Introduction
Kinship care is any situation where a child is being raised in the care of a friend or family member who is not their birth parent. The arrangement may be temporary or longer term. Local authorities may have different eligibility criteria for support based on the type of kinship care arrangement. Therefore, local authorities should be mindful of the support needs of different types of kinship families, especially those from minoritised ethnic backgrounds as these families are more likely to provide informal care but are less often involved in formal kinship care. It’s also important to make sure services for these families are easy to access and appropriate for their needs.
In this Guide, ‘kinship care’ refers to different types of legal arrangements – including Kinship Foster Care and Special Guardianship Orders – and informal kinship care arrangements, where friends or family members care for a child without a legal order.
The number of children and young people in kinship foster care is increasing.1 This Practice Guide has been produced to support senior leaders and commissioners in local areas to commission and develop effective services to support kinship families. This Practice Guide is based on findings from a systematic review
A systematic review is a type of research that uses rigorous methods to collect evidence from multiple research studies & summarises them to answer a research question., which brings together the evidence on programmes or services that aim to support kinship families and allows us to identify themes across the body of research. The systematic review also drew on qualitative research evidence which explored the views and experiences of kinship carers in the UK. Below you can read the full systematic review and access the implementation resource which has been designed to support local authority senior leaders to consider how to apply the recommendations in their areas.
Although the evidence underpinning this guide is from a mix of the UK and other high-income countries, we are confident that our recommendations are appropriate and relevant for kinship carers in the UK because the studies we looked at involved kinship carers with similar characteristics of this population: older, socio-economically disadvantaged and more likely than other carers to be from minoritised ethnic backgrounds.
We would like to acknowledge the invaluable input of our Kinship Advisers who worked closely alongside our Guidance Writing Advisory Group to develop this Practice Guide: Kinship – The kinship care charity; Ann Horne at CoramBAAF; Jude Eyre at Nuffield Family Justice Observatory; Sharon McPherson, Families in Harmony; Lorna Stabler, CASCADE; and Clare Walsh, Family Rights Group.
We would also like to thank the Centre for Evidence and Implementation (CEI) and their collaborators for their work on the systematic review that underpins this Kinship Care Practice Guide.
Key Principles
Kinship carers are more likely than other carers to be older, socio-economically disadvantaged, living with long-term health conditions, and be from some minoritised ethnic backgrounds.2 It should be recognised that kinship carers come from all ages and ethnic backgrounds and have unique needs and strengths. Support should be responsive and tailored to the specific and diverse needs and strengths of kinship carers.
Support should involve building trust and familiarity with kinship carers, and an understanding of sometimes poor past experiences of statutory services based on family history and/or wider discrimination, such as experiences of structural racism. Practitioners can build trust and familiarity with kinship carers through: active listening; showing empathy; showing up prepared; taking time to build genuine relationships with kinship carers and children; as well as promoting positive relationships through consistent intensive interactions, rather than frequent but short interactions.
Some kinship carers have had negative experiences of statutory services in the past, and so prefer to receive support through non-statutory services. It may therefore be helpful for statutory services to mirror some of the approaches taken by non-statutory services. Although separate, specialist support may help address barriers to access, local authorities (who are required to publish their local offer to kinship families) and the Voluntary and Community sector (VCS) should maintain close connections. This will allow for referrals and coordination of services between them, quick responses to safeguarding concerns, and the development of holistic offers for kinship families.
For example, the VCS could offer advice to kinship carers about how to access the support available to them, as well as signpost, empower and encourage kinship carers towards other sources of support, including universal and more specialist services. VCS organisations may be well placed to lead delivery of interventions such as peer support and community-based programmes that help kinship carers navigate and access services. The VCS can also provide services such as legal advice, addiction support and access to specific activities for kinship families (e.g., homework clubs, trips, etc.).
Local kinship families, especially those from minoritised ethnic backgrounds, should be pro-actively involved by both local authorities and the VCS in co-design of local interventions. When developing supportive interventions, local authorities and voluntary and community organisations should use iterative processes for testing interventions and kinship carers should be invited to give feedback. Their feedback can then be used to refine the intervention.
Trusted relationships with practitioners are a key aspect of successful support. The most common feature of effective interventions, in terms of both carer and child outcomes, is dedicated one-to-one support for kinship carers. Kinship carers also report that consistent intensive interactions with practitioners are an effective way of developing positive relationships that promote engagement with the support available.
