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OxfordshireChildren's Services Procedures Manual

Treatment Foster Care - Oregon (formerly MTFC)


The Statement of Purpose for this service, which sets out more detailed information about its operation and processes, can be found elsewhere on the Intranet.



  1. Overview of the Programmes
  2. Eligibility Criteria
  3. Referral Process
  4. Child Assessment Process
  5. Case Planning Process
  6. Services to the Child
  7. Permanent Placement, Aftercare, Birth Families
  8. Assessment of Foster Carers

    Appendix 1: Job Description for Foster Carers

1. Overview of the Programme

The Treatment Foster Care programmes are for children aged 3-6 (TFCO-P Prevention), 7-11 (TFCO-C Middle Childhood) TFCO with complex needs, emotional disturbance, and challenging behaviour.

The programmes have an emphasis on positive reinforcement of pro-social behaviour and on behaviour management in a structured environment. A multi-agency team of key professionals and specialist foster carers provides high levels of supervision with a focus on positive parenting.

The programmes are specifically tailored to bring about successful permanent placements including reunification with birth family, long-term fostering, and adoption.

2. Eligibility Criteria

It is appropriate to consider the TFCO Programme for children whose needs may not be fully met within the regular fostering services, where the child is:

  • Looked After by Oxfordshire, or at high risk of becoming Looked After, and requires more intensive support;
  • Is aged between 3 and 11.

It is likely that the child or young person:

  • Has experienced abuse and neglect including harsh parenting;
  • Has experienced multiple placements;
  • Has severe emotional and relationship difficulties and is experiencing developmental delay;
  • Is experiencing difficulties with learning and educational attainment;
  • Displays a significant level of challenging behaviour.

Children and young people are not likely to be appropriate for referral if:

  • They have a significant learning disability, where the degree of impairment is likely to limit their capacity to participate in the programme;
  • Their parent or carer in their permanent placement is unwilling to participate in the programme;
  • They are placed with siblings and separation is not appropriate. However, sibling placement will be considered at the discretion of the team.

3. Referral Process

Where social workers wish to have children referred, they will complete the placement duty system's referral form and/or telephone the TFCO team to discuss the referral.

If appropriate, the TFCO Team will then meet with the social worker and Team Manager to consider whether to accept the referral and undertake an assessment.

4. Child Assessment Process

Assessment procedures will be decided on a case-by-case basis so as not to repeat elements of assessment already completed. It will be necessary to ensure that the following areas are covered: behaviour, functioning and developmental issues across all domains, intellectual functioning and educational attainment (where relevant), functioning of family of origin (where relevant), and the child/young person's understanding and views (where possible/relevant).

Any previous assessment information must be provided to the TFCO Team and will be reviewed prior to the start of the assessment process.

The assessment will be completed prior to the child entering the TFCO programme. Consents will be obtained from the appropriate person with Parental Responsibility (including consent for the child to be videoed in the playgroup).

The written assessment report will be coordinated and signed off by the Programme Supervisor, following consultation with other Team members and the child's social worker.

The assessment will inform the following:

  • Access to a TFCO Placement and the matching process;
  • The child/young person's individual programme;
  • The need for any additional interventions;
  • Outcomes for individual children/young people;
  • Risk Assessment.

5. Case Planning Process

The child or young person's social worker will lead the case planning and will identify their permanent placement on leaving the programme.

Whilst on the programme, each child/young person will have an individual treatment plan, which will be reviewed on a weekly basis in the clinical team meeting. The Programme Supervisor is responsible for leading the clinical team meeting as well as co-ordinating and overseeing the implementation of the treatment plan.

The child or young person's social worker and any other relevant professionals will be regularly informed of the child/young person's progress within the treatment plan, and a member of the team will attend the child's Looked After Review and any other meetings, including PEP meetings, as appropriate.

There will be regular case discussions with the child/young person's social worker to share information and review exit plan/follow-on placements.

6. Services to the Child

6.1 Individual Programmes

Foster carers provide daily recordings of problem behaviours through the Parental Daily Report (PDR) checklist. This is the heartbeat of the programme, and provides information on behavioural patterns as well as opportunities for identifying problem behaviour. The PDR is also used to track rewards, time-outs, and levels of foster carer stress.

Each child/young person's progress on the programme will be reviewed weekly in the clinical team meeting. The Programme Supervisor is responsible for leading the clinical team meeting, as well as co-ordinating and overseeing the implementation of the treatment plan.

