Fostering a Child With a Disability or Additional Needs

For a lot of people this is the point where they stop and think, that is not me. You picture hospital appointments and a level of expertise you do not have. Most carers doing this work started exactly where you are now, with no clinical background. Here is what it really involves and what you would never be expected to handle alone.

Please note: general information, not personal advice. Education law and benefits change. Everything here is correct at 26 August 2026, drawn from the Equality Act 2010, DfE statutory guidance on looked-after children’s health and gov.uk guidance on SEND support. Check anything specific with your social worker.

What “additional needs” actually covers

The phrase does a lot of work, and that is part of why it sounds daunting. It stretches from a child who needs a bit more time and a quieter classroom, all the way to a child with severe learning disabilities who needs help with everything. Under the Equality Act 2010, a person is disabled if they have a physical or mental impairment with a substantial and long-term negative effect on their ability to do normal day-to-day activities, where long-term means 12 months or more. That is a wide net. In the Department for Work and Pensions Family Resources Survey for 2024 to 2025, one in four people in the UK reported a disability, around 16.7 million people, and 12 per cent of children.

Children in care are more likely than most to have additional needs, and those needs are usually layered. A child may have a diagnosed condition and also be carrying the effects of what happened before they came into care. The two pull on each other, which is why a diagnosis on paper tells you far less than you would hope about your Tuesday morning.

You are one part of a team, not the whole of it

This is the most useful thing to understand before you enquire. A child with additional needs arrives with professionals already attached to them. Your job is to know the child better than anyone else in the room and to say plainly what you are seeing, not to diagnose or to decide what the child is entitled to.

• Your supervising social worker, employed by us, who visits regularly and is your first call
• The child’s social worker at the local authority, who holds the care plan
• The school’s SENCO, a designated teacher and the local authority’s virtual school head
• Health professionals as needed: a paediatrician, occupational therapist or CAMHS clinician
• Us, on the end of a phone at any hour of any day, including Christmas Day

You will spend a fair amount of time in meetings with these people, and some carers find that the hardest adjustment of all. Our guide to the support foster carers receive covers who does what.

Health appointments and who arranges what

There is a statutory framework here and it works in your favour, because health needs are not left to your memory. Every child coming into care has an initial health assessment by a registered medical practitioner, timed for the first review of their care, which happens within 20 working days of the child starting to be looked after. After that, a child under five has a health review at least every six months, and a child of five or over at least every 12 months. You should be given a copy of the child’s health plan. If you have not been, ask.

Day to day, you are the one who gets the child to the appointment, gives medication as prescribed and notices when something has changed. Equipment and adaptations are not things you fund or chase alone: raise them with your supervising social worker, who takes them to the local authority. Monitoring equipment such as a night alarm needs agreeing with the fostering team rather than simply buying.

School, SEND support and the paperwork

Most children with additional needs are helped through what schools call SEN support, which the school arranges and reviews without any formal plan. Where a child’s needs cannot be met from the school’s own resources, the local authority can be asked to carry out an education, health and care needs assessment. A foster carer can ask for one, and so can a teacher or a doctor. The timescales are set in law: the local authority must tell you within 16 weeks whether an EHC plan will be made, and it has 20 weeks from the request to issue the final plan. These deadlines slip often enough that keeping dated notes of every request and reply is time well spent.

One honest word about change. The government published a Schools White Paper on 23 February 2026 proposing the biggest shake-up of SEND in a decade. EHC plans are being kept, not abolished, and according to the House of Commons Library the legislation is not expected to take effect until September 2029. If you read a headline saying plans are disappearing next term, that is not what is happening.

Looked-after children also have a personal education plan, reviewed as part of their care planning. We have written separately about how foster carers support children at school, including what a PEP meeting is actually like.

What the day-to-day actually looks like

Ask a carer what the work is and they rarely mention the diagnosis. They talk about the practical texture of the day:

• Personal care: help with dressing, bathing or continence. This has to be written into your safer caring arrangements, agreed with your supervising social worker before you change a routine, and explained to the child every time.
• Eating, where the difficulty is sometimes chewing or swallowing rather than appetite. Adapted cutlery and advice from an occupational therapist help more than persuasion does.
• Sleep, which is often what grinds carers down. Physical adjustments help, and so does being honest about how tired you are.
• Getting about, which means ringing ahead and finding out whether the lift at your local station is actually working.
• Communication, learning how this child prefers to be understood, whether that is Makaton, pictures or simply you not covering your mouth when you speak.

Then there is the part nobody puts in a leaflet: the low-grade fight with institutions. Chasing a wheelchair service that has gone quiet. Ringing the leisure centre again about the accessible session. Disabled children are also more likely to be bullied, so a real part of the role is being the adult who refuses to let something slide.

The money side, plainly

At Greater London Fostering you receive £479.50 a week for a child under 11 and £507.50 a week for a child aged 11 or over. That is one fixed weekly amount covering both the child’s costs and your reward, paid per child while the child is placed with you, with no one-off payments for things like birthdays. Where a child’s needs are higher there is usually an enhanced fee on top, generally around £100 to £200 more a week. The full picture is on our foster carer pay page.

Beyond the fee, gov.uk says you can get disability benefits for your foster child if they meet the criteria, and that you may be able to claim Carer’s Allowance if your foster child gets Disability Living Allowance or Personal Independence Payment. How that works for a child in care depends on arrangements the local authority may already have made, so treat it as a conversation with the child’s social worker. Most fostering income is covered by Qualifying Care Relief, which we cover in our article on whether foster carers pay tax.

The worry almost everyone has

It is usually some version of: I am not qualified for this. You are not expected to be, and nobody is asking you to be a nurse. What agencies look for is someone patient enough to learn a child’s signals, organised enough to keep records and honest enough to say when they are out of their depth. Training covers the rest, starting with Skills to Foster before you are approved. Our pieces on trauma and attachment and on supporting neurodiversity are a reasonable place to start reading.

The other honest thing to say is that this work can tire you in a way that creeps up slowly. Short breaks exist for a reason and using one is not a failure.

You won’t have to do this alone

We are a small agency and we know our carers by name, which matters more than it sounds when you are ringing at ten at night about a child who will not settle. You get a supervising social worker who knows your household, out of hours support 365 days a year, training matched to the child in front of you and other local carers who have been through something similar. Ofsted inspected us from 21 to 25 July 2025 and rated us Outstanding in all three judgements, which is in large part a judgement about how well carers are supported. If you are reading this thinking you would probably be no good at it, that is a very common place to start from, and it is worth a conversation rather than a quiet no.

Frequently asked questions

Do I need medical or nursing experience to foster a child with a disability?

No. Foster carers are not clinicians and are not expected to act as them. You need to be able to follow a health plan, give medication as prescribed and say clearly when something looks different. Where a child needs a specific technique or piece of equipment, you are trained on it first.

Is there extra pay for a child with higher needs?

Usually, yes. Our standard weekly fee is £479.50 for a child under 11 and £507.50 for a child aged 11 or over, and where needs are higher there is normally an enhanced fee on top, generally around £100 to £200 more a week. The exact amount is agreed before a placement starts, so ask us directly rather than guessing.

Who arranges equipment and specialist appointments?

Not you on your own. Raise what the child needs with your supervising social worker, who takes it to the child’s social worker and the local authority.

What happens if I find I cannot manage?

You say so, early, to your supervising social worker. The usual response is more support rather than an ending, whether that is extra training or a short break. Where a placement is genuinely not working there is a meeting to look at what could help, and any decision about the placement rests with the local authority and the agency, not with you alone.