Official Report: Minutes of Evidence

The Chairperson (Mr McGuigan): I welcome Martina Moore, director of family and children's policy, and Stefani Millar, head of the looked-after children and adoption policy unit. You are welcome. You heard the previous presentation and have probably anticipated some of the questions that we are likely to ask. Is there anything that you want to add to the written briefing that you provided?

Ms Martina Moore (Department of Health): First, I just want to introduce myself, because I, too, am new. I have just taken up the post of director of family and children's policy. I was in the Department and just moved across. Many of you will be more familiar with Eilís in this role. I wanted to assure you that she has not gone away. She has taken on the role of director of strategic reform. In that role, she will have children's services reform and adult social care reform. That is very much about allowing her to drive forward momentum in that space. It is a positive move in trying to drive forward the changes that we need while I can look after the day job and the policy arena around that.

As you said, Chair, members got a written briefing in advance, so we will focus on some of the provisions. Probably, you will have already heard a lot of it. I am conscious of time, so I will take you through them as fast as I can.

As has already been said, these regulations have been in development for quite some time. They were first developed and consulted on in 2014. As we know, while it was the Department's intention to bring them forward at that time, a number of issues had an impact on that. Given the passage of time, we carried out a further consultation in 2022. As was mentioned in the earlier evidence session this afternoon, that included engagement with care-experienced children, young people and foster carers through workshops, surveys and online social media.

Currently in Northern Ireland and in line with the 1996 regulations, as we know, foster parents can be approved only by trusts or voluntary organisations but not by the independent fostering agencies. In practice, that creates a delay for potential foster parents who are being assessed by an independent fostering agency, as they have to go through two assessment processes. The new regulations have been drafted with the intention of revoking and replacing the 1996 regulations.

As you have heard, one of the main changes is that the new regulations will allow the fostering agencies to act on behalf of the trusts to approve foster parents once they have been assessed. The intention of that is to streamline and shorten the assessment and approval process and make it less daunting for those who wish to apply. The Department has responsibility for ensuring that all fostering services, statutory and independent, are operating in the best interests of children in foster placements and foster parents.

Health and Social Care (HSC) fostering services are subject to a departmental framework of accountability through regular accountability meetings and ongoing performance monitoring, but there are currently no mechanisms in place to provide assurances on the quality of services that are provided by the independents. Again, it is intended that the new regulations will address that by bringing the fostering agencies within the scope, as we have heard, of inspection regulation by the Regulation and Quality Improvement Authority (RQIA).

As we have heard, the regulations provide the independent agencies with a clear legislative basis for their services and set out the requirements for registration with RQIA. The Department does not have the powers to require the registration of HSC trust fostering services with RQIA. Having looked at the situation, however, we know that many of the registration requirements mirror the current arrangements that are in place with the trusts.

In summary, the trusts will continue to provide statutory fostering services alongside the independent fostering agencies. Those services include the placement of children and the monitoring and review of those placements. I know that there was a lot of discussion around that, but the new regulations will place specific duties on trusts in relation to the health and education of children as well as in relation to the support, training and information to be provided to foster parents. The regulations will provide a clearer framework for foster parent assessments that are carried out by the trusts and the independent agencies. Again, as discussed in the previous session, the regulations will specify the details of what has to be considered as part of that process, as well as the notification of approval and reviews, and that applies to all services.

I will touch on a few other things. The regulations were subject to consultation, and we have made amendments, as has been reflected. We wanted to give you some examples of the feedback that we received. There were amendments to the language that was used in previous iterations of the regulations to do with restraint and discipline. We have changed that to reflect positive behaviour management techniques. Obviously, that includes that the responsible authority should promote well-being alongside health and development.

One of the other things that we have done is to add timescales. The regulations will set out clearly the timescale within which providers should notify prospective parents of their approval or otherwise. All of the feedback that we have had and the changes that we have made as a result of the consultation have helped to make the regulations more robust and fit for purpose than they were originally.

The other aspect that I wanted to mention — it has been touched on a lot — is the standards that we have been developing. The same set of standards that RQIA uses in inspecting fostering agencies and in the assessment of the quality of services provided by trusts will be used to provide consistency across all fostering services. Those standards are built into the provisions in the regulations to cover assessments as well as support and training and the management of placements.

