Venue: Mezzanine Room 1, County Hall, Aylesbury. View directions
\n\t\tContact: Helen Wailling \n\t\t\n\t\t
\n\t\t\n\t\tItems\n\t\t\n \n\t\t\t\tNote \n\n\t\t\tNo.\n\t\t\tItem\n\t\t\n\n\t\t\n\t\t\t\t\n\n\t\t\t\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\tApologies for absence
\nMinutes:
\nThere were no apologies\nfor absence.
\nDeclarations of interest
\nMinutes:
\nMargaret Aston declared\nan interest as she sat on the Fostering and Adoption\nPanels.
\n\n
Brian Roberts declared\nan interest as he had sat as an observer at a Fostering\nPanel.
\n10:00am
\n\n\t\t\t\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\tIntroduction by Chairman
\nBrenda Jennings,\nChairman of the Achievement and Learning Task and Finish Group,\nwill open the meeting.
\nMinutes:
\nThe Chairman welcomed\nmembers to the meeting and reminded them that the main scope\nof the review was:
\n\n\n· \nTo make recommendations to Cabinet that might help inform their\ndecisions around possible different delivery methods.
\n\n\n· \nTo identify options for additional savings in order to meet\nanticipated £27 million deficit in funding pressures for the\nCounty Council.
\n\n
Today was the third evidence-gathering\nsession.
\n\n\n· \nKey findings from last week’s sessions with Alan Dinning and\nChris Munday had been summarised. Full minutes would be available\nfor the next papers.
\n\n\n· \nAdditional data had been requested – this was listed on the\nsummary sheet.
\n\n
\n\n· \nMembers had learned that:
\n\n\no \nthis was an area with considerable pressures and\noverspend
\n\n\no \nit was demand-led and based on statutory duty
\n\n\no \nDiscretionary, preventative action could lead to lower spend in\nstatutory areas
\n\n\no \nHow these services were provided was currently being reviewed by\nthe service areas in order to find ways to deliver the services\nmore effectively
\n\n
\n\n· \nAt the meeting members would learn more about the commissioning of\nplacements, how they were monitored and the costs
\n\n\n· \nMembers would also hear case studies involving the placement of\nchildren in care and how BCC worked with partners to keep children\nout of the care system.
\n\n\n· \nThis part of the session would be closed due to the possibility of\nidentification of individuals.
\n\n
\n\n· \nIt would be helpful again to have a brief meeting to consolidate\nwhat members had learned and the next steps during/ after lunch,\nwhich would be provided at 1pm.
\n10:10am
\n\n\t\t\t\n\t\t\t\t\n\t\t\t\t\t\n\t\t\n\t\t\t\t\tCommissioning of Placements PDF 421 KB
\nContributor:
\nIain Campbell,\nSafeguarding Lead Commissioner, Access to Resource Team,\nChildren’s Services, Joint Commissioning Unit
\n\n
Purpose:
\nIain Campbell will give\na perspective on cross-regional commissioning placements,\nmonitoring, contracting and costs.
\n\n
Background papers:
\n\n· \nAccess to Resources – team description
\nMinutes:
\nIain Campbell,\nSafeguarding Lead Commissioner, Access to Resource Team (IC), and\nSimon Brown, Operations Manager, Commissioning (SB), were\nw
\nwelcomed to the\nmeeting.
\n\n
SB had a background in\nplacements and had been in post since September\n2009.
\n\n
IC told members the\nfollowing:
\n\n
IC had worked for\nBuckinghamshire County Council (BCC) for 25 years. IC had managed\nall the BCC Children’s homes and had an MA in therapeutic\nchildcare.
\n\n
The Access to Resources\nTeam (ART) was formed about 3 years ago. The Local Authority used\nto rely on Ofsted reports but now also made\nvisits.
\n\n
ART was used across the\nUK, particularly in the London boroughs. Olga Sullivan and IC had been\nbrought together to form ART.
\nThe ART Team had started\nwith 200+ educational placements with external\nproviders. The Team\ndealt with all external placements for SEN, fostering and mother\nand baby placements, when a placement could not be provided\nin-house.
