Manchester City Council
Young People and Children Scrutiny Committee
Item 7
4 March 2014
Manchester City Council
Report for Information
Report to:
Young People and Children Scrutiny Committee – 4 March 2014
Subject:
Looked After Children Commissioning Strategy
– Quarterly update on the progress of the Strategy
Report of:
Strategic Director of Children’s and Commissioning Services
Summary
To provide members with an update on the LAC Commissioning Strategy; and to
note the attached Integrated Placement Strategy for details of the commissioning
intentions.
Recommendations
That the committee:
 Note the updates on the progress of the work streams of the LAC
Commissioning Strategy.
Wards Affected: All.
Financial Update - Revenue
The LAC budget for 2013-2014 is £47.5m and the Medium Term Financial Plan for
2013-2015 reflects the LAC Commissioning Strategy. It includes planned savings
from decommissioning of internal and external residential provision and investment
into additional foster care provision and early help targeted and specialist support
services for families to reduce the numbers of children needing to become LAC.
Contact Officers:
Name:
Position:
Telephone:
E-mail:
Mike Livingstone
Strategic Director of Children's and Commissioning Services
0161 234 3804
[email protected]
Name:
Position:
Telephone:
Email:
Mark Barratt
Senior Strategic Lead (Safeguarding)
0161 234 4994
[email protected]
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Manchester City Council
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4 March 2014
1.0
Background
1.1
Manchester City Council continues to be ambitious for children and young
people and as a Corporate Parent of 1329 Looked after Children (LAC), it has
a priority to secure the very best care and opportunities for them. The aim of
the Looked after Children’s Commissioning Strategy is to improve outcomes
for vulnerable children and young people, including Looked after Children,
through a commissioning approach which will secure a range of Early Help
and targeted and specialist services to support parents care for their children
and reduce the need for children to be placed in care settings.
1.2
In November 2012 the Looked after Children’s Commissioning Strategy was
considered by Scrutiny and approved by the Council’s Executive.
1.3
The strategy is being implemented through a number of clearly defined but
interdependent work streams which will deliver more timely interventions with
partners and commissioned providers.
1.4
This approach is supported by a newly developed Integrated Placement
Strategy which is attached for information (Appendix 1).
2.0
Introduction
2.1
As agreed at Scrutiny in November 2012, a quarterly report is to be presented
to the Young People and Children Scrutiny Committee setting out the progress
and impact of the Looked after Children’s Commissioning Strategy.
2.2
The strategy is being implemented through a number of clearly defined but
interdependent work streams which will deliver more timely interventions with
partners and commissioned providers. The commissioning approach will
enable greater integration between Looked after Children’s services and
universal and specialist services. Central to the strategy is a shift in placement
profile from residential placements to providing and commissioning more high
quality local foster care.
2.3
The progress to the end of December 2013 shows that the strategy is working
effectively in significantly increasing the number of children in foster care
placements and reducing the use of residential provision to improve outcomes
and make savings. At the end of December there had been an increase of 96
foster care placements and a reduction of 39 residential placements over the
past year. Six internal children’s homes have closed and there is a plan for a
further four to close before end of March 2015. There has been a decrease in
the use of internal and external residential care.
2.4
This report provides a brief update on the work streams covered by the
strategy. Future updates will provide further information on the work steams as
they develop.
2.5
Whilst the integrated commissioning strategy for LAC has made good
progress, the overall success of the strategy is reliant upon safely reducing the
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Manchester City Council
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Item 7
4 March 2014
numbers of children in placement through alternative permanence planning
options. Further action is being taken by:
 Implementing a revised decision making process for all new admissions into
care and for admission into higher cost external residential placements.
 Further review of all 87 existing external residential placements.
 Audit of all external foster care placements made in the last four months.
 Seeking to have greater joint funding/transition planning for looked after
children, particularly with NHS and particularly for children with complex needs
and high cost care.
 Accelerating the timing of the remaining internal residential closures.
 Continuing to develop the suite of reforms that will reduce demand for LAC
placements and the length of stay in care e.g. Multi-systemic therapy
beginning in April 2014; Multi-treatment Foster Care; Troubled Families
including families at risk of becoming troubled; Early Help; the creation of a
Multi-agency Safeguarding Hub.
 Focus on securing permanent placement arrangements for children through
adoption, special and guardianship and residence orders and improved
services for young people leaving care towards independence.
2.6
Progress and scrutiny around the activity of the workstreams is managed
though the regular meetings of the Members Task and Finish Group chaired
by Cllr Hyde. The focus of the meetings being upon the timely completion of
action plans within clearly defined agreed timescales.