6.2 Children's Therapeutic Playgroup (Prevention Programme only)

Each child who enters the TFCO-P programme (for 3 to 6 year olds) will attend a weekly two-hour therapeutic playgroup. Behaviour management strategies are employed for shaping positive behaviour and managing negative behaviour.

6.3 Skills Coaching Sessions

Each child or young person will participate in weekly individual skills coaching sessions lasting approximately 1-2 hours. Sessions will typically take place in the community, in the child/young person's home, or at school. Behaviour management strategies are blended and employed to shape positive behaviour and manage negative behaviour, to help the child/young person successfully achieve treatment targets.

7. Permanent Placement, Aftercare, Birth Families

The Programme Supervisor co-ordinates the transition and aftercare placement plans for each child in conjunction with the Birth Family Therapist and child/young person's social worker.

They will identify the aftercare support and training needs for the receiving family and ensure their delivery.

Aftercare support and consultation will be maintained following permanent placement for an appropriate period to be determined by the Team.

The family consultant works with the permanent placement family before and after any rehabilitation home. Support and input is also provided around contact.

8. Assessment of Foster Carers

Foster carers are assessed in the same way as mainstream carers with an additional assessment of their suitability for the programme. Details about the foster carer's tasks can be found in the Job Description. See Appendix - Job Description for Foster Carers.

8.1 Recruitment Assessment and Approval

Foster carers will go through the standard approval process - see Assessment and Approvals of Foster Carers Procedure

They will then undergo MTFC training and be approved at the Fostering Panel as MTFC carers. For existing carers, a report will be submitted to Panel, recommending them as carers for the programme and updating any information and checks as necessary. For new carers, this report is incorporated into the full Form F.

The report will include the following:

  • Motivation for joining the programme;
  • Chronology of placements to date;
  • Any changes to Form F within each section - family composition, career history, matching considerations, health etc;
  • Report from 2 referee visits - we send information about the programme to the referees prior to visiting. If we have recent references (less than 3 months old), this can be a verbal reference via telephone;
  • How carers meet the specific requirements of the treatment model - working as a member of the team, sense of humour, emotional regulation, an ability to put behaviour into context, implementing behavioural programmes and so on (see Appendix 1: Job Description for Foster Carers);
  • Strengths and any areas of potential difficulty;
  • Recommendation.

8.2 Fostering Panel Process

Cases need to be heard by the same Panel that carers were originally approved by, if carers are already active. If the application is new, then it comes to whichever Panel is convenient. As with all applicants, the Fostering Panel encourage prospective TFCO carers to attend Panel to discuss their application.

Panel will endeavour to meet the deadline of the scheme requiring a child to be placed within a month of carers completing the TFCO training, and will create a prioritised agenda space for TFCO applications from the time the Panel Chair is informed of prospective carers.

Panel recommends that the Foster Carer Consultant assessing the carer(s) should check what the Panel minutes say about active carers and whether their First Annual Review has been completed and presented to Panel, as an indicator of any Panel concerns and, where possible, should respond to these concerns in their report and presentation.

The Panel Chair welcomes consultation about prospective carers at any time.

Following Panel decision and ratification by the Agency Decision Maker, an approval letter and contract will be sent to the foster carer(s). 

The fee will be paid to approved carers from this approval date.

8.3 Training and Support

Foster carers are trained in the social learning model and employ a behaviour management system that emphasises encouragement, reinforcement, consequences and clear expectations. This system adds structure and predictability into the home environment and helps increase opportunities for the child to experience success.

Foster carers are required to attend a weekly foster carer meeting and to have daily phone contact with the team to complete the Parental Daily Record checklist for the previous day. Foster carers can access out of hours support from team members 24 hours per day, 7 days per week.

Appendix 1: Job Description for Foster Carers

The UK National Standards for Foster Care and the Code of Practice recommend that Fostering Services make explicit the skills and competencies required by carers.

It is suggested that this is used alongside the Cue Sheet for Initial Home visits to new or existing foster carers interested in the MTFC scheme. A copy can be given to the applicants.

