Last week another of the essays from our second Shining a Light collection was published in the MJ. The essay was by Nick Barnett who is Managing Director of Caldecott, a residential care provider. In his insightful piece, Nick reflects on the importance on relationships, and in particular on the necessity of a sound understanding of a child’s needs in order to develop a package of care that is most likely to deliver desired and positive outcomes. As he says, “an assessment of need at the start of the placement is critical…. too often we know too little, and the limited assessment work focuses on the containment of risk and not the real young person that we need to connect with”.
Nick’s statement resonates with me, because of my own experience of working with children’s services departments across the country over the past few years. Too often I have seen weaknesses in the placement commissioning process, to the point where huge investment decisions are made into a young person’s future without adequate consideration of their needs, or of how the delivery of those important outcomes will be managed. But the solution isn’t only about how we purchase placements and manage providers – the opportunity comes much earlier in the process, at the time when a child’s needs are first evaluated.
Understanding needs lies at the heart of our Valuing Care programme. We are working with a number of councils to strengthen understanding of their care population, and to develop a response to their sufficiency challenges (including rising placement costs) and inability to find local, appropriate placements to meet the need of children in their care.
We have found that there is very little correlation between the level of expenditure and need, and very little evidence of the delivery of desired outcomes. What is also apparent is that there is a real opportunity to do something about these issues, and this is reflected in the appetite for change amongst providers as well as commissioners, social workers, and young people themselves. The narrative needs to shift from one of containing risk and cost, to one of value and investment in creating futures. Councils also need to become more confident in shaping the market and in their own provision to do so.
The Valuing Care programme supports councils to take a real step forward for the children and young people who will enter their care, and has been designed so that participation costs no more than a placement. Specifically, it helps local authorities to:
· Develop an understanding of need, so that there is a much clearer picture of what services need to be commissioned;
· Develop a framework to codify need for children and young people entering care, enabling better placement commissioning from the outset;
· Develop a commissioning approach and tools that support the fair allocation of resources, linked to needs, and a clear demonstration of outcomes;
· Work more effectively with providers, shaping the market, changing the dynamic of the relationship, and increasing the opportunity to work collaboratively to achieve positive outcomes.
With such important outcomes at stake, it is high time to address the broken market for care placements. The challenges are complex but not unsolvable – let’s make sure they are not pushed to the bottom of the list again.