What authority does a therapeutic foster carer have in day-to-day decisions?

A therapeutic foster carer can make routine decisions within the authority delegated by the child’s responsible authority. The fact that a placement uses a therapeutic approach does not give the foster carer parental responsibility or unlimited decision-making power. Instead, authority comes from the child’s legal arrangements, care plan, placement plan and delegated authority agreement.

In practice, the foster carer is usually trusted to make ordinary choices that a responsible parent would make during the day. These decisions should be guided by the child’s age, understanding, personal history, risks and therapeutic needs. Examples can include:

• choosing suitable meals, snacks and clothing;
• agreeing ordinary household routines, including screen use, homework and sleep routines;
• supporting hobbies, exercise and local activities;
• arranging ordinary social activities, subject to any restrictions in the placement plan;
• managing agreed pocket money and encouraging age-appropriate independence;
• helping the child practise coping strategies recommended by the therapeutic team; and
• making reasonable decisions about day-to-day behaviour, boundaries and consequences.

Therapeutic fostering requires the carer to consider what sits behind a behaviour, not simply whether a rule has been broken. A carer may therefore have discretion over how to respond to distress, refusal, conflict or changes in routine, provided the response is safe, proportionate and consistent with the child’s agreed therapeutic plan. Physical punishment is not permitted, and restrictions should never be used as an informal substitute for a properly agreed safety measure.

Some decisions need checking before they are made. The placement plan should explain who can approve matters such as haircuts, changes to appearance, overnight stays, babysitting, use of social media, photographs, mobile phones, travel, participation in particular activities and contact with people outside the approved arrangements. These areas can be especially sensitive where there are safeguarding concerns, cultural or religious considerations, previous exploitation, family conflict or court directions.

Medical decisions depend on the authority that has been delegated. A foster carer may be able to consent to routine treatment or arrange ordinary appointments, but this should not be assumed. Significant treatment, planned operations, decisions about medication, mental health treatment or matters involving serious risk may require consent or involvement from the appropriate person. The carer should follow the written arrangements and ask the child’s social worker or supervising social worker if the position is unclear.

Education decisions also vary. A foster carer can normally support attendance, homework, communication with school and everyday participation, while changes of school, exclusion matters, major educational decisions or additional assessments may involve the child’s social worker, education professionals or someone with parental responsibility. The same principle applies to contact: a carer can support agreed contact arrangements but should not independently change, cancel or add contact unless authorised to do so.

There is a difference between making a decision and taking action in an emergency. If a child faces an immediate risk of serious harm, the carer should take reasonable steps to protect them and obtain urgent help through the appropriate emergency or safeguarding route. The incident should then be reported and recorded in line with the fostering provider’s procedures. An emergency does not automatically create ongoing authority for similar decisions later.

Where a child is older or able to understand the issue, their views should be considered even when an adult has the legal authority to decide. A therapeutic carer should explain decisions in an age-appropriate way, offer choices where possible and avoid presenting a restriction as negotiable if it is required for safety or by the care plan. Giving a child controlled choices can support trust and independence without transferring responsibility for decisions that remain with adults.

Good records help demonstrate how authority has been used. A carer should record significant incidents, concerns, decisions outside the normal routine and the advice received from professionals. If the same issue arises repeatedly, it may indicate that the placement plan or delegated authority agreement needs reviewing rather than being dealt with through increasingly restrictive household rules.

The safest approach is to check the written agreement before a placement begins, identify decisions that may arise, and ask for clarification whenever the authority is uncertain. A supervising social worker, the child’s social worker and other members of the professional network can help interpret the plan. Therapeutic foster care involves thoughtful, relationship-based care, but important decisions must remain within the child’s legal framework and agreed safeguarding arrangements.