What does the future hold for commissioners of child placement services?

Andrew CozensStrategic Adviser (Children, Adults & Health Services)

3 July 2007

Summary• How are councils doing?

• The White Paper priorities.

• Understanding outcomes.

• Commissioning and the reorientation needed.

• Changes to inspection.

• The IDeA contributions.

How are councils’ doing?Strong performers:• Detailed knowledge, understanding and analysis of local

need that informs planning and service development• Focus on services that support early intervention and

prevention, with an emphasis on safeguarding and promoting the welfare of children

• Availability of high quality placement options for looked after children that enable them to develop secure attachments

– Effective needs analysis and commissioning strategies, good support for foster carers and adopters; securing specialist placements where necessary

How are councils’ doing?Weaker performers:• Thresholds governing access to social care services are set too

high, with no share understanding of their purpose and application.• Weak management information, quality assurance and performance

management systems, including case recording and auditing of current cases.

• Weak action to reduce the numbers of looked after children or to secure affordable and appropriate local placements

– Absence of commissioning strategy and the range and availability of placements, especially in the council’s areas, is inadequate to meet need. Concerns about quality and stability of placements.

• Insufficient range and quality of services for children with a disability to meet their needs.

Time for Change priorities• Strong focus on stability.• Enabling local authorities to improve their commissioning of

placements.• Improving foster care support and training.• Better enforcing the National Minimum Standards for residential

care.• Piloting a ‘social pedagogy approach in residential care.• Ensuring that children in long term residential placements in

education or health settings get the best possible support.• Improving practice in responding to children who go missing from

care; and• Ensuring that local authorities deliver a better placement experience

for children in care, including a new set of regulations in relation to visits.

Outcomes Based Approach

• How do we get better results for:

– The whole population?

– Those using our services

– Each individual and their carer?

Population, programmes and peoplePopulation, programmes and people

• Fixing the formal system of government and non profit services is not the same thing as improving the quality of life for children and families. We could get the service system spinning like a top, while overall conditions got worse.

• Programmes must do the best possible job improving the lives of their customers, those directly served by the programme.

• For populations, we must create the community, city, county, state and national partnerships necessary to make progress for people, whether they are receiving services from programmes or not.

• These are separate but connected efforts and we must do both of them well.

Mark Friedman Trying Hard is Not Good Enough (2005)

Commissioning levels

• Strategic– Overall planning and negotiation of priorities– Integrated, cross-sector, specialist services.– Authority-wide, or sub-regional/regional

• Operational e.g.– Continuous improvement in universal or targeted services– Areas, GP practices– Service networks collaborate to meet needs– Performance managing local providers

• Individual– People, families, carers, social workers, case managers– Direct payments and individualised budgets– Micro-commissioning, co-production, volunteers

• What gets delegated to which level?

Commissioning levers

• Influencing and negotiating (visible leadership with partners and stakeholders; working through partnerships/Local Area Agreements; investing in relationships and trust)

• Allocation of resources to services(Reallocation of funding between services; pooled budgets with partners)

• Incentivising other providers to change(Contributing resources to developing or remodelling services)

• Procurement of services(Ensuring good process for specifying and obtaining services from in-house and other providers)

The necessary reorientation• Normal childhood opportunities.• Kind, understanding, committed carers – with stickability.• Devolution of decision making wherever possible – the

child and carer at the centre of all the activity around them.

• Every placement decision based on a proper assessment of the child’s needs, wishes and feelings.

• Placements as far as possible close to home.• Stability and continuity – and maximising the opportunity

for permanence.

What is commissioning?

“Developing an overall picture of (children and families/adults) needs within an area, and developing provision through public, private, voluntary and community providers to respond to those needs.”

Source: Green Paper Every Child Matters and September 2005 guidance

It’s all back to needs………It’s all back to needs………

“Capacity to evaluate need is the building block to developing a responsive commissioning strategy. Good commissioning means developing a dynamic understanding of changing needs and a capacity to evaluate the range and effectiveness of services……..few councils have developed the capacity to do this systematically”

Dame Denise Platt, Chair, CSCI, January 2006

The elements of commissioning

Strategic PlanningArea Profiling

Market MappingCommissioning Strategy

Commissioning Framework Provider Identification and Development

Tactical Procurement and Call Off ArrangementsWorkforce Planning

Quality Monitoring and ReviewManaging Decommissioning and Market Failure

Collecting evidence of Better Outcomes and Unmet Needs

Good commissioning• Good commissioning raises the quality of provision,

allows good providers to flourishes and incentivises poor ones to improve.

• Proposed new statutory duty on local authorities to secure a sufficient and diverse provision of quality placements within their local area.

• Strategic needs assessment drawing on better data analysis.

• Regional Commissioning Pilots.• Guidance on managing the market and supply planning

data.• New National Minimum Standards• Arrangements to improve national consistency of care.

Changes to inspection by Ofsted

• Inspection and regulation will be coherent, rigorous and proportionate.

• Frameworks for inspection, regulation and self-evaluation will focus on weaker provision and on the needs of under-achieving groups and those in vulnerable circumstances.

• Focused surveys on those areas which are a priority for improvement nationally, regionally and locally.

• Baselines will be established for the “By 2010” targets, so these priorities can be measured.

IDeA’s contribution• Better Outcomes Programmes.• Commissioning – particularly Strategic Needs

Assessment.• Role of the Third Sector – guidance for commissioners,

how to develop small, local organisations.• The contribution of Local Strategic Partnerships; how

Local Area Agreements might be framed; local targets and indications.

• Working at the inter-face with adults services and the NHS.

• What constitutes effective practice and how we can best share it.

Getting it right

It is with the corporate parent that responsibility and accountability for the well-being and future prospects of children in care ultimately rest. A good corporate parent must offer everything that a good parent would, including stability. It must address both the difficulties which children in care experience and the challenges of parenting within a complex system of services. Equally it is important that children have a chance to shape and influence the parenting they receive.

(Care Matters: Time for Change Summary p.4)

What does the future hold for commissioners of child placement services?

Andrew CozensStrategic Adviser (Children, Adults & Health Services)

3 July 2007