\nThe placements were\nmonitored every year.
\nBCC was part of a\ncross-regional group, and also part of Pan-London, to ensure that\nfostering placements were monitored\nthoroughly.
\n\n
The Commissioning\nStrategy aim was not to place children away from home where\npossible, and to keep the placement local.
\n\n
The current figures for\nplacements in the County were as follows:
\n\n
45 children in 52-week\nresidential placements/special schools\n(LAC)
\n4 children in mother\n& baby units (where assessment is needed around the parenting\ncapacity of the mother)
\n\n
The cost of these\nplacements started from £1,300 per week and a 12-week\nresidential placement could cost £40,000. Residential placements cost\n£2,000 - £4,600 per child per\nweek.
\n\n
There were currently no\nplacements abroad.
\n\n
Mother and Baby\nplacements - some of the families were very vulnerable, with\nprevious children having been removed. The process took about 12 weeks,\nand consisted of monitoring and training. More and more\nresponsibility was passed to the mother in a safe\nenvironment. Where\ndrugs and alcohol were involved, the recovery often depended on the\nmother staying away from her partner, which could be a very complex\nissue.
\n\n
SB\nexplained that he had undertaken research in mother and baby\nplacements. Based upon 6 years’ worth of data, he had found\nthat only 1 in 3 mothers and\nbabies stayed together following the assessment and a year after\nthe assessment, 1 in 3 of that number were still\ntogether.
\n\n
In the first year of ART\nthere had been a saving of £0.5m. In the current year there had been\na zero percentage increase to providers. For 2010-11 the Pan\nLondon Consortium was recommending a -2%\ndecrease. ART negotiated with the providers\nre: price on individual placements. The number of children needing\nplacements was increasing and they were staying longer in\nplacements (longer Court processes).
\n\n
There were still issues\n- some units had been found to be sub standard, with problems not\npicked up by Ofsted. \nThis is monitored very carefully.
\n\n
Benjamin UK had four\nunits in Buckinghamshire. They provided residential\nplacements in a Therapeutic Community for young people who were at\nrisk of offending, as well as those with a history of criminal\ntendencies and severe or mild behavioural difficulties. They also\noffered specialist placements for unaccompanied asylum\nseekers.
\n\n
A member suggested that\nit would be useful for the Group to visit one of the units. A\nmember said it would be interesting to see a breakdown of the total\ncost of a placement, from beginning to\nend.
\n\n
Members then asked\nquestions, which are summarised below.
\n\n
Also, with Pan London,\ndo the tariffs differ i.e. will a placement in Buckinghamshire cost\nmore than a placement in Uxbridge? How do you reconcile this and do\nyou end up subsidising the cost of the\nplacement?
\nAll the members of PAN\nLondon pay the same cost for placements.
\nThere are very few\nspecialist Children’s homes in London. They are mostly high volume, low\ncost homes. The\nplacement price is higher, the lower the volume of a\nhome.
\nIn London prices have\nbeen driven down. Staff\nhave been lost but quality is also being lost as well. London still places children in\nAylesbury etc.
\n\n
The Loughborough cost\ncalculator tool looks at the cost of looked after children.\nIt may show that for a child entering care within Local Authority\nFoster Care on the 1st April, and staying in the\nplacement for a whole year, this may cost\n£27,000.
\n\n
With regards to\nindividual administration costs, how does this fit into the\ntariff?
\nWe are currently running\nlast year’s data through the Loughborough cost\ncalculator. We will\nknow the real cost following that. In April we will run the 2009/10\nfigures and will have benchmarking\nfigures.
\nIf we use a private\nprovider, there is a profit element for the provider of around\n10%. We are also paying\nfor vacancies so the provider mitigates\nagainst the risk of making a loss. This is hidden in the costs and\nthat is how providers manage the risk.
\n\n
A project with other\nlocal authorities had been started 2 years earlier. There were currently six local\nauthorities who all had the same issues, aiming to manage the\nmarket and to bring the provider to the middle of the\nregion.