I wanted you to give a feel of what those standards looked like. For example, one of the standards is about ensuring that foster parents, staff and other caregivers have the right skills and supports to care for children and that children and their foster parents are meaningfully involved. A whole subset of standards sits below that, but I just wanted to give you a feel of the kind of standards that we have in that. They are being developed by a working group, and you have heard from some of its members today. It is a wide-ranging group and includes people who have experience of foster care.

It is important for us to say that, together, the regulations and standards will bring improvements for children in foster placements and those who care for them. The regulations will have an impact across all areas of fostering services from assessment to approval and from support and training to planning at the end of a foster placement. They go some way towards addressing some of the concerns in Professor Jones's report about the delays experienced in implementing previous initiatives for foster care.

Avery put it well: it is the start of the journey, not the end. Much more needs to be done to address the challenges in foster care, and change will not stop here. Foster carers are absolutely the cornerstone of the care system, and it is important that we do all that we can to attract and retain them and show them that they are valued.
A lot of work is being taken forward in the reform, as you know, but, in getting to that point, the regulations and standards form a piece of the puzzle. Today is an important step forward.

I am trying to rush through this because I am conscious of the time.

A lot of what was said in the previous session was about what we were going to set out. It is really about this being an important step forward in ensuring that all fostering agencies operate in the best interests of the children and the foster parents, that we have mechanisms in place to ensure the effectiveness of operations across all services and that quality is provided consistently.

That was just a quick overview. Obviously, we are happy to answer any questions.

The Chairperson (Mr McGuigan): Thank you. Your written submission was thorough. You heard the presentation that came before. The representatives of the independent foster care sector — I will not put words in their mouths — are genuinely content with the regulations and are happy to see them.

I will focus a couple of questions on costs and resource. You heard earlier some of the questions that we asked about the cost implications. You said that no financial implications arise from these regulations. However, we had a bit of a conversation earlier about Part VI, regulation 17(2)(c), which states:

We asked the question, but I am just not sure that, at the minute, there are adequate resources. Will adequate resources follow to ensure that that regulation can be carried out as designed?

Ms Moore: You are well versed in the financial challenges that we face across the Department at the minute and across health and social care in general. The regulations and the duties placed are absolutely the right thing to do. It is up to us now, in moving them forward and implementing them, to work right across the providers.

Can I tell you today that a package of money is going alongside this? I cannot, but I can say that we will work right across the system to implement the regulations and continue to advocate them. Work is very much going on in the fostering work stream as well, looking at fostering and the financial supports for it. We are connected to that. Stefani sits on that group. As I said, I have just come into post, so I need to connect to it. I cannot sit here and say that there is an underpinning implementation package, but this is the right thing to do. It is absolutely right that those supports have to be in place for children, and it is up to us to work with our providers to make it happen.

The Chairperson (Mr McGuigan): Do you understand my concern?

Ms Moore: I do, absolutely. You are putting a big ask in there that you have to —.

The Chairperson (Mr McGuigan): If it is the right thing to do, it obviously needs to be done. The Budget is being debated in the Assembly next week. Was any request or ask made? Is nothing additional included in the Budget for this set of regulations?

Ms Moore: I will have to defer, as they say. Do you know, Stefani, whether any ask was made?

Ms Stefani Millar (Department of Health): There was no particular ask related to the regulations. I can say that, for the health and care needs of the child as specified in regulation 17, the expectation at the moment is that those needs are being met. Whether they are is another matter. We just wanted to be clear in the regulations that that is our expectation and to clarify that what should be happening now anyway is clearly expected for foster children in particular. It is not that a new requirement is being placed on providers; it clarifies the existing requirement. We do not necessarily think that additional resource is required as a result of these regulations being introduced, but that is not to say that additional resource is not required to meet the needs of all children in need and in care. Of course, we would very much value additional money.

Ms Moore: Absolutely.

