A rise in the number of relatives applying to give foster care to vulnerable children in Northern Ireland has left official services stretched.
Between 2009 and 2011 the volume of applications from other family members stepping forward to help young people in state care increased by just over 50%. That caused delays in processing applications, which were vital to ensuring the safety and suitability of placements.
A health service regulator found much evidence of good practice but noted a steady rise in the number of preliminary assessments required.
"The repeated message from health and social care trusts was their difficulty in terms of capacity as a result of the increased demand for kinship carers' assessments," it said.
Fostering happens when the birth parents of children are unable to look after them and they are put in state care, sometimes with an aunt, sibling or some other responsible relative.
The Regulation and Quality Improvement Authority (RQIA) report said the prevalence of kinship fostering had grown in recent years.
It said assessments can take too long to complete and often foster carer allowances are not sufficient to cover the costs of bringing up children.
The review also noted that record keeping needs to be improved and records need to be appropriately audited.
The report said: "Health and social care trusts also stated they had to complete extensive kinship care assessments, in situations where families could not agree who should be the main carer.
"These situations impact on the trusts' ability to progress their mainstream fostering assessments in a timely way.
"The Health and Social Care Board should urgently review the time scales and numbers of kinship carers currently awaiting approval.
"Appropriate action should be taken to improve efficiency and free up resources, while ensuring the protection of children."
The drive to formally approve existing kinship placements was enhanced by the development of standards for care in May last year.
From March 2011 to September last year there was an increase of 103 placements with relatives, equivalent to a 14% increase. For the same period there was a decrease of 53 non-kinship placements, equivalent to a 5% decrease.
Children in state care are visited regularly by social workers and the report said many were working over and above their daily hours.
"It is unclear how much of this is masking a capacity issue, which may be a contributory factor to the high levels of staff turnover," it added.
In September last year a total of 2,073 households were involved in fostering, providing 2,837 placements.
The number of foster carers in Northern Ireland has increased by 5% from 2012, and in the last decade has risen by 8.5%.
The Fostering Network recently indicated that four new foster families are needed each week to provide care for vulnerable children.
RQIA chief executive Glenn Houston said the clear message coming from children and young people looked after by foster carers was the need to feel secure, and to be treated the same as children living with their own parents.
Young people also told us they wanted more involvement in decisions about their lives.
Mr Houston added: "RQIA's review team makes 46 recommendations for improvement in fostering services, including a call for agreed regional standards for fostering services in Northern Ireland.
"We believe that adoption of these recommendations can benefit all those involved in fostering."
Margaret Kelly, director of the Fostering Network Northern Ireland, said the report was a wake-up call for all those involved in fostering.
"It shines a light on the significant issues facing foster care in Northern Ireland and the need for improvement," she added.
"It makes clear that for the children and young people in Northern Ireland who live in foster and kinship care, more remains to be done to ensure they can grow up with security, stability and improved life chances.
"We echo the statement from foster carers that placements are more likely to be successful when they're treated as a member of the team, receive adequate information and have access to advice from social workers."