Archived decisions

Appendix

The rights of children in our corporate care - briefing note by Pam Robinson, Deputy Director of Children's Services

The health, safety and wellbeing of children and young people are at the heart of policies and practice related to children in care. This includes taking into consideration the effects of smoking on children who are in foster care and those placed for adoption, and recognising the important role that carers and social workers have in protecting all aspects of a child's health while they are in care.

Social care professionals who make placement decisions on behalf of vulnerable children must give a high priority to the present and future health of these children. The issue of smoking and foster carers is controversial and requires that the rights of substitute carers to smoke must always be balanced against the rights of children to remain healthy. This is especially true for children in care, who frequently come into the care system with neglected or impaired health. The Corporate Parent has a responsibility towards children in care that has to be balanced against the rights of carers to do as they wish in their own homes.

The National Minimum Standards for Fostering Services emphasise the importance of health promotion awareness for foster carers both in relation to their own health and that of children in their care.

Adoption agencies are required to take into account the Government view that there should be no `blanket bans' when considering applications from prospective adopters. The issue is, therefore, not one of banning prospective adopters and new carers, but of engaging with them, providing information and advice and facilitating access to smoking cessation programmes.

British Association for Adoption and Fostering (BAAF) strongly recommend that all substitute carers should be pro-actively encouraged to stop smoking.

Hampshire's Current Policy:

Applicants to become Foster Carers or Adopters: When assessing applicants who wish to become county foster carers, or adopters, we inform them about the research into potential damage to children's health and well-being caused by passive smoking and about our policies in relation to placing children.

We advise them about services in the community they can access in order to obtain help to give up smoking.

For those applicants or members of the household who are in the process of giving up smoking, to be classed as a non-smoking fostering household they will need to have given up for a period of, at minimum, 12 months.

Applicants are made aware that if they continue to smoke, their approval will be affected. Panels will also be very concerned about recommending them for approval as foster carers or as prospective adopters, because of the risk to all children from passive smoking.

Adoption: Hampshire currently follows the old BAAF guidance whereby no child under 0-2 years of age is placed with smokers: this includes social smokers and those that smoke outside. Neither do we place children with asthma/other respiratory problems/disabilities with smokers. If carers smoke one cigarette anywhere they are classed as smokers.

Anyone who smokes who contacts Hampshire with an interest in adoption is informed of this but also that Hampshire is considering new BAAF guidelines which advise that we should not be placing children under 5 with smokers. They are also informed that social workers will most certainly choose a non-smoking family over a smoking one when considering placement of children aged 3+ years.

Smokers are offered advice re quitting including by our Adoption Medical Advisors.

Fostering: Hampshire does not place any child 0-3yrs with anyone who smokes. Neither do we place children with asthma/other respiratory problems/disabilities with smokers. At the panel which approves foster carers, if applicants smoke, the Medical Advisor offers help in stopping. We do not accept the fact that people say they smoke in the garden - we would still not place a child under 4 with them.

Family & friends Placements: The nature of family and friends foster care is very different from that of County carers. There are additional complex issues to consider. Any risk to the health of a child resulting from such a placement will need to be weighed against the potential benefits to a child of being placed with people who are part of their family (or friends) and with whom they are likely to have a pre-existing bond. Children generally have better outcomes in such placements and an assessment of need is made in each case as to whether the best interests of an individual child would be served by living with family and friends, even where there may be some doubt as to their ability to provide a smoke-free home for that child.

Hampshire family and friends foster carers represent a significant resource to children who have to live away from home. Currently , approximately 45% of all children fostered with Hampshire approved foster carers are fostered with family or friends.

When assessing family members or friends as prospective foster carers therefore, there should be an analysis of risks and benefits to the child of the placement e.g. the possible health risks to the child of carers smoking, against the security for the child of the bonding already in place between him/her and the prospective carer .

As part of our work to revise the policy, some initial research has been carried out into the number of fostering households that include a foster carer who smokes. Early indications are that at least 18% of County Fostering households include carers who smoke (this excludes numbers of other adults and/or young people who smoke and who may live with a carer who does not smoke). In terms of Family and Friends foster carers, this increases to at least 34%.

