Approach better aligns children’s needs and outcomes

Derren Hayes
Tuesday, November 26, 2019

Programme works with children’s services to better match children’s needs with desired outcomes.

Valuing Care aims to shift the emphasis from the cost of care to the value it delivers. Picture: Drobot Dean/Adobe Stock
Valuing Care aims to shift the emphasis from the cost of care to the value it delivers. Picture: Drobot Dean/Adobe Stock
  • Valuing Care works to change behaviours and culture across the system for children in care, to improve both
  • Two councils alone have delivered £2.8m of savings to date

ACTION

“Local authorities collect children’s services management information mainly for the purpose of sending it to the Department for Education,” says Olly Swann, director at consultants Impower. But the data councils generate through this process can reveal a lot about what children’s needs are, the scale of interventions provided and what outcomes are achieved.

What is often missing for councils, says Swann, is consistent analysis and monitoring of children’s needs and outcomes – a clear indicator of whether the placement is working, and whether interventions are being provided to the right children at the right time.

For children’s services leaders and commissioners, understanding how much is being spent on different types of placement (and why) is crucial in the management of overall budgets. Across children’s services, concerns have been raised about the high cost of some specialist independent sector care placements. This has resulted in cash-strapped councils frequently undertaking audits of their high-cost placements with a view to making savings.

“Nearly every authority has done a placement review and concluded in many instances that they are actually getting good bang for their buck,” he says.

Councils are approaching the problem from the wrong angle, says Swann. Instead, it is the majority of the other placements and those children on the edge of care – “those in the middle” – whose moderate needs are not being adequately met despite their placement costing thousands of pounds a week.

Analysis by Impower found that the link between children’s needs and councils’ spending levels are weak, and there is often no evidence that the best outcome has been achieved. This has been driven by a shortage of care placements which in turn has seen the development of a culture of “any placement, often at any cost” to contain risk.

“The current system is broken,” explains Swann. “We must have a deeper and more consistent understanding of children’s needs, the cost of their care and the outcomes being achieved, and then triangulate that information to take a view on value.”

Impower has developed its Valuing Care programme, which aims to develop a systemic focus on what the young person needs, so that the emphasis moves from containing risk to ambition for young people, and from the cost of care to the value it delivers. This process is underpinned by a common needs framework and language that is adopted by all agencies and practitioners working with children.

Five councils – Hertfordshire, Oxfordshire, Norfolk, Central Bedfordshire and North East Lincolnshire – have been involved in developing Valuing Care, all with a slightly different focus. For example, Hertfordshire has introduced a Valuing Care dashboard to track individual children’s needs quickly and collect information about how these change over time. Practitioners can then better match needs to support to improve a child’s outcomes.

Meanwhile, Oxfordshire has used the new intelligence provided by using the approach to identify young people in residential care who may benefit from a family placement. The council has worked with care providers to identify children who can transition to supported fostering placements instead.

Sarah Duerden, strengthening placement lead for Oxfordshire, says undertaking the analysis produced strong evidence for which children would benefit from supported placements.

“Out of the 20 children and young people we have profiled in this way, we are searching for 10 foster placements,” Duerden says. “For the remaining 10, the process provided the evidence to either say they were appropriately placed or that joint funding with health or education needed to be explored.”

Duerden adds that by writing their own personal profile, children can be part of the process, with care planning taking into account how to meet the child’s goals in the short and long term.

A sixth authority, Stockton, has recently implemented the approach for their children in care, but they are also using it to transform their work with children on the edge of care as part of a broader demand management strategy. It aims to target intensive support to children at risk to prevent them needing to come into care and in so doing significantly reducing costs.

Swann says: “Stockton is the first council to use the approach earlier in the child’s journey, but why stop there? We should be aiming to ground the whole system in value.”

IMPACT

Swann says that Valuing Care is about shifting a children’s services culture from a “transactional and risk management approach” to placements, to one that is both “value-driven and better able to transform lives”.

It’s impact report on the programme published in the summer showed that across the five initial councils, 3,400 children in care had clearer aligned needs, care plans and outcomes. It had generated an estimated £2.8m in savings so far in 2019/20 across two councils.

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