Ms Millar: Chair, you asked particularly about the Budget. We continue to lobby for allowances and fees for foster parents, and work is ongoing by our colleagues in the strategic planning and performance group (SPPG) to review those. In our policy roles, we are mindful that we need to keep pressing to make the best case for improvements there.

The Chairperson (Mr McGuigan): Subsequent to that, there is a new role for the RQIA in this. Are you confident that it has the resources to do that additional and important work in what is a new role for it? That could be another concern.

Ms Moore: Yes, it has been supportive of the position, and, as I said, I know that the team in the Department has been working closely with the RQIA, and there have been discussions on that additional requirement, which covers not just the independents but assessments of the trust. Those are part of the conversations that are ongoing currently to shore that up. At this point, it is supportive of the move.

The Chairperson (Mr McGuigan): OK, 100%.

Miss McAllister: Thank you very much for the presentation. Martina, I think that this is the first time that we have met you in your capacity of having taken over this role, so you are welcome to the Health Committee. The reform of children's social services is something that I am passionate about and that the Committee has put great focus on since the Assembly was restored, so we look forward to having you here on an ongoing basis.

I have a specific question on something that was not touched on but is in your briefing. Regulation 3(5) says that the further requirement has been introduced that independent fostering agencies can operate only on a not-for-profit basis, and that arises from the recommendation from Ray Jones of no privatisation of children's social care. I very much welcome that, and I think that it is a great move forward that that is set down in regulations. Is that to be expanded to all children's homes as well? We have asked the Health Minister that previously but have not had an answer.

Ms Moore: I will have to come back to you on that. Not that I am aware of, Nuala, but, as I said, I am literally just in post. Obviously, I was aware of Ray Jones's recommendation, and, as you said, it is great to see that in these regulations for the fostering agencies. I will need to come back on that.

Miss McAllister: Has it been discussed or prioritised as a topic to say "We really need to get this sorted"? Has it been a focus?

Ms Moore: Do you mean in the reform programme itself?

Miss McAllister: Yes.

Ms Millar: Yes, it has. Obviously, a very low number currently are private providers of residential care, and that number includes not-for-profit organisations and private profit-making organisations in the independent sector. That makes up a very small proportion. We are mindful that there are others who wish to come into our sector here in Northern Ireland and make efforts in this area, but, in the reform programme, of which I sit on the residential work stream, we are very clear that our focus is on increasing capacity in our statutory services.

Miss McAllister: That is absolutely where it should sit. At the next update, can we have a specific update on that? It is great to be able to welcome the fact that that regulation is now contained in the element of foster care agencies, but it would be good to say the same about residential children's homes too.

My other question is about what you said previously about the health and care needs of the child. What about cross-departmental working in that sense? My question in the previous session, which you listened to, was about the individual needs of each child. For example, if we have a looked-after child (LAC) review, we have people from education and health in the room. However, a lot of the time, the person from education is a representative of the school rather than of the Education Authority (EA), which is able to carry out more work and do educational assessments, particularly for special educational needs. What cross-departmental working has been done on regulation 17 to assess the resource capacity? Data is very important. Are we meeting the individual caring plan needs of the children?

Ms Millar: I will need to go back and check. I have been working on these regulations for around a year. I think that that was carried over from an earlier version, so we can certainly go back and check what engagement has been carried out on that.

More generally on engagement and how that holistic care planning is carried out under the new framework for integrated therapeutic care that is being phased in for all looked-after and adopted children, we are bringing in the "one child, one plan" approach, which will include our colleagues in Education. That is subject to an ongoing care-planning pilot for a small cohort of young people: in the pilot, their personal education plans and care plans are being brought together into one plan. We are trying to work together so that all of that is held together in one place. That is what we are aiming for in the longer term. It will take a while to get there, but that work has started, and that is what we are aiming for.

Miss McAllister: The child needs to see the benefits. A young child who has been placed in foster care already experiences trauma related to that event. Then, as if they do not already have enough to deal with, they may have to wait longer to get a SEN assessment and even longer for help through child and adolescent mental health services (CAMHS) support. I am not saying that they should be prioritised or put at the head of the queue, but they have additional needs that children who are not looked after by the state do not have, so that is definitely worth doing. I look forward to engaging further on that. Thank you.