\nIt had been decided the\nprevious Friday that this was going to be taken as a Cabinet Member\ndecision. It was\nproposed that there would be a five year contract and that there\nwould be five places allocated for Buckinghamshire.
\n\n
Under the contract, a\nschool would also provide day care facilities. Significant savings would be made\nby not sending the children further afield.
\n\n
The location of the\nhomes was not yet clear but a building in Hertfordshire would be\nincluded in the agreement. It would be part of the\nprovider’s responsibility to ensure that the children could\nget to school.
\n\n
The school would be a\nbehavioural, emotional and social difficulties (BESD) school and it\nwould ideally be near to Aylesbury.
\nThe contract would state\nthat the school had to be located within an hour of each\nhome.
\n£3,500 was the\ncurrent average cost per week per child. However through working\nwith other authorities, this had been reduced to nearer\n£3,000 per week per child. It is likely that the children\nbeing placed under the contract would be at the more\nchallenging end and cost substantially higher than the average\ncost.
\nAll the short-listed\ntenders were from high quality providers, and the tender would be\nawarded to a national provider.
\n\n
Members then asked\nquestions, which are summarised below.
\n\n
Why do we need to use a\nprivate provider?
\nThere were no in-house\nbids received for the tender.
\n\n
We already have a very\ngood provision of special schools. Why do we need further\nprovision?
\nWe have had long\nconversations with Wendover House and other special\nschools. Prestwood\nLodge has recently removed its residential provision. The children who will be placed\nunder the contract are those who cannot be managed\nlocally.
\nThe Verney Unit at High\nWycombe has been developed to work with a very small number of\ncomplex children. We\nwant to develop more of this kind of unit and to keep our young\npeople as local as possible.
\n\n
As local authorities can\nnow commission schools, can they not build\nthem?
\nWe can invest in our own\nservices but we have recently invested a lot in advertising for\nfostering placements. \nUnfortunately this has not been very successful and we have had to\nuse external providers.
\nThe key for this\ncontract was to include therapeutic care and therapeutic schools so that the\nsame philosophy is in place for the whole of the child’s\nday. That may have put\noff bids from other local authorities as they do not provide\nthis.
\n\n
With costs being so\nhigh, is it not better to buy people with the expertise required\nrather than go external?
\nSome schools do that.\nYoung people are excluded for a number of reasons, and Social Care\nand Education need to work better together. Children’s\nCentres etc may help with this.
\n\n
How do children who need\nhelp become known by Children’s\nCentres?
\nFamilies who are hard to\nengage do not tend to attend Children’s Centres, so we need\nmore than one way of engaging with them. We also have to go out to the\nfamilies. Professionals\ncan quickly pick up if a child has issues.
\nThe longer a child is in\nChiltern View etc, the harder it is for them to go\nhome.
\n\n
How do you measure\noutcomes?
\nWhen a Social Worker\nwants a placement for a child, it needs to be very clear what the\noutcome should be. \nCurrently the main concern is the day to day safety of the\nchild.
\nOne of the changes is\nthat ART will now be doing individual commissioning for\nchildren. They will\nalso be looking at the outcomes very carefully (outcomes may change\nand develop both short term and long\nterm).
\n\n
Target setting within\nthe Pan London contract will raise the quality of the providers on\nthe ground - not just day to day survival. Experienced staff and\nongoing training will be a requirement in the new\nunit.
\n\n
Will we always have\nproblems with staffing?
\nFinding good quality\nstaff is always a problem.
\nAll changes are welcome\nfinancially but quality of care is very\nimportant.
\n\n
Are there\nmonitoring/controls in place for external\nplacements?
\nRegional monitoring is\nalways an issue. We\nhave done some training so that there is a standard\napproach. We check that\nall staff have a CRB, insurance documentation etc.
\nWe look at all the\nfiles, complaints and restraints. This information is covered in a\nstandard form and is evidence-based. If any issues are found then we\nlook deeper into the matter.
\nThere are annual checks\nand we can also carry out checks ourselves such as spot checks on\nnew providers or local providers. The providers value the things\nthat we pick up. \nRegulation 33 visits are also carried out to internal homes too and\nspecial schools.