3.0
Reducing Demand
3.1
As part of the workstream to reduce demand, MST (Multi-systemic Therapy) is
being commissioned; MST is an intervention which will be used to help keep
young people (aged 11-17) out of care and/or the criminal justice system. The
programme was formally launched on 23rd January 2014; the provider is
Action for Children. As previously described, MST is a licensed product and
the process of setting up the site continues to progress. The programme
supervisor has been recruited and the therapists are in the process of being
recruited at the moment. The therapists will begin taking on families once they
have completed their mandatory accredited MST training - this will take place
during March – the therapists will begin to work with families from the
beginning of April. Each of the 4 therapists will be working with between 4 and
6 families concurrently meaning that the team will be working with an average
of 20 families at any one time (depending on the complexity of individual
cases), likely to be around 50 over a twelve month period. The intervention
itself will normally take place in the homes of the families. MST is primarily a
Troubled Families intervention and the referral route will be formally ratified
through the multi agency Steering Group.
3.2
A Family Resource Panel scrutiniseS all decisions that are made in relation to
children potentially becoming looked after to ensure that all alternatives to
care are considered where it is safe to do so.
3.3
The following graph shows the current overall position in terms of the number
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Manchester City Council
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4 March 2014
of children currently being looked after by the City Council as Corporate
Parent.
3.4
The number of Looked after Children at 31st December 2013 was 1,329,
which is an increase of one compared to November 2013 and 35 higher than
the equivalent point at the end of 2012.
Total LAC Placement Profile
No of Placements
1200
1000
800
600
400
200
0
Sep-12
Dec-12
Mar-13
Aug-13
Sep-13
Dec-13
Mar-14
Jun-14
Sep-14
Dec-14
Mar-15
Internal Residential
86
82
71
63
63
54
51
48
44
39
35
External Residential
94
90
95
95
92
87
67
63
57
48
42
Fostering
919
892
929
955
955
1002
957
961
967
971
977
Actual Sep 2012 to December 2013 and Planned Jan 2014 - Mar 2015
3.5
The position overall with the LAC profile is that there are 1,143 children and
young people in a placement funded by the local authority, an increase of
57 since the financial modelling of the proposals took place in November
2012. The change in placement profile has been an increase of 96 foster care
placements and a reduction in 32 internal residential placements and 7
external residential placements. Six internal children’s homes have closed
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Young People and Children Scrutiny Committee
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4 March 2014
and there is a plan for a further four to close before end of March 2015.
4.0
2012/
13
2013/
14
Residential
Q4
Q1
Q2
Q3
Q4
Internal
Residentia
l Target
Internal
Residentia
l Actual
66
63
48
44
37
71
62
57
54
%
difference
External
Resident
ial
Target
External
Residen
tial
Actual
7.6
-1.6
18.8
22.7
-100.0
92
90
87
85
67
95
96
92
87
%
difference
3.3
6.7
5.7
2.4
-100.0
Ratio
internal to
external
residential
1.3
1.5
1.6
1.6
4.1
The number of children in Internal Residential placements at the end of
December 2013 (Q3) has increased by one since the previous month. This is
still above the target set for the end of Quarter 3 (44).
4.2
The number of children in external residential placements has decreased by
one compared to the previous month to 87. However this does still exceed the
target for the end of the quarter (85).
4.3
The ratio of Internal Residential placements to External Residential
placements has increased slightly to (1:1.6) which is in line with the strategy.
5.0
Foster Care
5.1
The number of children in external foster care has increased by 48 in the
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4 March 2014
quarter ending December 2013. This is an increase of 99 (18.5%) since the
equivalent month last year and an increase of 80 (14.4%) since the end of the
financial year 2012/13. However the number of children in internal fostering
has increased by four in the same quarter to 374. This is an increase of 18
(5.1%) since the equivalent month last year and is the same as the end of the
financial year 2012/13.
6.0
Next Steps
6.1
Whilst the integrated commissioning strategy for LAC has made good
progress, the delivery of savings is at risk largely due to the significant
increase in the number of children in a placement. To accelerate the pace of
delivery of savings the following actions are being taken:
6.2
Admission of Children to care and specifically into external residential
placements
The decision-making process around the admission of children care and into
external residential children’s homes has been reviewed and implemented.
The process draws both from operational case work decision-making and
commissioning practice together; to provide assurance, scrutiny and rigour in
determining that the decision-making is consistent, that the placement meets
the needs of the young person and that the placement evidences value for
money in accordance with financial regulations and that other less expensive
options have been considered.
6.3
Further review of all external residential children’s homes placements
Currently there are 87 placements of looked after children within external
residential children’s homes. A panel has been established with its chief focus
to review each placement to ensure the placements are appropriate, providing
value for money and maximising positive outcomes for those looked after
children. There is a clear focus on ensuring that the care planning does not
drift and ensures that transition and safe discharges from the placements
occur, with the panel establishing clarity of accountability, expectations and
timescales for the work to be completed.