Kinship carers value practitioners who are proactive and knowledgeable about services, and who listen to and recognise a kinship carer’s specific situation and its challenges. Interventions which are focused on the individual kinship carer and the child, and are able to adapt to an individual’s needs, are strongly preferred by kinship carers and may help foster a sense of agency and empowerment. Practitioners’ interpersonal skills are key to building positive, supportive, trusting relationships with kinship carers. Practitioners should be solution focused and committed to supporting the kinship carer and the child or young person in their care.
Ongoing personal support from a specialist practitioner has been shown to benefit kinship carers where the support includes assessing families’ needs and connecting them to relevant services and interventions. Good quality personal support for kinship carers can include activities like: family needs assessments; providing information; referrals to support services; peer support to navigate systems and services; and support to identify eligibility and need for services and interventions. Matching of interventions to the kinship carer and child’s needs is vital.
Kinship families may need support to overcome barriers to accessing support. In particular, it is important to consider: economic barriers; how support is delivered; how to ensure that support on offer is culturally sensitive; and incorporate flexibility when delivering an intervention.
Effective interventions have been delivered in a range of settings, including home visits and in-person meetings in community settings, and online, virtual, and telephone engagement. No specific setting or way of delivering support was found to be more effective, so support should be flexible and reflect the needs of the kinship families that practitioners are working with. Kinship carers reported benefits to receiving support from non-statutory services, and support from these services can have a positive impact on kinship families.
Kinship carers report not always knowing what support services they’re entitled to, or what support is available in their area. Local authorities should undertake proactive communications and engagement with kinship carers to raise awareness of local services through either the local authority and/or the VCS.
Recommendations
Programmes that provide specialist practitioners, information, and infrastructure to support kinship carers to understand and access support can improve placement stability, improve kinship carer wellbeing, and increase the likelihood of reunification with birth parents for some children and young people.
Practitioners should be dedicated kinship family support workers/case workers, with social work training and/or training in the specific model or method of supporting kinship carers to access services.
These programmes should be delivered by dedicated kinship family support workers/case workers. These are often practitioners with social work training and/or training in the specific model or method of supporting kinship carers to access services.
Additional support can improve the wellbeing of kinship carers who are experiencing high levels of stress and adversity related to their caring responsibilities. This might include the development of a support plan, an in-depth assessment, being offered additional follow-up visits, and/or active hands-on encouragement to take part in support group activities.
In the US, there is evidence that Kinship Navigator Programmes3 can be effective, especially for securing permanent placement arrangements for children and young people. Kinship Navigator Programmes were developed specifically to support kinship carers to provide stability, safety, and where possible, permanency for the children in their care. There is also promising evidence for their effect on carer wellbeing, and for improving the likelihood of longer-term reunification with birth families.
Click here for a case study with more information about Kinship Navigator Programmes.
Providing training and support in parenting skills for kinship carers can improve children and young people’s behaviour.
This includes improving behaviours that risk causing further problems for the child and carer if left unaddressed. These behaviours can be associated with the child or young person’s past or ongoing experiences of adversity or complex additional needs and can include frequent aggressiveness, consistent noncompliance with carer and adult boundaries, and frequent sadness or fearfulness.
Parenting support for kinship carers should focus on improving carers’ knowledge of child development and parenting skills. It should be delivered through structured programmes, workshops or sessions designed to equip carers with the knowledge and techniques to support the children in their care. These programmes may cover child development, attachment styles, the impacts of trauma on child development, and conflict management. These programmes should be delivered either by the developers of the intervention or by practitioners with training in the specific programme. Supporting kinship carers to understand and respond to these types of behaviour can have benefits for carers and for the children that they care for.
Click here for a case study with more information about parenting support programmes for kinship families.
Peer support can improve kinship carers’ emotional health and wellbeing and is consistently found to be popular among kinship carers.
Kinship carers have reported that access to a network of peers can improve ongoing engagement with other forms of support. Peer support can be especially effective for kinship carers with more complex caring arrangements, or carers of children with additional needs. Kinship carers report that peer networks and peer support can provide practical and emotional support, mutual understanding, and combat isolation and loneliness.
Peer support services should be used in combination with other services and carefully designed to maximise their potential. Kinship carers delivering peer support should receive suitable training to equip them to deliver effective support, as well as ongoing supervision and help to maintain quality and set parameters.
Cognitive Behavioural Therapy (CBT) for kinship carers can reduce these behaviours among children and young people they care for. The research supporting this was focussed on grandmothers who were kinship carers.
