Effective commissioning for looked after children

1
Effective commissioning for looked after children

• Mary Lucking, Head of Adoption,
• CIC Division, DCSF
• Julie Selwyn, Director, Hadley Centre for
  Adoption and Foster Care Studies, Univ of Bristol
• Claire Lazarus, Regional Lead, CSP

2
Format for the workshop

• Commissioning Context
• Sufficiency Guidance
• Adoption Research how it can help you
• Discussion
• Interactive throughout please!

3
What are the Major Commissioning Issues?

• 1. Where should we put our overall resource to
  best help children and families particularly
  children in need?
• 2. How do we ensure that services will be
  efficient and effective and improve outcomes?
• 3. How do we make sure that services deliver
  desired outcomes?

4
CIC - The Commissioning Challenge

• Increased referrals
• Increased number of children in care
• The need to make efficiency savings whilst still
  improving the lives and outcomes for our looked
  after children and young people

5
CIC - The Commissioning Challenge 2

• Strategic commissioning for CIC - research with
  providers and commissioners suggests the key gaps
  are
• quality of individual needs assessments
• strategic needs assessment and demand analysis
• market management
• procurement including purchasing and contract
  management
• adopting a whole systems approach
• involvement of children and young people in
  placements decisions

5
6
Examples service re-design

• South West
• Eastern Region 5

7
Sufficiency Guidance securing sufficient
Accommodation for LAC

• Discussion document examples of interesting
  practice
• Sufficiency Guidance itself
• From April 2010 if they have not already done
  so, local authorities should include in relevant
  commissioning strategies their plans for meeting
  the sufficiency duty
• From April 2011 Working with their CT partners,
  local authorities must be in a position to
  secure, where reasonably practicable, sufficient
  accommodation for looked after children in their
  local authority area

8
The new sufficiency duty

• Builds on existing duties eg section 17 of the
  1989 Act and Section 20
• An explicit new duty on LAs to act strategically
  to address gaps in provision
• Requires LAs to have regard to the benefit of
  having
• A number of accommodation providers in their area
• A range of accommodation capable of meeting
  different needs

9
How to move forward?

• Existing good practice requirements can best be
  met through a step change in commissioning
  practice
• Support and maintain diversity of services
  including a focus on early intervention and
  prevention
• Placing children in area where reasonably
  practicable
• Supporting the market to deliver more appropriate
  placements and other services locally

10
(No Transcript)
11
(No Transcript)
12
(No Transcript)
13
(No Transcript)
14
(No Transcript)
15
(No Transcript)
16
Effective commissioning for looked after
children adoption
Dr Julie Selwyn, University of Bristol
17
Adoption context

• 3,200 (5) children
• adopted from care in
• 2008-9.
• 150 local authorities and 27 third sector
  voluntary adoption agencies (VAAs).

18
Adoption - context

• When adoption is the right option, children in
  care are placed by LAs with their own adopters,
  or with adopters provided by another LA or a VAA

VAAs adopters
Other LAs adopters
LAs adopters
19
Inter-agency fee

• The fee charged is called the inter-agency fee.
  Currently the fees are

20
Adoption outcomes

• More stable placements than foster or residential
  care
• Most children have good psycho-social outcomes
• Provides a family for life
• Less likely to be NEET than those who stay in
  care

21
But...

• Research suggest that
• about 1 in every 4 children
• recommended for
• adoption are never adopted
• Nearly all will probably stay in care for the
  rest of their childhood
• Their outcomes are likely to be poorer than they
  could have been

22
Meanwhile...

• VAAs say they have a surplus of adopters,
  especially for difficult to place children
• Some LAs assert VAAs are too expensive, using
  them as a last resort after months of searching
  or not using them at all

23
Better information better decisions

• Are the assumptions that VAAs are too expensive
  right?
• DCSF wanted evidence to help commissioners decide
  
• It asked Bristol and Loughborough Universities to
  carry out an 18 month study of LA and VAA
  adoption costs

24
Adoption costs research
25
Adoption budgets

• Mean expenditure 1,876,336
• Variation in the use of the inter-agency fee-
  1-18
• Variation in performance - two LAs were three
  times more effective at placing children and four
  times less costly than the poorest performing LA

26
Costs of adoption

• LAs and VAAs have similar levels of overheads as
  a proportion of total expenditure
• Different presentation and budget management
  leading to
• Perceptions that VAAs are more expensive

27
VAAs and LAs

• Assuming overhead rate of 43 of total
  expenditure, achieving each adoption costs

28
Numbers and characteristics of children
29
Staying in care costs - example

• Joe is aged 3 and is recommended for adoption by
  the adoption panel
• But his social worker has trouble finding LA
  adopters and are reluctant to go to a VAA due to
  the perceived cost
• As Joe gets older, his adoption becomes
  increasingly unlikely

30
Staying in care costs - example

• Joes stay in care continues. By the time he is
  18, Joe has been in foster care for 15 years
• The care bill is about 360,000 nearly 10 x the
  actual cost of a VAA adoption

31
Commissioning adoption services- challenges

• Ensuring sufficient numbers of adoptive
  placements
• Sustainability
• Choice

32
Partnership case study
33
The London Borough of Harrow and Coram
partnership

• Problems identified at LB Harrow
• transient unstable workforce.
• workforce lacking in confidence and skills
• poor adoption performance
• (only 3 adopted)
• children not placed or
• long delays

34
New model

• A LA partnership with Coram a VAA delivering
  domestic adoption services
• Focused on achieving better outcomes for children
• What does the partnership look like?

35
Governance structures

• Initial three year contract
• New permanency tracking panel established.
• Coram working IN the LA
• LB Harrow remained responsible for its looked
  after children
• Workforce strategy established

36
Managing internal change

• Suspicion and fear of new arrangement
• Issues of accountability and power
• Major difficulties with access to electronic
  databases and files
• Affected all parts of the service
• Workforce strategy established

37
Partnership outcomes

• Adoption performance
• improved.
• Better planning processes and less delay for all
  children.
• Harrow staff more confident in making decisions.
• More stable workforce.

38
Questions?
39
What are the barriers to finding timely and
suitable placements effectively?
40
How will you use this research to improve
sufficiency?
41
How can DCSF/CSP help improve local delivery?
42
Can the interagency fee help or hinder effective
commissioning?