Placement Sufficiency Strategy

 

The following extract is our Children in Care Placement Sufficiency Strategy 2020-22, the main aim is to place children with our in-house carers wherever possible.

 

3. CURRENT PROVISION

3.3 Independent Sector: Frameworks and Dynamic Purchasing System

3.3.1 The Children’s Placement pod works within the other Fostering & Placements pods to ensure that placements are made in the independent sector only if a child’s individual needs cannot be met by in-house services. The primary source of commissioning foster care placements is with one of the 24 agencies on the East Sussex County Council (ESCC) Foster Care framework of preferred and approved independent providers. This framework is re-opened for applications every two years.

3.3.2 The primary source of commissioning residential child care placements is through the Southern Region Residential Child Care framework of preferred and approved independent providers. This framework is re-opened for applications once every year.

3.3.3 Brighton & Hove is also named on the West Sussex County Council (WSCC) DPS for independent foster care and residential child care placements but is not currently using either category for placement finding.

3.3.4 If a placement is required in the independent sector an Individual Placement Tendering (IPT) process is used to ensure that the best available placement is identified for a child. This process was sighted as a good practice example in the OfSTED publication “From a Distance (OfSTED: April 2014)

3.3.5 Providers receive all referrals for the relevant type of placement and the decision is primarily based on the ability of the provider to meet the needs and identified outcomes for the child. Providers respond on the basis of how they will meet child’s needs and these responses are evaluated to determine which provider is best able to meet the needs of the child. Cost is a factor where the evaluation process identifies multiple providers who can satisfactorily meet the child’s needs.

3.3.6 IPT ensures that the child’s needs remains the core focus of decision making and improves clarity regarding the expectations of providers and encourages creativity. It also ensures, together with quarterly placement data, that providers are aware of the needs of the local authority and encourages development of responsive services.

3.3.7 There has been a reduction in the use of residential placements as the number of looked after children has reduced and fostering providers have been able to offer services to children who would previously have been referred only to residential providers. This has resulted in better matches for children and young people in independent placements, as well as a cost saving to the local authority.

3.3.8 The use of a joint framework and IPT to select placements first began in 2008 and was fully evaluated in November 2011. This evidenced that this arrangement had led to improved placement stability, more placement choice, higher quality placements and better value for money. The original WSCC foster care and residential child care framework has now been replaced by the ESCC Foster Care framework and Southern Region Residential Child Care framework. ESCC and Southampton City Council act as the central procurement bodies in the establishment and maintenance of the relevant frameworks and there is a memorandum agreement between the parties governing joint working relationships and the responsibilities of each party.

3.3.9 The quality of services of all independent providers is regularly reviewed by unannounced and announced visits, annual evaluations by Young Assessors (care experienced young people) from the Ask Report Change (ARC) project and contract monitoring. All providers on the ESCC Foster Care framework must retain a ‘good’ or higher rating from OfSTED. All providers on the Southern Region Residential Child Care framework must retain an OfSTED rating of ‘requires improvement to be good’ or above. Failure to retain the relevant rating, or not reaching the required standards in the other quality assurance processes, results in providers being suspended or removed from the relevant framework.

3.3.10 There is an annual opportunity for new and emerging providers to join the Southern Region Residential Child Care framework, a biennial opportunity for new and emerging providers to join the ESCC Foster Care framework and a continuous opportunity for new and emerging providers to join the WSCC Foster Care and Residential Child Care DPS via a tendering opportunity. Regular provider meetings discuss the placement services needed, changes to legislation, regulations and practice guidance and challenges facing the sector. Within the provider forums, or occasionally via separate workshops, additional training is provided; for example workshops and presentations by relevant agencies on issues relating to children who go missing from care, sexual exploitation and the reduction in the criminalisation of children in care.

3.3.11 This robust commissioning approach used to procure placements has led to the quality of external provision utilised by Brighton & Hove improving. Whilst the number/percentage of children placed at a distance from Brighton (i.e. outside of East and West Sussex) reduced when the commissioning approach was first adopted, it has become more difficult to place locally in recent times and the percentage of placements in Sussex reduced from 97% in 2015 to 88.5% in 2020.

3.4 Independent Fostering Agencies (IFA)

3.4.1 The number of placements purchased from Independent Fostering Agencies (IFA’s) has decreased from 120 (27.8% of children in care) in March 2018 to 77 (20.8% of children in care) in March 2020.

· 90.9% of all children placed with IFAs live within Sussex

· 52.2% are placed less than 10 miles from Brighton & Hove

· 81.2% are placed less than 20 miles from Brighton & Hove

· 94.8% (73) of external fostering placements are with IFA’s who are rated by OfSTED as providing a “good” or “outstanding” service

· 5.2% (4) placements are with providers rated as Requires improvement to be good

· A full breakdown of placement types, numbers and annual spend is completed monthly to understand placement needs and changing demand. This has evidenced an increase in demand particularly for placements for young women at risk of child sexual exploitation.