There is ongoing review and
scrutiny exercise within the panel arrangements.
6.4
A tracking and savings spreadsheet is being further developed to ensure that
casework, financial and commissioning information is captured in a coherent
and timely manner.
6.5
Joint Funding/Transitions Planning
An approach has been developed to strengthen the involvement of partner
agencies with those children with disabilities. The work is led through the
Senior Strategic Lead for Education and is focused upon maximising third
party- contributions to meet the financial costs of placement and developing
timely transition plans to reduce dependency upon high cost specialist
services.
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6.6
The work is focused upon practice, costs and judgements on quality of
provision from an Ofsted, operational and internal commissioning perspective.
Joint visits between operational and commissioning staff are being progressed
to review the quality of provision and value for money.
6.7
In governing this work, a Transitions Panel has been established, drawing
operational staff from a children’s and adults social work background,
education and health and commissioning representatives which will also focus
on any future placement requests.
6.8
Audit of all new foster care placements made during the last four
months.
In order to understand any underlying causes of the significant growth in foster
care numbers in recent months an audit of the cases approved through the
panel will be undertaken.
7.0
Integrated Placement Strategy
7.1
The Placement Strategy as at October 2013 is attached at Appendix 1 for
information. The strategy is currrently being developed with partners and will
be presented at a future meeting of the Committee.
7.2
Note that Cayside, Lynwood and Riverside children’s homes have been decommissioned. Woodlands will be de-commissioned by the end of March
2014.
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Manchester City Council
Young People and Children Scrutiny Committee
APPENDIX 1
Integrated Placement Strategy
For Looked After Children
2012-15
(Refresh – October 2013)
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Appendix 1 - Item 7
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Manchester City Council
Young People and Children Scrutiny Committee
Appendix 1 - Item 7
4 March 2014
1. Introduction and Background
The aim of this document is to describe Manchester City Council’s strategy
with regard to our role and responsibilities relating to the children and young
people for whom we are the corporate parents. The City Council takes the role
of corporate parent extremely seriously and is committed to ensuring that all
those that we look after have the opportunity to achieve to their full potential. It
has a priority to secure the very best care and outcomes for them.
Our aspiration for our Looked After Children forms a part of our vision that all
children and young people in the city will be healthy, safe, enjoy and achieve
in learning, and will have the skills, abilities, self-esteem and outlook to access
sustainable employment, make a positive contribution to society and be
successful in adult life. The key priorities for the Manchester Children’s
Partnership, in terms of improving outcomes for children and young people
are;
 Developing an offer of Early Help to ensure that there is a commitment
to finding early solutions to family and individual problems.
 Ensuring children are ready for school by leading on the
implementation and commissioning of a core universal offer for prebirth to five year olds.
 Children leave school ready to access employment, further education
and training
 Minimising family poverty by tackling the root causes of dependency as
articulated in the Family Poverty Strategy 2012-2015
 Narrowing the gap in key health outcomes for children by ensuring that
all families receive timely interventions and have access to the right
health care at the right level of provision and at the right time.
This strategy describes the type of placements that we aim to both
commission and provide for our Looked After Children and articulates how we
will be improving our current arrangements to ensure better outcomes for
those children and young people.
The strategy document incorporates a market sufficiency assessment around
the availability of foster care placements from Independent Fostercare
Agencies.
The strategy also describes the activity that we are undertaking, and will
undertake in the future, to ensure that children on the edge of care are given
appropriate support that will help them to remain safely at home with their own
families. We are committed to the belief that, however well we care for our
looked after children, their life chances are more likely to be improved if they
remain with their family. We know that looked after children are usually less
likely, than those living with their own family, to progress to university, and are
more likely to enter the criminal justice system, more likely to be involved with
drugs and more likely to become parents whilst still in their teens.
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Appendix 1 - Item 7
4 March 2014
The strategy is also an action plan and sets out the specific areas we are
aiming to rationalise, refine and introduce.
The strategy also reflects the fact that, since 2010, local authorities have had
a statutory duty to secure sufficient accommodation for looked after children.
Manchester’s commissioning approach is consistent with fulfilling this duty
which requires a choice of placement options and better integration between
Looked After Children’s services and universal and specialist services. The
overall approach will reduce the number of children coming into care, improve
individual outcomes and, in the longer term, reduce costs.