Ms Millar: There is a therapeutic team for looked-after and adopted children in each trust. The witnesses in your previous evidence session touched on that, recognising that those teams are different in each trust and have different areas of focus. They are there, however, and, as we move to implement the framework for integrated therapeutic care, we are looking to bring a more consistent approach to that.

We have a model that is based on the numbers of looked-after children in each trust area and the needs in each trust area for which we want to bring in professions such as occupational therapy. We want to bring a multi-profession approach to those therapeutic teams so that we can get better support more quickly for the young people who need it. We are working on that and hope to have some new staff on the ground towards the end of the next financial year. We will have to see how that process goes. That is the start of a process to expand the therapeutic teams in recognition of the great challenges that the children face and the trauma that has been experienced.

Miss McAllister: That is good news. I look forward to that being rolled out. Thank you.

Mrs Dillon: On the back of that answer, Stefani, can we get an update on the consistency approach as it goes forward? I would like to be kept updated on whether it is happening and whether there are blockages or issues that we need to be aware of.

Ms Millar: No problem. Funding will be a big issue, but it will certainly be no problem to provide that update. If it would be helpful, we can provide you with a briefing paper that sets out our plans for that and how we anticipate it happening over the next number of years.

Mrs Dillon: That would be really helpful.

My other question is not really a question, but I would like you to clarify something. Is it the case that there is currently no plan in place in the Department for the, hopefully, increased funding for foster carers?

Ms Millar: That work is ongoing in the Department.

Ms Moore: That is ongoing. Stefani is in that work stream, so she is probably more able to speak to it than I am. The work stream is looking at options and costs.

Ms Millar: A lot of information has been gathered from trusts on how much they spend. The Committee will be aware that there are two systems of financial allocations for foster parents: allowances, which are standardised across all trusts; and fees, which are for more specialist placements, skills and that sort of thing. That is not particularly consistent, but we are trying to gather the information on that and bring it together into a consistent approach. My understanding, from our colleagues in SPPG, is that the information has been almost completely gathered and assessed and that it is now a case of looking at how to use that better in order to make sure that everyone gets a fair deal money-wise.

Mrs Dillon: I ask that we receive a briefing on that when there is more information. I am content for that to be a written briefing, and, if there are things in that briefing on which the Committee feels that it needs somebody from the Department in front of us, we could come back to you for that.

I appreciate that. Thank you very much.

Mr Donnelly: I will follow on from Linda's points. You will have heard the witnesses in our previous evidence session talking about the need to resolve remuneration. Do you accept that that is a barrier to recruitment and retention?

Ms Moore: Yes. There is absolute recognition of it as a barrier, of the need to have that review in order to make it more consistent and of the need to invest in our foster carers, since we know that they are the cornerstone. Part of that work stream is costing out options and working through the budget implications, but there is absolutely an acceptance of that being a barrier.

Mr Donnelly: You mentioned that you made a bid to SPPG. Is that correct?

Ms Millar: Is that about the Budget Bill? That was in the Budget briefing that you asked about earlier. As the Budget briefings and things have come around, we have continued to lobby for additional money. A specific bid has not been made recently, but our Finance colleagues are very well aware — believe you me — that we are targeting and want to increase that. However, we need the data, which comes back to some of the work on the review that is being carried out by SPPG. We need to make sure that we have robust data to inform the exact recommendations that we are going forward with and the exact details of a specific bid. I think that Professor Jones recognised that, although money is important for a lot of the people who come in to foster, it is not the be-all and end-all and that the other support mechanisms are equally important in order to make them feel valued and that their views are important in caring for that child.

Ms Moore: And part of that team.

Ms Millar: Yes.

Ms Moore: Their role as part of that wider team around that child is important. That is where a lot of the work on the standards really comes in. It is about setting standards for what is expected right across the board. That is not necessarily about finance. I know that people have to be resourced and that there are issues around time, but working collaboratively and as part of a team benefits everybody in the long term. It is important that the foster carer be really valued. Obviously, remuneration is important, but we have to focus on those other aspects as well.