3.4.2 Once placed in an IFA some children may remain with their carers on a long term or permanent basis whilst others may subsequently move to an in-house placement if a more suitable placement is identified. All decisions about placement changes will be made on the basis of the child’s needs.

3.5 Independent Residential Child Care Provision

3.5.1 Residential placements are commissioned when the IPT process indicates that this is the best available provision to meet a child’s needs. Approval to place a child in a residential provision is obtained by the Assistant Director to ensure consistent decision making and that the proposed placement is the most suitable.

3.5.2 Brighton & Hove has no in-house residential care placements for non-disabled children and thus all such placements are purchased from the independent sector. A total of 29 full time residential placements (3 of which were for children with complex needs and disabilities) were being purchased from the independent sector as of March 2020 as follows:

· 26 placements for non-disabled children of which:

- 9 (34.6%) children’s homes placements within Sussex and

- of these 7 (26.9%) are within 20 miles of Brighton & Hove

· 4 placements for children with complex needs/disabilities of which:

- 1 full time specialist boarding school placement

- 3 (75%) of these placements are within Sussex

- 1 (25%) at a distance from Brighton & Hove (Hampshire)

3.5.3 These placements were carefully selected in conjunction with birth parents and are regularly monitored to ensure they continue meet the specific needs of the child.

3.5.4 Partnership working with residential providers has resulted in the development of a 6-bed children’s home 8 miles from Brighton, predominantly for use by Brighton & Hove and a further 4 bed house 14 miles away. However, there continues to be a lack of suitable residential accommodation within the geographical boundary of Brighton & Hove.

3.5.5 82.8% (24) of children placed in independent children’s homes and special boarding schools are rated by OfSTED as providing a “good” or “outstanding” service.

 

3.6 South East Sector Led Improvement Project – Complex LAC

3.6.1 The council participated in a regional project that looked at looked after children with complex needs.

3.6.2 Of the sample of 75 complex LAC cases reviewed the following was identified.

Main Risk Factors (some concerns or prevalence)

Vulnerable to CSE 52%

CSE risk to others 32%

Risk of radicalisation 4%

Violent risk to other children 59%

Violent risk to adults 68%

Exposed to severe family violence 56%

History of involvement in gangs 9%

Exposed to parental substance misuse 23%

Direct involvement with substance misuse 35%

Involvement in supply of drugs 12%

Mental Health

55% of the sample had exhibited some concerns or prevalence in relation to mental health. The main two areas of mental health were attachment disorder and self-harm.

Learning Disability

23% of the sample had exhibited some concerns or prevalence in relation to a learning disability. The main three areas were ASD/ASC, ADHD and moderate learning disability.

Placement Stability

The percentage of previous care episodes at 2 or less placements for this sample was 96%.

Education

44% of the cohort were in mainstream schools, 28% in a special school, 4% in a PRU, 16% in other types of education and 8% not in education. 5% of those in education were on a reduced timetable and none were excluded in their current period of care.

3.9 16+

3.9.1 Of the 104 young people in care aged 16-17 years at March 2020, 25 were placed with in-house foster carers, 23 with Independent Fostering Agencies, 8 in Children’s Homes and 33 in Hostels or Semi-independent placements. With the increase in admissions to care of adolescents and the elimination of the use of Bed & Breakfast for 16/17 year olds, the development of provision and choice of provision for this age group has been high priority (see ‘16-25 year olds Accommodation and Support Pathway’ below)

Staying Put

3.9.2 Brighton & Hove has fully implemented its Staying Put duty contained in the Children and Families Act 2014 which requires local authorities to provide financial support for every young person who wants to say with their foster carer (with their foster carer’s agreement) from their 18th birthday for any length of time up to their 21st birthday.

3.9.3 As of March 2020, Brighton & Hove had 38 young people Staying Put with their former foster carers; 30 with in-house carers, 8 with IFA carers. Staying Put has an impact on placement availability for younger children, as most foster carers do not have additional room capacity to continue to foster other children in addition to the staying put young person.

3.9.4 The duty to meet the accommodation needs of young people who have left care and are not ‘Staying Put’ ends on their 18th birthday where responsibility moves to the Housing authority. The Joint Protocol for Care Leavers (a Corporate Parenting Agreement between Brighton & Hove Children’s Services & Housing) details the process for meeting their varied accommodation needs.