Our systematic review found a lack of evidence on the effectiveness of therapeutic approaches other than CBT, designed specifically for kinship families. Other therapeutic approaches could also be important for kinship families, but these approaches need further testing and evaluation for us to be confident that they are effective for kinship families.
While there is evidence of effectiveness of CBT, it is important that a thorough needs assessment is carried out to determine suitability for CBT before delivering the intervention to the kinship carer.
There will be variations between Local Authorities in terms of commissioning and making available therapeutic support, including the role of local health commissioners, local authorities’ own workforce skills, and the role of VCS partners.
NICE guidelines3 on children and young people’s mental health should be referred to when offering therapeutic support for children and young people in kinship care, with careful tailoring of interventions to their needs and conditions. For children and young people with more serious and complex trauma (e.g. associated with past experiences of abuse), NICE currently recommends the use of Trauma-Focused Cognitive Behavioural Therapy (TF-CBT).
Click here for a case study on the description and delivery mode of CBT.
Carer training in self-care refers to interventions which mainly involve programmes, workshops or sessions to equip carers with the necessary knowledge and skills to support their own emotional wellbeing, and cope with the challenges associated with being a kinship carer.
Self-care strategies should include the kinship carer using positive statements, positive reframing, and organising their daily activities to manage their own wellbeing and emotional health while caring for the children and young people in their care. Training in self-care should recognise the importance of kinship carers prioritising their own mental health and self-care practices to better support the children under their care.
There is evidence that these approaches can be effective for kinship carers showing signs of more serious challenges with emotional health, including symptoms of depression. These approaches led to improvements in perceived stress levels, depressive symptoms and quality of life of kinship carers.
Financial allowance refers to providing financial support directly to kinship families.
In the US, a number of evaluations have been conducted to assess the impact of financial support provided to to kinship carers who assume legal guardianship for the children in their care. In these studies, kinship carers who assumed legal guardianship received a subsidy of $300 a month. This was $112 more per month when compared with unlicensed (informal) kinship carers receiving benefit payments. Licensed (formal) kinship carers receiving foster care payments were given an average allowance of $600 per month. The evidence shows positive impact of financial allowances on increasing placement permanency, reducing the likelihood of placement disruption, and improving the likelihood of permanent guardianship.
Case Studies
Cognitive Behavioural Therapy (CBT) and training in parenting skills
Seven-year-old Yvonne has lived with her grandparents for two years because of well-evidenced concerns that her parents were being physically abusive towards her. At times, when frustrated or upset, Yvonne throws things, bites and head butts, which has sometimes resulted in her grandparents being hurt.Yvonne’s grandparents do not know how to respond when this happens and worry about looking after Yvonne as she grows older. Yvonne’s grandparents find themselves getting stressed and angry, and raising their voices or restraining Yvonne when they do not know what else to do.
Cognitive behavioural therapy (CBT) is a talking therapy that can help manage problems by changing the way people think and behave. These changes can lead to better coping and problem solving which then improves affective functioning, including emotions, mood and feeling. CBT is most commonly used to treat anxiety and depression but can be useful for other mental and physical health problems. A study conducted in the United States found CBT to be particularly effective at reducing challenging behaviours of children cared for by kinship carer grandmothers. If Yvonne’s grandparents access CBT, it could support them to manage their own emotions at times when Yvonne becomes overwhelmed with her feelings and reacts by physically hurting others.
As part of ongoing support and assessment of Yvonne and her grandparents’ needs by children’s social care, Yvonne’s grandparents receive CBT across ten, two-hour group sessions co-led by a practitioner, and a peer kinship grandmother, in a community setting. Within the CBT sessions, the group are taught to use adaptive cognitive and behavioural strategies, including modifying thoughts, relaxation techniques, increasing positive activity, and enhanced problem-solving.
Yvonne’s grandparents also attend parenting skills training. This involves structured workshops designed to equip parents and carers with the knowledge and techniques necessary to effectively nurture and support children in their care. The parenting skills training covers a range of topics, including child development, behaviour management strategies, communication techniques, and methods designed to improve parent-child interaction and the overall quality of parenting that a child receives. Yvonne’s grandparents have the opportunity to reflect on how they were parented and how they parented their own children, and consider how to now care for Yvonne, bearing in mind her own experiences and needs.
After attending this training, Yvonne’s grandparents feel more able to cope when they find her behaviour challenging and are able to use techniques to improve how they interact with Yvonne.