Ms Millar: As an example, when the standards come along, we expect that foster parents will be fully involved in the care-planning process for a child and that their views will be taken on board as part of that. I do not think that that is happening in the way in which it should be. It will be very much set down, "This is what we expect to see happening in future".

Mr Donnelly: That feeds into the point that was made earlier about not feeling valued —

Ms Millar: Very much so.

Mr Donnelly: — in the system.

Ms Millar: I do not think that we have mentioned this yet: the standards will be subject to public consultation, so we will be in contact with you, hopefully in the next few months, about the launch of the public consultation.

Mr Donnelly: No problem. Thank you.

The Chairperson (Mr McGuigan): I was just reading that in your document.

Ms Flynn: I asked the Fostering Network whether the Department had any plans to review the effectiveness of the regulations. Has any of that been discussed?

My second question is about the new powers that are being granted to the RQIA in the registration process and inspections. In one of the most recent briefings that we had with the RQIA, it talked about constraints on its budgets and staff. Have you had any conversations with the RQIA? Are you confident that it will have the capacity to deliver timely, high-quality inspections?

Ms Moore: We will have to look at that in the review. As I said, work is ongoing on the standards. That will play an equally important role in the regulations and the supporting standards. We will need to work on that with all of the stakeholders. I am very much in that space. You will know that my previous job was all about collaboration and partnership. I am trying to bring that same ethos to my current role. We will have opportunities to propose amendments to the Adoption and Children Act 2022 at a later point through some of the mechanisms. It is about the regulations and the standards. We will consult on those and on how we insert a mechanism for review. That will be done collaboratively. As I said, I am new to this, but, for me, it has been great today to hear about the ongoing work on the standards and about the approach that has been taken by Stefani. It has been seen today that people have felt part of that. That is really important.

Ms Flynn: Yes. Everyone is working together.

Ms Millar: The Adoption and Children Act will give us powers to make regulations around fostering panels. That might be an opportunity for us to bring in anything else that we want to bring in. An independent review mechanism will also be brought in, so there will be more of an appeals process. Unfortunately, however, those are linked to other provisions that have become slightly blocked, so we cannot bring them in just yet, but that is the next step. If there is anything that raises a challenge in the regulations, there will be an opportunity to amend it at that stage.

Ms Moore: Those conversations with RQIA have been progressing, and they continue.

Ms Millar: We had some early ones, and we have more planned in the diary. We will meet RQIA very soon to explore those more fully.

Ms Moore: It is generally supportive, but, as I said, there will be more conversations over the next few months as we move to implementation. The conversations have not flagged anything yet, but, as I said, we will stay alert.

Ms Flynn: It is another issue that we will, I am sure, raise and discuss in any of our future interactions with the RQIA about its work and inspections and how all of that is going. I wish you the best of luck with it all. Thank you.

The Chairperson (Mr McGuigan): No other member has indicated. I will pick up on something that Diane mentioned. You will have heard the conversations about the importance of getting the guidelines right so that they align with the regulations and are rolled out properly. Can you give us the time frames and a template of what we can expect and when?

Ms Moore: Stefani leads on that work. On Diane's point, our intention is to time it so that they go together. I will let Stefani answer, because she leads the work.

Ms Millar: We have talked about how fundamental the standards are for the registration and inspection of independent fostering agencies. That means that the standards have to come at the same time as each regulation. We do not think that it would be in any way fair to expect an independent fostering agency to register against something that was not finalised. We intend to bring them in together.

You will notice that the provisions on bringing the regulations into operation mention a six-month lead-in period. That is six months after they come into operation. The intention is to do that fairly soon. I need to tie up a little bit with some of our colleagues about the fees and inspection regulations that need to support those. The regulations will be made and come into operation. Certainly, they will be made within a couple of months and, hopefully, by the start of the financial year. At the end of the following six-month period, independent agencies will have to be registered, and the standards will be in place. I am aware that the clock is ticking and that we need to do a public consultation on the standards within that time, so I do not want to start the clock until we are ready to go. I do not want to put unrealistic expectations on independent fostering agencies until everything else is ready and in place.