The aim of the Commissioning and Sufficiency Strategy is to secure and
improve the safety, welfare and outcomes of children and young people. The
last Ofsted ratings, including the last inspection of services for LAC in
November 2010, judged as ‘good’ a number of aspects including capacity to
improve, quality of provision and leadership and management. The strategy is
to build on this and the need to drive further progress, working in an integrated
way with partners who share the ambition and responsibility to improve
outcomes for looked after children. The strategy therefore is to:
 Safely reduce the number of children requiring council care by
commissioning
early help proven to work, drawing on the work of
Community Budgets,
specifically the ‘Troubled Families’ initiative
 Significantly improve outcomes for those children looked after by
commissioning a greater range of local placement provision to meet
individual needs and provide greater choice – this will include
increasing the number of local foster carers - particularly for teenagers,
and ensuring a range of smaller high quality local residential and
leaving care services tailored for individual needs
 Integrate the commissioning and delivery of services at a place level
thus reducing considerably the number of children who are currently
looked after in placements outside of the city. The strategy will create
a more integrated care pathway to safely prevent a child or young
person entering care through building resilience in the child and family.
This will be closely aligned to the troubled families’ initiative. The
integrated care pathway looks to commission evidence-based
interventions so that if a child or young person is taken into care they
have the right services in the right placement to more closely meet their
needs. Ensure clear and effective integrated pathways with external
partners including Clinical Psychology, Educational Psychology and
Children and Adolescent Mental Health Services.
2. Governance
 The strategy is governed by the LAC Strategy Partnership Board whose
work is underpinned by a number of work streams. The Board reports
to the Targeted and Specialist Transformation Board and is
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Manchester City Council
Young People and Children Scrutiny Committee




Appendix 1 - Item 7
4 March 2014
accountable to Senior Management. The Board membership includes
commissioners from the Central Manchester Clinical Commissioning
Group (who have commissioning responsibility – for children’s services
and CAMHA for the whole city on behalf of North and South
Manchester CCGs). Membership also includes the LAC Nurse from the
Acute Trust.
The Young People and Children Overview and Scrutiny Committee
receive a quarterly update on the progress and impact of the strategy
The Corporate Parenting Panel have the strategy as a standing item on
the agenda and have an overview of the impact of the strategy on
outcomes for Looked After Children and Care Leavers
Regulation 33 Visitors – Regulation 33 visits are a regulatory
requirement for registered children’s homes and provide a key
independent quality assurance mechanism in which elected member’s,
and others, play a significant role. It is the intention to establish a
Regulation 33 Visitors Reference Group. This group will bring together
members and officers involved in the visits to provide additional
challenge and insight into any decommissioning activity and service
remodelling. There is an unannounced visit
The Care 2 Change Council is a representative group of young people
who are in care or who are care leavers. The C2CC has a critical role to
contribution to make in regard to the Commissioning and Sufficiency
Strategy. We believe it essential that young people who have
experience of being cared for are able to influence current and future
practice and provision.
3. Profile and needs analysis
As at 31 March 2013 there were 1302 children looked after. The figure at the
end of March 2012 was 1281 There has been an increase in the number of
children on a Child Protection Plans from 631 in March 2012 to 738 in March
2013.
The figures given below are from the SSDA 903 returns for the previous three
full years. (second and third figures -- / -- / -- in the table below are for
March 31st 2012 and 2011 respectively).
Boys
Age
Girls
Number
Age
2013 / 2012 / 2011
Number
2013 / 2012 / 2011
Under 1
34 / 33 / 38
Under 1
23 / 25 / 27
1-4
123 / 122 / 111
1-4
91 / 100 / 108
5–9
153 / 146 / 147
5–9
123 / 121 / 120
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10 - 15
267 / 271 / 296
10 - 15
217 / 232 / 250
16 - 17
135 / 140 / 171
16 - 17
136 / 121 / 123
Total Boys
712 / 712 / 763
Total Girls
590 / 599 / 628
Total of All Children Looked After at 31 March = 1302 / 1311 / 1391
Key points from the above data show that the overall number reduced significantly
between 2011 and 2012 and reduced slightly in 2013.
 There continues to be a clear downward trend in the volume of children in care
after the age of 10.
 The overall LAC population is skewed towards boys.
Legal Status of the above children as at 31-03-2013 (SSDA 903 Legal Status
Code)
2013/2012/2011
Interim
244 / 308 / 309
C1
Full
705 / 666 / 648
C2
Voluntary
Agreement
(S.20)
209 / 269 / 355
V2
Freed for
Adoption
3/5/6
D1
Placement
Order
134 / 62 / 71
E1
On remand,
committed for
trial or detained
7/0/1
J1, J2,J3
Emergency
orders or police
protection
0/1/1
L1, L2, L3
Total
1302/1311/1391
Care Orders
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Manchester City Council
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Key Points
 Clear shift from interim care orders to full care orders
 Section 20s reducing steadily
 Placement orders have significantly increased between 2012 and 2013
Placement Details as at 31 March 2013 with SSDA 903 placement code
Foster placement
relative or friend
Inside local
authority
125 / 140 /138
Q1
Outside local
authority
58 / 67 / 85
Q1
Inside local
authority
242 / 270 / 287
Q2
Outside local
authority
533 / 484 / 452
Q2
Secure Unit
8/2/5
K1
Homes and
Hostels
8 / 20 / 48
K2
Hostels and other
supportive
residential
placements
1/1/1
H5
Residential
schools
11 / 12 / 14
S1
Other residential
settings
152 / 149 / 153
R1, R2, R3, R5
Placed for
adoption (inc
former foster
carer)
46 / 30 / 49
A3, A4, A5, A6
Placed with own
parents
85 / 96 / 110
P1
Foster placement
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In lodgings,
residential
employment or
living
independently
29 / 35 / 46
P2, P3
Absent from
agreed
placement
3/3/0
M1, M2, M3
Other Placement
1/2/3
Z1
TOTAL
1302/1311/1391
Key Points
 Clear drift towards foster care placements outside the local authority
boundary.