\n\n
An Independent Reviewing\nOfficer (IRO) goes to the homes three to four times a year and\ntalks to the child. \nSocial Worker visits meet the minimum requirement which is part of\nICS. There are also\nfamily visits and the child can contact us as\nwell.
\n\n
In the future we are\naiming for ART to go to the provider to look at the care being\nsupplied and to see how this can be\nimproved.
\n\n
We use a national\ncontract and the Pan London contract. They are very similar and are both\nfor top quality services.
\n\n
Do you have budget\n‘brick walls’? How do you\nprioritise?
\nA whole range of\nservices are provided for families, including preventative work to\nsave money later. When\na young person comes into care, the decisions are based on the\nneeds and safety of the child, not on cost\nalone.
\n\n
For any child to be\nplaced externally, you have to consider the\nfollowing:
\n\n
\n
A placement can be found\nvery quickly if necessary. If the request is agreed then it\ncomes to ART. The\noptions are given to the Social Work team for their\ndecision. If funding is not there\n(from Heather Clarke) we don’t even look for a\nplacement.
\nThis means that the\nSocial Worker will try everything else before asking for an\nexternal placement. The\nsuccess rate of finding a placement for some of these young people\nis very high and some of their lives have been\nsaved.
\n\n
There is concern about\nthe transition once a young person leaves\nour
\nservice. What happens when they leave\nresidential placements?
\nThere are new DCSF\nregulations coming into force. There has to be a plan built in\nfor all young people in care (any age). We have employed transition\nworkers in the past.
\n\n
Where is the\n‘black hole’ of provision?
\nMany looked after\nchildren do not have parents who advocate on their\nbehalf. We have\nadvocates to support young people and there has been a move forward\nthrough the Transition and Leaving Care teams.
\nWe have commissioned\nsome flats for young people to use after they leave residential\ncare. This has been\ndone through Paradigm Housing at a cost of around\n£1m.
\n\n
The Chairman thanked IC\nand SB and said that it had been very helpful to hear their views\nand questions.
\n\n
SB told members that\nthey had had a meeting the previous week with eight local\nauthorities to look at fostering as a partnership (BCC would take\nthe lead). There were\n12 local authorities who wanted to be involved and who all had the\nsame issues with recruitment. It was hoped that overheads could\nbe reduced, e.g. expertise could be ‘shared’ across a\nregion.
\nFor instance, currently\nthe adoption/fostering panels took place in every authority,\ncosting a lot to run, and the possibility of these being joined\ntogether would be looked at. This could also reduce\ndelays.
\n\n
A Member said that\nwhatever happened, the quality of service should not be\nreduced.
\nExclusion of the Press and Public
\nTo resolve to exclude the press and public as the\nfollowing item is exempt by virtue of Paragraph 2 of Part 1 of\nSchedule 12a of the Local Government Act 1972 because it contains\ninformation which is likely to reveal the identity of an\nindividual
\nMinutes:
\nRESOLVED
\n\n
That the press and public be excluded for the\nfollowing item which is exempt by virtue of Paragraph 2 of Part 1\nof Schedule 12a of the Local Government Act 1972 because it\ncontains information which is likely to reveal the identity of an\nindividual
\n11:30am
\n\n\t\t\t\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tPlacements in Context
\n\nContributors:
\nDiana Large, Divisional\nManager, Permanency and Placements
\nLiz Fillingham, Team Manager, Children in Care Under 14\nTeam South
\nIsabella Docherty, Team\nManager, Children in Care 14+
\nJoan Ferguson, Team\nManager, Fostering Recruitment Team
\nSandra Carnall, Social Worker, Children in Care Under 14\nTeam South
\nCecilia Bool, Assistant Team Manager, Care and Protection\nTeam North
\n\n
Purpose:
\nDiana Large and\nrepresentatives of her team will give an overview of the work of\nsocial workers in out-of-county placements and will present case\nstudies which will demonstrate the complexity of this area of\nwork.
\n\n
Paper:
\n\n· \nFamily Placement Recruitment Team - overview
\n