1. Caring for Children/Young People

  • The ability to understand and provide a good standard of care to 'Looked After' children/young people which promotes healthy emotional, physical and sexual development as well as their health and educational development;
  • An ability to communicate appropriately with people who are important to the child/young person. To facilitate contact where appropriate. Understanding the possible vulnerability of family members when caring for a child/young person who has been sexually abused;
  • To undertake work with children/young people towards achieving specific goals with appropriate supervision and consultation from team members. To see challenging behaviour as skills deficits due to developmental delay and to help children/young people develop appropriate social behaviour, encouraging positive behaviour patterns. An ability to grasp social learning theory and set appropriate boundaries to manage children/young people's behaviours within the individualised behavioural programme devised with the clinical team. To adhere to this exactly, working within a positive/ reward-based model;
  • To never use physical chastisement and other inappropriate punishment;
  • A knowledge of normal child/teenage development and an ability to communicate with children/young people appropriate to their age and understanding;
  • To observe and assess children and young people and clearly record and track their development;
  • To promote the educational attainment of looked after children and young people by ensuring nursery/ school/college attendance, liaising with these establishments, participating in child/young person-focused college/school/ nursery events and supporting achievement e.g. attending parent/toddler meetings and sports days;
  • To facilitate the child attending the weekly children's group as part of the programme (P programme only). 

2. Providing a Safe and Caring Environment

  • An ability to provide a home with adequate sleeping space and privacy. To maintain an appropriate standard of furnishing, fitting, decoration, cleanliness and hygiene;
  • An ability to care for children/young people in a home and network that is free from harm and abuse;
  • An ability to help children/young people keep themselves safe from harm or abuse and to teach them to seek help if their safety is threatened.

3. Working as Part of a Team

  • To work as part of a multi-disciplinary team;
  • An ability to welcome the child or young person into your family and to form a real relationship even if only for a short time. To help the child/young person move on in a positive manner by assisting and supporting them and working alongside the Department's plans;
  • An ability to work with other professional people, working to Placement Agreements and contributing to the individually devised programme for the child/young person. To also contribute to the broader planning for the child or young person at the Department's planning meetings. To attend any meetings such as medical, education meetings court and act as advocate for the child/young person;
  • To attend the weekly foster carer meeting facilitated by the PS and FCCs;
  • An ability to communicate effectively by maintaining written diary recordings and to verbally convey daily information about children/young people's behaviours via a daily phone call to complete a behavioural checklist/ Parental Daily Report (PDR);
  • An ability to keep information confidential and only share information about a child/young person/ family with the permission of the fostering provider;
  • To translate your awareness of discrimination e.g. gender, race, sexuality,  social status etc. into anti-discriminatory practice.

4. Own Development

  • To take responsibility for your own development, recognising your role and your abilities or limitations;
  • The ability to appreciate and reflect of how personal experiences have affected yourself and your family and the impact fostering is likely to have on you all;
  • Have people and links within the community which provide support;
  • Use training opportunities to increase skills. This includes a mandatory course on Treatment Fostering as well as post approval foster carer training provided by Oxfordshire County Council. To identify your own training needs;
  • An ability to sustain positive relationships and maintain the quality of family life incorporating warmth and humour through periods of stress. To be able to stand back from a stressful situation and regulate one's own emotions, rather than get caught up in the child or young person's behaviour. To recognise the effect of secondary stress on yourself and your family;
  • To monitor the effect fostering is having on you and your family and to share experiences generally with your Foster Care Consultant and other members of the Team. This means issues can be resolved early and you remain supported to stay positive and true to the Programme;
  • To become familiar with the Department's policies and procedures and to work within the legal framework;
  • To maintain professional relationships, particularly during challenging periods and when differences of approach arise.
In Addition
  • Carers will be supported by a 24 hour emergency duty rota run by the Clinical Team;
  • Foster Carers can have periods of relief care to be arranged on a case by case basis, with careful consultation with the Clinical Team and the child or young person's social worker;
  • Only one child/young person on the Programme will be placed in a foster home at any time. No other foster children will be residing in the placement unless they are siblings;
  • One adult in the foster home will be expected to be at home undertaking the fostering role full-time;
  • In the face of an allegation an independent support worker can identified by the Department. The investigation will be carried out by a separate team;
  • You will be asked to sign a Fostering Agreement on approval setting out the Agency's terms and conditions;
  • All carers can contact the local Fostering Network Representative in case of queries and advice as well as the National Fostering Network helpline. They can also attend mainstream support groups locally.

Please see the allowances booklet for details on fees and allowances.