 No significant reduction in numbers accessing residential settings
 Gradual reduction in those placed with own parents.
Category of Need for Children Looked After with SSDA Code
Abuse or Neglect
831 / 892 / 909
N1
Disability
40 / 37 / 37
N2
Parental illness or
disability
74 / 82 / 78
N3
Family in acute stress
103 / 81 / 84
N4
Family dysfunction
143 / 107 / 122
N5
Socially unacceptable
behaviour
47 / 35 / 41
N6
Low Income
7 / 2 / 10
N7
Absent Parenting
57 / 75 / 110
N8
Total
1302 / 1311 / 1391
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Manchester City Council
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Key Points
 Increase in families in acute stress and in family dysfunction.
Ethnic Origin of Children Looked After
White
833 / 849 / 906
Mixed
198 / 216 / 219
Asian or Asian British
66 / 54 / 76
Black or Black British
168 / 138 / 129
Other Ethnic Groups
37 / 54 / 61
Total
1302 / 1311 / 1391
Key Points
 Significant proportionate increase in numbers from black or black British ethnic
origin
4. Context
It is fundamental to our strategy for looked after children in Manchester that
those children and young people have the right to achieve the same outcomes
that we would expect for all children across the city. A very high proportion of
the children and young people who necessarily come into our care will have
complex needs and may require a range of support services delivered at a
multi-agency level. These agencies will include specialist teams, including
youth offending services and drug and alcohol services, within the local
authority, health services and specific mental health services. These services
have a clear focus on ensuring the welfare of our looked after children and
young people, safeguarding them from harm and protecting those whom,
without intervention, would be at significant risk of harm or neglect.
 Where practicable, children and young people requiring it are supported
by specialist services whilst they live with their families helping to
prevent them from needing to become looked after.
 Those children, and young people, in need of protection are supported
by specialist services. This group includes disabled children and young
people and those who are fostered by friends and relatives. Also
included are secure services caring for those liberty has been restricted
or removed.
5. Key Assumptions
The City Council is committed to the following key assumptions in regard to its
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Manchester City Council
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4 March 2014
approach to its role as a corporate parent.
There are eight elements that underpin the new commissioning strategy:
 Supporting increasing numbers of families to stay safely together
through an effective early help strategy which is supported by a new
delivery model for early years, and a particular focus on young people
aged 11-17 who too often achieve the poorest outcomes in care.
 Using evidence based interventions to provide the right support at the
right time to ensure the right children come into care at the right time.
 Developing a clear, planned pathway through care so that, at the
earliest point, children and young people can be reunited with family
and friends where appropriate, have permanent stable placements and
leave care positively and prepared for adult life. Creating a culture of
permanency planning and exit routes at all levels.
 Commissioning a range of flexible, affordable and high quality, local
placements that offer choice and the best outcomes for the child or
young person by allowing them to live locally, access local services,
remaining at the same school and maintaining contact with family and
friends where appropriate.
 Children and young people must only move placements if the change is
absolutely in their best interest. Changes will be planned and managed
with safety, sensitivity and utmost care.
 A mixed economy of residential, foster, leaving care and adoption
provision with a balance between specialist and more generic types of
provision will be commissioned
 Over the life of this strategy there will be a re-balancing of the resource
profile from high cost placement to the prevention of children, young
people and families entering care.
 Ensuring that we maintain an effective, quality service for those leaving
care. Providing support allowing care leavers to access
accommodation, welfare support, education and employment
opportunities.
 There will be a continued drive for further efficiencies through
continuing to review contracts and speeding up processes.
6. Priorities
Priority Areas
Transformation will be achieved by:
Reducing Demand
Changes in social work culture and practice with
active management and support in decision making
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processes.
Reducing the need to take children and young people
into care by introducing effective evidence based
interventions. Eg; Multi- Systemic Therapy (MST),
short break and respite provision for the 11-17 age
group.
Increasing the use of a range of family orientated
engagement activity - developed and used through
the Troubled Families work
Reducing subsequent demand for services through
the effective use of Early Help and early intervention.
