One explores the destination of early care leavers (n= 271) of whom 71 were in kinship care and care leavers ‘aging out’ (n= 48) of whom three were in kinship care. The exploration was comprised of a case file audit in two local authorities with follow- up of medium-term placement outcomes for early care leavers (12 months) and those aging out of care (18 months). Phase two explores the impact of kinship care on young people and kinship carers. Standardised measures explored the mental health, emotional literacy, attachment, cognitive skills, literacy and numeracy of young people. Bespoke questionnaires captured quantitative and qualitative data regarding placement characteristics and viewpoints from young people in kinship care (n=21), their carers (n=24), and their social workers (n=21). These areas were further explored via semi-structured interviews with each participant and a focus group of supervising social workers (n=4). Results from phase one indicate that pre-leaving care placement type had an effect on the post-care destination of young people leaving care early and that SGOs are stable in the medium-term. Phase two results demonstrated that kinship care is beneficial for the mental health and attachment of young people iii within the care system. The study also found kinship care to be advantageous in maintaining a strong personal and family identity. The study reports novel data on the educational attainment of young people in formal kinship care finding that children are achieving at an appropriate level as predicted by cognitive ability. However, attempts to regulate formal kinship placements from within the current model has created hardship for kinship carers, has led to feelings of intrusion and undermined the concept of family. This thesis posits that it is crucial that the social work system adapts to incorporate the differing needs of kinship carers rather than attempting to shoehorn a family unit into a professionalised care model. The concept of a dual model of social care, in which foster placements and kinship placements are treated as inherently different, is discussed in relation to modern social work practice. iv “Ohana means family. Family means nobody gets left behind or forgotten.” (Spencer, Sanders, & DeBlois, 2002) v Contents Abstract .......................................................................................................... iii Acknowledgements ....................................................................................... xi List of Appendices ........................................................................................ xiii List of Figures ............................................................................................... xv List of Tables ............................................................................................... xvii List of Abbreviations ..................................................................................... xix Chapter 1: Introduction ................................................................................... 1 1.1 Thesis objective, aims and research questions. ................................... 8 Chapter 2: Literature review: empirical literature and policy ......................... 12 2.1 Defining kinship care........................................................................... 14 2.2 Literature review search strategy ........................................................ 18 2.3 History of Kinship Care ....................................................................... 19 2.3.1 Trends in social work policy, practice & research ......................... 19 2.3.2 Trends in kinship care .................................................................. 25 2.3.3 Kinship care in the United Kingdom ............................................. 27 2.3.4 Kinship care in Wales ................................................................... 27 2.4 Wellbeing ............................................................................................ 28 2.4.1 Health ........................................................................................... 28 2.4.1.1 Physical health of children and young people in kinship care ... 30 2.4.1.2 Physical health of kinship carers ............................................... 36 2.4.2 Mental health ................................................................................... 38 2.4.2.1 Mental ill health and accessing healthcare ................................ 38 2.4.2.2 Positive mental health ............................................................... 46 2.4.2.3 Assessing mental health and mental illness .............................. 46 2.4.3 Resilience ........................................................................................ 47 2.4.3.1 Defining resilience ..................................................................... 47 2.4.3.2 Resilience factors ...................................................................... 48 2.4.4 Identity ............................................................................................. 52 2.4.5 Attachment ....................................................................................... 54 2.4.5.1 Attachment Theory .................................................................... 54 2.4.5.2 Attachment in public care .......................................................... 57 2.5 Voice of the child ................................................................................ 62 2.6 Stability ............................................................................................... 69 vii 2.6.1 Defining stability ........................................................................... 69 2.6.2 Benefits of placement stability ...................................................... 70 2.6.3 Stability and barriers to stability in kinship care ............................ 72 2.7 Permanency ........................................................................................ 76 2.7.1 Defining permanency ................................................................... 76 2.7.2 Permanency in kinship care ......................................................... 77 2.8 Birth family contact ............................................................................. 83 2.8.1 Birth family contact in foster care ................................................. 84 2.9 Education, employment and training ................................................... 89 2.9.1 Academic performance ................................................................ 90 2.9.2 Employment ................................................................................. 93 Chapter 3: Literature review: theoretical underpinning of kinship