Table of contents

Level of need in the population

Background papers: children :: Looked After Children :: Level of need in the population

  2011 2012 2013 2014 2015
Medway 425 440 410 380 425
England 65,510 67,070 68,060 68,800 69,540
Table 1: Number of Looked After Children as at 31 March each year.[1]

Table 1 above shows the total number of Looked After Children as at 31st March each year across England and Medway.[2] The children looked after rate declined between 2012 and 2014, then rose again in 2015 to 68 per 10,000 of the population aged under 18 compared to 60 per 10,000 for England[1]. Between April and September 2014 there were a 100 new entrants into care in Medway. As of March 2015 there were 425 Looked After Children in Medway. In addition traditionally the largest number of children coming into care has been in the 11–15 year old age range. However during 2014 a 100% increase in the 1–4 age range and 170% increase in the 5–9 age range was seen.

Modelling taking account of housing and regeneration plans has been undertaken by the School Organisation and Capital Team. This modelling supports the assertion of continued population growth up to and including 2019 in the under-five age range (see 'Projected service use' section for further information.)

The increase in looked after children can also safely be assumed to be as a result of:

• Greater awareness of child protection and safeguarding amongst all agencies
• Thresholds for intervention are appropriate and consistently applied

The knock on effect is that the need across a number of areas and support services has also increased. Amongst these are the provision of health services, services that support emotional well-being, education, the availability of placements, and child sexual exploitation.

The Clinical Commissioning Groups have responsibility for the health of Looked After Children, even when that child is placed out of area. Since 2012, there has been a continual reduction in health checks and dental checks undertaken as shown in tables 2 and 3 below.

  Medway South East England
2009 205 4,275 36,800
2010 185 4,300 37,200
2011 200 4,710 38,840
2012 270 4,970 40,200
2013 265 5,100 41,200
2014 255 5,140 42,140
2015 245 5,460 43,140
Table 2: Number of Looked After Children having health checks[3]
  Medway South East England
2009 200 4,540 37,300
2010 170 4,400 36,400
2011 190 4,600 37,970
2012 260 5,100 38,370
2013 250 5,090 38,720
2014 155 5,030 40,240
2015 140 5,330 41,250
Table 3: Number of Looked After Children having dental checks[3]

Mental Health and Emotional Well Being

Improving the mental health of children has a positive impact on their ability to form positive relationships with peers and adults whilst helping them to succeed at school and make a success of their lives as adults.

The Strength and Difficulty Questionnaire is used to assess the emotional and behavioural health of children. The questionnaire scores children on a range between 0 and 40 with scores of 17 and above being cause for concern.

  2013 2014 2015
LAC aged 5–12 195 190 200
SDQ score completed 185 170 175
SDQ score submitted 94 88 89
Avg. score 15.5 16.0 15.9
Normal % 38 35 38
Borderline % 11 16 15
Concern % 50 49 46
Table 4: Emotional and behavioural health of children looked after continuously for 12 months at 31 March for whom a Strengths and Difficulties Questionnaire (SDQ) was completed, Medway[1]

In Medway 46% of looked after children scored within the range for concern during 2015 compared with 37% nationally. The norm for British children as scored by parents is around 9.8%. This suggests that presently looked after children in Medway are almost five times more likely to have emotional and behavioural problems than would be expected across all children in Britain. In addition the average score has seen a small year on year increase over the past three years and now sits at 15.9.

  Cumulative number of pupils
October 2004 294
April 2007 631
July 2008 899
September 2010 949
July 2011 986
June 2012 1,009
June 2013 1,089
Table 5: Number of children and young people diagnosed with ASD and supported by the autism outreach team attending mainstream schools in Medway[4]

In addition 6.2% of looked after children in Medway have a learning Disability, whilst 4.7% are on the Autistic Spectrum and 2.8% have a behavioural disorder. It is well documented that these children have an increased risk of developing a mental disorder. If as the table above suggests the numbers of children with ASD are increasing year on year then again it is likely that this increase will be replicated in the population of Looked After Children. Further information can be found in the JSNA chapter “Emotional Health and Wellbeing of Children and Young People”.

Educational Attainment

“A lack of educational achievement is one of the biggest barriers to children looked after realising their potential”.[5]

  Medway South East England
Number eligible to sit Key Stage 2 tasks and tests 15 300 2,300
Mathematics % 47 53 59
Reading % 60 59 63
Writing % 47 48 55
Grammar, Punctuation and Spelling % X 41 45
Reading, writing and mathematics % 40 39 45
Table 6: Eligibility and performance of children who have been looked after continuously for 12 months at Key Stage 2, 2013. Percentage who achieved at least Level 4[3]

Table 6 above demonstrates those Looked After Children regionally and locally during 2013 were underperforming in relation to their peers. Data marked with an 'X' has been suppressed to preserve confidentiality. No data is available for 2014 due to the smaller number of children in Medway compared to 2013.

Placement - Overview

The Sufficiency report 2015 - 16 identified that there was risk of insufficient suitable accommodation being available in Medway for Looked After Children. The children's Act 2008 states that “For those looked after, Local Authorities and their partners should seek to secure a number of providers and a range of services, with the aim of meeting the wide-ranging needs of looked after children and young people within their local area”. Medway has a rate of 68 Looked After Children per 10,000 which is above the national average[1].

Figure 2: Percentage of looked after children by placement type, 2014
Figure 2: Percentage of looked after children by placement type, 2014

Figure 2 above denotes the percentage of looked after children by placement type.

In order to ensure that the placement service is able to offer the sufficient provision to meet the needs of Looked After Children there is a need to increase the number of foster carers, ensure the quality and range of supported living accommodation, residential services and increase the quality and type to wrap round provision on offer.