Looking to develop effective us of family group
conferencing.
Making more availability of short break/respite
provision to allow individuals and families time to
address issues.
Ensuring efficient management around issues related
to homelessness for 16 and 17 year olds.
Residential
Reducing the use, except where clearly the best
option, of residential children’s homes – in particular
those located some distance from Manchester
SEE – APPENDIX a
Introducing phased withdrawal from our own
residential homes as the need for residential beds
decreases in line with recruitment of new foster
carers.
Ensuring that future use of residential provision will
be more versatile to meet need, will be as local as
possible and offer better value for money.
Foster Care
Developing strategies to support the recruitment of
an additional 100 foster carers to allow movement
away from the use of residential care settings. These
additional foster carer placements to be particularly
focused on the needs of young people aged 11-15.
Ensuring that, wherever possible, placements are
local – allowing children and young people to remain
close to the communities and networks with whom
they are familiar.
Working with external independent fostering agencies
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to ensure sufficiency of suitable local placements.
Continuing to work with the other local authorities in
the north west to maximize value for money through
a framework arrangement.
Commissioning provision, through a Social Impact
Bond (SIB) , to deliver a Multi-dimensional Treatment
Foster Care programme to support moving young
people, with severe behavioural issues, from
residential to foster care placements.
To further develop a placement panel to manage all
external placements – so managing outcomes and
costs
Permanence
Speeding-up adoption by exploring the delivery of the
adoption process in partnership with a voluntary
sector adoption agency.
Improving services to care leavers and access to
education, employment, training and supported
housing, integrating with Adult Services to provide a
single transition pathway to adulthood.
Contract efficiencies
Re-commissioning the leaving care service and
achieving clearer value for money.
Making efficiencies on existing placements contracts
through renegotiation and more imaginative
approaches to decommissioning.
Negotiating down the cost of high cost placements.
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APPENDIX a
Refreshed Strategy - Residential Placements
A significant element of the Integrated Strategy is to improve the range of local
placement choice for Looked After Children. The objective is to improve outcomes so
as to narrow and ultimately eradicate the gap in outcomes between Looked After
Children and their peers and to significantly improve outcomes for those children
looked after by commissioning a greater range of local placement provision to meet
individual needs and provide greater choice.
This will include increasing the number of local foster carers, particularly for
teenagers, and ensure a range of smaller high quality local residential and leaving
care services tailored to individual needs. This requires a phased reduction in the use
of residential provision. There are a number of reasons for this:
 Residential provision can lead to poorer outcomes for LAC than foster care
placements.
 There are varied levels of occupancy, in residential provision, the demand for
residential placements is reducing and there is currently a surplus of supply.
 Foster care placements are approximately a third of the cost of residential
placements.
 Smaller (no more than six bed) units are seen as best practice in supporting
children and young people.
A phased approach to the changes is taking place over a three year period, 2012 –
2015. The first phase is complete and the second and third phases are dependent on
a reduction in demand for places and the increased capacity in foster care
placements available locally. The remaining residential capacity will be remodelled to
offer more bespoke and personalised provision.
A detailed Needs Analysis of children and young people placed in residential care,
both internal and commissioned, has taken place. This was accompanied by a review
of all children who are looked after, but not subject to legal orders, demonstrated that
the profile of placement requirements remains consistent with the need to increase
the range of local foster placements.
The decommissioning of internal1 residential provision over the next two years (up to
1st April 2015) will be working towards reducing the number of beds from 102 to 35
and reducing the number of externally commissioned beds from 98 towards 35,
giving a total of approximately 70 residential beds overall.
It is proposed that the decommissioning of internal residential provision will be
implemented over three phases. Phase 1 is now complete and has reduced the
overall provision internally to 83 beds. Phase 2 is scheduled to be complete by 1st
April 2014 and will reduce provision to 59 beds. The third and final phase is
scheduled to be complete by 1st April 2015 and will reduce provision to 35 beds. The
scheduling of the phases of the decommissioning process is an indicative timeline
which has a level of flexibility and the facility to accelerate and decelerate in
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response to the changing profile of need. The phases of decommissioning are
dependent upon the reduction in demand for places and the increased capacity in
foster care placement availability. The remaining residential capacity will be reshaped
to offer more bespoke and personalised provision.
The gross savings relating to all 3 phases equates to around £6.9m, this figure is
based on current LAC demand/numbers and on a shift in placement profile from
residential to foster care.
Phase 1 of the Residential Decommissioning Plan was completed in April 2013,
which included the decommissioning of Beech and Broome House and moving to
spot purchase arrangement with a former partnership home (Mary Mount).