Policy Development in Hampshire:

Officers are currently engaged in a revision of the current policy. This has included the research cited above and negotiation with the Hampshire Fostering Network to undertake extensive consultation with our carers. If we are to change the policy, it will assist our retention and recruitment of carers if we have worked with them on the changes. This will include consultations with health professionals, and with young people. Whatever the final recommendations to the Executive Member, it is unlikely that any revised policy will differ from BAAF's recommendations that no `stranger' carer who smokes should be approved to care for a child under the age of 5 years and that this will apply to both fostering and adoption applicants.

The issue in relation to Family and Friends carers is one that needs ongoing discussion, to ensure that smoking is restricted to areas of the house not used by any child.

The Fostering Handbook, which provides guidance to all Hampshire foster carers, now includes a statement in relation to smoking (see Annex 1 for an excerpt).

The Fostering Network (a national organisation) believes that all fostering services should be moving towards a position where children and young people in care are only placed in smoke-free homes. Expecting all foster carers to stop suddenly is not realistic and it is acknowledged that some foster carers who smoke have recognised sufficiently the needs of children and young people for whom they care and are already minimising the impact of their smoking on the children they foster.

The Fostering Network recommends that recruitment and retention processes should address the issue of smoking in a robust and open manner.

Hampshire's pending recruitment campaign will address this issue and , pending the final decision of the Executive Member on the issue, we would prefer not to recruit new carers who smoke for children under the age of 5 years.

Next Stage:

Consultations are beginning. The Select Committee will be presented with an Information Note at the end of March 2008 and it is highly likely they will request a full report on progress of policy development.

Following this, and following the consultation with our carers, a report will be presented to the Executive Member for Children and Families in July 2008. This will detail the full policy recommendations.

References:

BAAF Practice Note 51 `Reducing the Risks of Environmental Tobacco Smoke for Looked After Children and their Carers' (2007)

Fostering Network Policy Paper ` Foster Carers and Smoking' (June 2007)

Annex 1

Guidance for Foster Carers:

Fostering Handbook Update re Smoking

Smoking There is increasingly strong evidence to support the view that smoking and passive smoking have a detrimental effect upon the health and development of children. The health safety and well being of children and young people are at the heart of policies and practice related to children looked-after. This includes taking into consideration the effects of smoking on children who are in foster care/family link placements and the important role that carers and social workers have in protecting all aspects of a child's health.

The issue of smoking and carers is controversial and requires that the rights of carers to smoke be balanced against the rights of looked-after children who frequently have neglected or impaired health and who have the right to be healthy. The corporate parent has a responsibility towards looked-after children that has to be balanced against the rights of carers to do as they wish within their own homes.

The Department is currently revising its policy about smoking and will need to take into account the research, evidence and recommendations of various organisations regarding smoking and the impact on children and young people. The Fostering Network and British Association for Adoption and Fostering (BAAF) are currently recommending that no child under the age of five should be placed with non-related carers who smoke. They also suggest that a child of any age who has respiratory problems, or due to disability is unable to remove themselves from a smoky environment, should not be placed either.

Carers are currently advised to restrict their smoking to certain (well ventilated) areas of their home but preferably outside, to ensure that children play, eat and sleep in smoke free rooms. This should be a policy that applies to visitors also. Carers should also not smoke in the confined space of a car or take children anywhere they will be exposed to excessive smoking.

The law relating to smoking is as follows:-

A child/young person of any age can smoke, although it is an offence to sell tobacco products or cigarette papers to anyone under 18 - revised Government Policy from October 1^st 2007)). Under 18 year olds can have these articles confiscated by the police (or uniformed park keeper) if found smoking in a street or public place.

Carers should never buy cigarettes for children and young people in their care or use them as a reward for good behaviour. Carers' household rules should include expectations about smoking and these should be made clear to all at the outset of a placement. Smoking should never be allowed in bedrooms due to the obvious high fire risk and endangerment to all in the household. It will clearly help if carers ensure that any lighters or cigarettes in the home are kept secure and that they generally don't advocate or model smoking.

Help and assistance is available for all carers and young people who wish to stop smoking.