Ms Moore: The clear intention is alignment. It is not about putting out the regulations and then coming along with the standards later. Off the back of today's meeting, we need to do some of the outstanding work. The standards are in draft form. Some minor corrections might be coming back, but we can set the timeline now so that we can deliver them together.

The Chairperson (Mr McGuigan): Diane has now indicated that she wants to come in. It will probably be on that subject.

Mrs Dodds: Thank you very much, Chair. I really appreciate that. I thought that I had clicked the "raise hand" button, but I obviously had not.

The standards and the timeline, as the Chair pointed out, are really important, because we have waited a long time for the regulations. We have heard about the importance of the regulatory framework to fostering as a whole. It is really important that we get the standards and that we do not get into another time lag, as has happened before. That is my first point.

Here is my second point, and I have asked this question before: do the new regulations, standards and guidelines mean that every child who becomes a looked-after child in Northern Ireland will have the same experience across all five trusts? We know that not every foster parent has the same experience. Will every foster parent have the same experience? While there are standardised fees, there are different add-ons and supports in different trusts, as far as I understand it.

Finally, the Southern Health and Social Care Trust has a thing called "bail fostering", which is the fostering of young people who might otherwise end up in Hydebank Wood Secure College while they await trial or court proceedings. The people who do that fostering are extraordinary. They are probably giving young people an opportunity in life that they have not had. It is an extraordinary thing to do. How are you working with the Department of Justice, and what contribution does it make to that particular element of fostering?

Sorry, that might have been a lot more than you were expecting. [Laughter.]

Ms Moore: I heard a previous Committee session in which, I think, Colin mentioned bail fostering. I have not been involved in that to date. I am not sure, Diane, so we need to come back to the Committee on that. I totally take your point, but I do not have the answer about the engagement with the Department of Justice and how it contributed. We will take that question away.

The regulations and standards are about bringing consistency across all services provided by not only the trusts but the independent sector and bringing alignment across the piece. Will all children have exactly the same experience? In practice, that is what we would like, and that is the intent. We will have to stay alert to whether that happens in practice, but we very much intend to have consistency. Obviously, there will be variances in the additional fees, which are linked to need. The children come from very different places, and you have to accept that there will be variance. However, this is about the quality and consistency of the service, and that is our intent.

Ms Millar: We can certainly expect the same level of service quality.

Ms Moore: It is all about the consistent quality.

Was there another question, Diane? I thought that you said that you had three.

The Chairperson (Mr McGuigan): Ah, there you are, Diane.

Mrs Dodds: Sorry. For some reason or other, there was a technical issue. It may be that my battery is running low. Apologies.

Health needs to deliver for people on the same basis across Northern Ireland. Everybody deserves to know that they will be treated with some kind of equality if they are using a service, and these are very vulnerable children who do not have a voice. The Committee has taken a particular interest in the reform of children's services, and it is really important that we can be that voice. Today, I have heard a lot of, "We will come back to you", and I accept that you are new in post. However, I want someone to come back to the Committee and tell us how the standardisation and regulation will be done. I accept that it is necessary, and I accept the Fostering Network's opinion that it is important, but it is important to have consistency of standards not only in the independent sector but for our foster parents and children across the trusts. I am not sure that we have that. In fact, I am quite sure that we do not have that. I would like to know how you will do that. If you do not have the answers today, it is important to get the information on the standards and the monitoring of the standards going forward. Thank you.

Ms Moore: It is important to note that the standards are for not just the independent sector but everybody in the space. It is about holding the trusts to the same standards across the piece. Apologies, I have said that I will come back to you quite a lot today on some of the questions, because I am new to the post. Absolutely, we will come back on anything that we have not picked up, but the standards are intended to achieve consistency across all fostering services. As you said, it is not just for the children in foster placement but to give the foster parents consistent support, training and information. The point was made earlier about how foster parents are valued in the system and how that needs to be consistently applied.

The Chairperson (Mr McGuigan): Thank you. No other member has indicated.

Martina and Stefani, I appreciate your coming before the Committee and taking questions. Thank you very much.

Are members content with the merits of the policy and that the Department make the statutory rule?

The Chairperson (Mr McGuigan): Thank you.