Supported Accommodation

3.9.5 Sufficient and suitable supported accommodation is provided through the ‘16-25 year olds Accommodation and Support Pathway’, a jointly commissioned arrangement between Housing, Families Children & Learning, and Health & Adult Social Care. This provides a range of options suited to the individual needs of the care leaver and supported provision is allocated according to need by the Supported Accommodation Panel (SAP).This meets weekly with representatives attending from Housing, Families, Children & Learning and housing providers.

3.9.6 Families, Children & Learning and Health & Adult Social Care jointly commission services for care leavers and vulnerable young people who are homeless or at risk of becoming homeless. The range of services includes advice and support in the community, stays with a host household, and supported housing.

3.9.7 Agreements for supported accommodation come under a single Approved Provider hybrid DPS/framework which commenced on 1 July 2018. Organisations accepted onto the DPS/framework can bid for all block and individual agreements over the lifetime of the DPS/framework. Further opportunities to join the framework will be offered in a 2-month window annually. All block contract placements are currently located within the city of Brighton & Hove. The vast majority of individual placements are currently within Sussex.

3.10 18+ Leaving Care

3.10.1 We currently commission a range of placements for 16-25 year olds including care leavers and other young people at risk of homelessness. This incudes block contracts for the following types of provision located within Brighton & Hove:

· 30 rooms for 24/7 staffed high support – mixed gender

· 8 rooms for 24/7 staffed high support – women only

· 75 rooms for low to medium support – mixed gender

· 9 rooms for low to medium support – women only

· 23 rooms for young families

· 5 rooms for low floating support – UASC males only

In addition, individual placements are made for placements of varying levels of need and the majority of these placements are mainly within Sussex or London. It is rare for placements to be made outside of the south East.

3.10.2 The 18+ leaving care cohort have 70% risk of exploitation (40% for UASC), 70% risk of substance or alcohol misuse (10% for UASC) and 65% risk of mental health issues (75% for UASC).

3.10.3 Future need has been identified as less low and medium support but more support of 6+ hours per week. The leaving care cohort need more solo units, 3/4 bed units (staffed and floating), 5/6 bed units (staffed and floating), male only units and female only units. It is likely that further block contracts will be commissioned to meet this need and to reduce the number of individual spot placements.

4. Key Targets and Strategy for Provider Services 2020-22

4.3 Independent Sector Placements

4.3.1 BHCC Children’s Placement Team targets:

· support effective care planning and maintenance of children and young people within their families where possible, gatekeep placement referrals, prioritising in-house and best vfm placements that best meet the children’s needs

· reduce the number of independent sector fostering and external residential placements purchased in direct proportion to the increased availability of in-house provision

· quality and cost efficiency robustly negotiated via the frameworks and IPT process, including regular review of placement costs, negotiation on reduced fees for long term placements, and volume discounts

· ensure residential placements are only commissioned when assessed as the best way to meet a child’s needs and no suitable alternative option exists

· collaborate with East Sussex County Council to jointly commission foster care placements in the independent sector

· The council is a partner on the Southampton City Council led Southern Region residential child care framework. This is a hybrid DPS/framework with a minimum criterion for providers of an OfSTED rating of ‘requires improvement to be good’. The partnership comprises 18 local authorities across the south of England with a number of other local authorities named as potential future users of the framework. The framework commenced on 1 September 2018. It incorporates recommendations from Sir Martin Narey’s independent review of children’s residential care report (July 2016) in terms of joint commissioning and ability to block contract

· Semi-independent provision for those children and young people aged 16 or above whose needs are below the threshold for looked after children, and for care leavers whose needs can be met through this type of provision, is commissioned through an Approved Provider List (APL). This is a hybrid DPS/framework which commenced on 1 July 2018 and runs for up to five years. It re-opens annually for new providers to apply to join and for existing providers to apply for a higher tier ranking

The APL has three categories:

· Accommodation and Support (Block Contracts)

· Accommodation and Support (Individual Placements)

· Support (Individual Placements)

 

 

4.6 16+ & Leaving Care

4.6.1 16+ & leaving Care Service targets:

· continue to develop and implement the jointly commissioned young people’s ‘16-25 year olds Accommodation and Support Pathway’

· encourage young people to remain in their care placements until they are prepared, ready and able to leave by confirming 17 years as the earliest age at which “A Placement in Other Arrangements “will be considered

· eliminate the use of Bed & Breakfast establishments as temporary emergency accommodation for 16/17 year olds by the provision of alternative suitable emergency accommodation provided by a Brighton & Hove supported housing provider under a service level agreement that meets the statutory requirements

· increase as appropriate the number of “Staying Put” arrangements where young people and their carers wish for these to continue post-18 years and to provide the financial and personal support to encourage carers to provide continuing care and support

· ensure when care leavers are assessed as ready for independent living they are placed in safe, secure and affordable accommodation under the Joint Protocol for Care Leavers

· Increase the proportion of placements made from the DPS/framework to 75% of all placements

 

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