Critical to decommissioning residential provision is establishing a framework for
informing the decommissioning process and ensuring that the approach is
risk managed and safely delivers a reduced number of Looked After Children
and an increase in the numbers of children placed in local foster care. To support this
process the following elements are in place:
 Performance information and data which can be used to monitor the
impact of the integrated commissioning work streams which can
demonstrate that there is a range of alternative local placements to
meet need and a reduced demand for residential provision.
 Criteria which can be applied to the existing range of provision in order
to inform decommissioning decisions.
Criteria for Decommissioning Residential Provision
The following criteria will be used to inform the recommendation to decommission
children’s residential provision. The criteria provide a comprehensive framework
within which meeting the needs of children and young people is paramount.
Criteria
1. Strategically Relevant
2. Safeguarding Factors
3. Occupancy Demand
Descriptor
Score - H / M / L
Function aligned with
the LAC strategy
Specific consideration to
any safeguarding issues
which may impact on
the ability of the
resource to
safeguard vulnerable
individuals or groups.
E.G
Child Sexual
Exploitation
and Missing from Care
Data on occupancy and
the future need for the
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4. Cost
5. Location
6. Quality
7. Outcomes
Annex A - Appendix 1 - Item 7
4 March 2014
service
The cost of the provision
including comparative
unit costs
Suitability of the location
Outcome of Inspection
and other monitoring
activity
Ability to deliver
outcomes as set out in
the Statement of
Purpose and individual
placement and care
plans
Monitoring the Impact of the Integrated Strategy and Tracking Progress
In addition to monitoring improved outcomes for children and young people
through quality measures a suite of indicators have been brought together to
enable high level tracking of the impact of the strategy.
Table 1
Placement Type
End Apr 12
End Apr 13
No of LAC
No of LAC placed in foster care (internal and
commissioned excluding connected persons)
No of Internal residential placements
No of External residential placements
No of Manchester foster carers (excluding
connected persons)
1296
748
1301
792
79
98
212
66
96
216
NB. A person who is known to a child and then approved as a carer for that child is
described as Friends and Family or a Connected Person carer. Reference to Internal
and MCC residential homes refers to MCC managed and partnership homes which
are fully funded by MCC.
Table 2
Comparative Ratios
Mar-13
Apr-13
Ratio of MCC Residential to Commissioned
Residential placements
Ratio of all residential placements to foster
care placements
1 : 1.47
1 : 1.45
1 : 4.84
1 : 4.89
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Tables 1 and 2 begin to demonstrate:
 That there is an increase in the number of children placed in Foster care
 That Phase 1 of the Decommissioning Work Stream has resulted in an
increased use in foster placements and a decreased use in residential in line
with the objectives of the LAC Strategy
 There is an increase in Manchester approved foster carers
 The current analysis of need and demand confirms that Phase 2 of the
Decommissioning Work Stream can be achieved. The reduction of internal
beds in Phase 2 results in 59 beds. There are currently 66 young people in
internal placements. The evidence is that the reduction can be managed
safely and that need can be met in other types of provision.
Fig 1
Figure 1: Demonstrates the trend and impact following the decommissioning of
internal residential provision. As internal residential provision is reduced there is no
significant change in the number of external residential placements.
Phase 2 of the Decommissioning of Residential placements
Having applied the criteria for decommissioning it is being proposed that Phase 2 will
consist of the decommissioning of Lynwood an internally provided home, and
Cayside, which is an internally commissioned partnership home. It is proposed that
the decommissioning process for Lynwood and Cayside would commence in July
2013 and will be completed by Oct 2013. In addition the current analysis of need and
demand indicates that Woodlands, an internally provided home can also be
decommissioned by March 2014 as part of Phase 2.
Lynwood (Didsbury West)
Lynwood was a nine bedded home in Didsbury and in November 2013 the Councils
Executive agreed the proposal to reduce its capacity to 6. The home has struggled
over the past three years in producing good outcomes for Looked After Children. At
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its progress inspection in 2012, the home made inadequate progress and there are
ongoing issues relating to the performance of the home. Given the current position
and the number of children placed in the home we are not admitting other young
people at this time.
Cayside (Moss Side)
Cayside is a commissioned partnership home in Moss Side providing up to 6
placements. The home has proved difficult for the provider to manage due to a
number of factors relating to location and wider safeguarding issues; this has also
resulted in the home having a more restricted use than was intended. The property is
owned by the City Council. As this is a commissioned service officers will work
closely with the provider in the decommissioning process to ensure that young
people are moved to their new placements in a planned way and in accordance with
their individual care plans.
Woodland (Whalley Range)
Woodlands is a nine bedded home situated in Whalley Range. The home has
struggled with the complexities of an all male group within a building that is not fit for
purpose. Maintaining this longer term is not sustainable.