As the demand for placements increases there is a reliance on independent fostering provision in order to meet the needs of our children and young people. There is also a need to recruit foster carers who can be flexible in responding to critical and emergency situations and who can offer different types of placements. In addition there is a need to increase the number of foster carers who are able to support young people up to the age of 21 through our “staying put” drive.

Placement Stability

Improving outcomes for our children and young people requires that there is a continued focus on reducing the number of moves they experience in their lives. We know the chance to build trusting long term relationships through quality day to day care is a key factor in children and young people being able to realise their full potential in adulthood.

Reducing the number of unnecessary moves is a priority as stable and nurturing placements are thought to directly influence the child's ability to recover from the abusive and neglectful experiences, which they have previously had. [6]

Figure 3: LAC in same placement for at least two years or placed for adoption
Figure 3: Percentage of children who have been looked after for more than two and a half years and of those, have been in the same placement for at least two years or placed for adoption.[3]

The graphs above shows that placement stability in 2013 and 2014 was roughly in line with rates across the Southeast and England.

Placement stability is the result of a number of factors which include: listening to the wishes and feelings of the child, choice and matching of each placement, good initial information and assessment of the needs of the child, training and support of foster carers, multi-agency commitment to meet the educational and health needs of each child and monitoring and rapid response when difficulties occur.

Placed Out of Area (POLA)

Due to rising numbers of Looked After Children and the increased pressure on available placements Medway Council has 99 children (as of April 2015) placed out of area in either residential services or independent foster carers. Some of these young people have been appropriately placed to be nearer to extended family members or further away from potential risk of harm. However there is a growing recognition that being placed over 20 miles away can bring challenges in ensuring that the Looked After Child is well supported and is able to make good use of resources available to them with their local authority.

  Number Percentage
Total number of new placements for all children 440 -
All placements within 20 miles 350 79
Inside LA boundary within 20 miles 240 54
Outside LA boundary within 20 miles 110 25
All placements over 20 miles 60 14
Inside LA boundary over 20 miles 0 0
Outside LA boundary over 20 miles 60 14
Not recorded or not known 30 7
Table 7: New placements for children looked after during 2014/15 by locality of placementand distance between home and placement - Medway[1]

Placements with Family and Friends, Special Guardianship and Residence Orders

Where appropriate family and friend carers are supported to apply for Special Guardianships or Residence Orders as this provides permanence and longer stability. The number of children who ceased being “Looked After” due to Special Guardianship Orders was 25 in 2013 15 in 2014 and 10 in 2015[1]. However across England the rate of Special Guardianships awarded is increasing at a significantly faster rate.

Adoption and Permanence

The aim for most children when they become Looked After Children is for them to be retuned back to their family in due course, or for them to be placed permanently with another family via Adoption, Special Guardianship or Residence Order, if it would not be appropriate for them to return to their original family.

The number of children placed for adoption has increased significantly across England as the Adoption Reform requirements for Local Authorities has seen an increase in approved adopters who are now being approved within shorter timescales.

Figure 4: Percentage of children adopted from care
Figure 4: Percentage of children adopted from care.[3]

Unaccompanied Asylum Seeking Children - UASC

In Medway there is a small number of unaccompanied asylum seeking children. These children and young people often have additional needs as a result of traumatic experiences, a loss of custom, culture and separation. In Medway where particular racial, cultural and religious needs can't be met consideration is given to UASC being placed in communities out of area where their needs can be better met. It is difficult to anticipate the future number of UASC due to a range of external factors that impact on this.

Child Sexual Exploitation

Child Sexual Exploitation (CSE) is a national priority area and is an area recognised by Medway that needs careful monitoring and action to ensure that none of our children and young people are abused in this way. Multi agency working and information sharing are particularly key issues in tackling CSE. In November 2014 there were 14 adolescents in care known to be at risk of CSE. Of these only two were determined to be actively exposed to CSE. More work needs to be done to determine if this figure is a true reflection of children at risk of CSE or known to be involved in CSE.

Leaving Care

As a corporate parent Medway has a responsibility to ensure that all young people leaving care receive the support and encouragement they need to move confidently into adulthood. This means providing emotional support, financial advice and guidance about making plans for the future as well as practical support with accommodation and personal needs. Preparation for adulthood begins a long time before independence and is carefully planned through the development of a Pathway Plan prior to their 16th birthday. We know that encouraging young people to “stay put” in safe and secure homes will help them deliver on realising their potential.

Figure 5: Percentage of care leavers who were in not in education training or employment
Figure 5: Percentage of care leavers who were in not in education training or employment.[3]

Figure 5 shows that numbers of care leaves not in education, employment or training was previously very high in Medway. Following the reduction in 2013, there has been a rise to 49%.[3]

Figure 6: Percentage of care leavers who were in suitable accommodation
Figure 6: Percentage of care leavers who were in suitable accommodation.[3]

Figure 6 shows that the numbers of care leavers in suitable accommodation in Medway has fluctuated between 80 and 100 percent for many years. However a more recent drive to review in particular supported accommodation is identifying that this number maybe much lower as standards and expectations are raised.


[1]   Department for Education. Children looked after in England including adoption: 2014 to 2015 2015;
[2]   for Education D. Statistics
[3]   Department for Education. Local Authority Interactive tool
[4]   Medway Autism Outreach Service. Number of children and young people diagnosed with ASD and supported by the autism outreach team attending mainstream schools in Medway 2014;
[5]   for Looked After Children TA.-PG, Leavers C. Education Matters in Care: A report by the Independent cross-party inquiry into the educational attainment of looked after children in England 2012;
[6]   Harden BJ. Safety and Stability for Foster Children: A Developmental Perspective The Future of Children 2004; 14 (1): 30-47.