The organisation-wide discretionary (Voluntary) Severance (VS) and Voluntary Early
Retirement (VER) applications received from within the service, along with the
proposed decommissioning plan will inform a release schedule for VER and VS
applicants. Release dates will be determined by the needs of the service, therefore
ensuring there is sufficient resource in place to effectively manage remaining
provision.
Placement Plans for Children and Young People in Phase Two
Once the decommissioning processes commence the children and young people
who are residing at Lynwood, Cayside or Woodlands will not have their plans
disrupted by the closure process; their needs require that they would need a
placement change, and their plans are already being progressed and are subject to
agreement by their independent reviewing officer. As part of this process each young
person will be consulted fully and none will move until a suitable placement is
identified.
Third and final phase of the Decommissioning of Residential Placements
It is proposed that the third and final phase of decommissioning will consist of
Riverside (Didsbury West), Beech Mount (partnership home- Harpurhey), Halsbury
(partnership home- Ardwick) and Glendene (Baguely).This decommissioning would
commence in April 2014 and will be completed by March 2015. The remaining
provision will be 35 beds consisting of the Manchester Emergency Team (MET),
Acorns, Seymour, Willow Vue *Lyndene and *Olanyian (*Partnership Homes). A
further paper will be presented later in the year to outline the details of these
proposed closures in more detail.
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Given the volatility around the numbers of Looked After Children, demand from
population growth, and the possible impact of need arising from welfare reform and
the fact that all these proposals are subject to consultation with the young people, the
number and specific names of the homes due to be decommissioned in phase 3 may
be subject to change. Further information on monitoring the impact of the Strategy
will be reported quarterly to Young People and Children’s Scrutiny Committee.
Work needs to be progressed to determine what the internal residential service will
offer post 2015 (remaining 35 beds). This will work will be driven by data on needs
and trends and involve engagement with a range of partners. In addition a Regulation
33 members group is to be established to inform future development of the service.
In order to safely decommission residential provision the following Performance
Indicators will be monitored:
 Overall reduction in residential numbers (internal and external) over 2013/14.
 Increase in foster care placements (internal and external) over 2013/14. At
the end of quarter 4 12/13 there were 790 FC placements, the target for the
end of quarter 1 13/14 is 798 FC placements.
 Increase in % of placements that are FC placements. At the end of quarter 4
12/13 80% of all placements were FC placements, the target for the end of
quarter 1 is 84%.
Externally commissioned residential beds
There are currently 96 young people placed in externally commissioned residential
placements. Based on an analysis of future demands alongside the planned increase
in use of foster care it is proposed to reduce commissioned beds to 35 by 2015.
Integral to this strategy is improving the outcomes of Looked After Children. In order
to achieve this there is a commitment to move towards only placing children in
provision which is local and judged as Good or Outstanding.
Consultation and Engagement
Engagement with children, young people, staff and Trade Unions is fundamental to
the design and successful delivery of the strategy and it is a statutory requirement
that children and young people are consulted about these proposed changes. A
coordinated approach has been agreed with children and young people in care,
through the Care to Change Council. An engagement plan has been prepared that
will engage with both professionals and young people. This will be an ongoing
process, through-out the life of this project, helping to shape the strategy. As these
proposals are subject to consultation with the young people, the homes due to be
decommissioned in phase 3 may be subject to change.
Staff consultation over all three phases will take place through a series of employee
briefing sessions, which will be led by residential team managers and HROD. An in
box has already been set up to enable employees from within the service to ask
questions directly relating to the decommissioning plans and all employees will have
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access to an intranet page which will provide regular project updates.
Trade Union representatives will continue to be fully consulted about all phases of
decommissioning and will be kept updated throughout the whole process.
All children and young people directly affected by the plans will be individually
consulted about the overall proposals and will be offered support and opportunity to
give their feed back about the proposals. No young person will be moved until
suitable placements have been identified in accordance with their care plan. No
changes will take place which are not in the interests of the
individual.
A full communication plan has been drawn up covering engagement with Trade
Unions, Staff, Young People and the media.
Remodelling Residential Provision
Reshaping Residential Provision has to be set in the context of a wider
commissioning approach to supporting children and families an important part of
which is providing what could be described as out of home or care placements.
Work is underway to refresh the LAC Strategy Needs Assessment which will provide
the information needed to inform the model of residential care provided by
Manchester.
Property Issues
The future of any buildings released by the decommissioning in phases 1, 2 and 3
will be considered in the context of a wider Council Asset Management Strategy.
The first Phase of the Decommissioning Residential Plan has been implemented.
The evidence is demonstrating that this has been achieved with out the need to
increase the use of external residential provision and that the numbers in residential
care have reduced overall and the numbers in foster care have increased.
As the next phases are implemented the impact of the other work streams in the
wider LAC Strategy will further support the changing placement profile which is
needed to fully realise the objectives of the Integrated Commissioning approach.
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