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Providers sign up to a contracting framework that makes them preferred suppliers and block contracts provide income security
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Places commissioned through the block contract are cheaper for the council while providers deliver a higher standard of care
ACTION
In little more than a decade, Plymouth has gone from having virtually no children’s residential care provision within the city to now having more than 20 beds and is seeing the benefits of local placements.
Emma Crowther, strategic commissioning manager at Plymouth City Council, says when she first joined the authority as a placement officer in 2009 there was “very little” in terms of children’s homes in Plymouth.
“There was one home that was run by an adult provider with two beds in it and we could never get Plymouth children in there because they were too complex, so all our children needing residential care went out of the city,” she says.
The council sought to improve the situation by approaching providers in the wider area.
“We worked very hard with providers based in Devon having conversations with them about this gap,” Crowther says. “A number came into the city to do a ‘soft market’ test, and all then opened homes because they knew the demand was there.”
Initially, three providers – Cambian, Phoenix Learning and Care, and Keys Group (previously known as South West Childcare) – were commissioned under the council’s Peninsular Children’s Home Framework making them preferred suppliers for children placed locally.
In 2017, the arrangements progressed further with the introduction of block contracts because, according to Crowther, “we realised we needed to give those providers more commitment as a local authority”.
“They had done a fantastic thing for us,” she adds. “We needed to take it to the next stage so they felt secure and could carry on expanding further.”
Initially, 12 beds were block contracted. That has gradually grown to 17. A further eight beds continue to be provided through the framework, meaning there are now 25 children’s residential care places within the city.
Crowther says that critical to the expansion was the way in which block contracts were divided into two “lots” – one for providers who already had homes in the city or within 20 miles, and another for providers who might be interested in opening more provision in or near to the city during the life of the contract.
“We put in place a mechanism whereby they could come and tell us what they would like to open,” says Crowther. “We share information about our needs and consider what we collectively want – whether it is in a suitable part of the city.
“It means that if we say yes to that they can go and open it in the knowledge we will put it on the block contract, so they have that security to invest in opening those homes.”
Block contract purchasing of places is not common practice among other local authorities across the country, and Crowther acknowledges there are potential downsides.
“The nervousness has always been around the fact you might end up with lots of empty beds and be paying for them,” she says.
“You do end up with some, but actually the majority of the time those beds are full.
“You have to make sure you have got the providers you can really trust, who you know are working really hard to put children into those beds and they have to trust us that we are not just shoving children in them.
“We’ve had times when beds have stood empty and that’s been fine because there’s a reason for that, whether the other child in the placement is too fragile to have a child living alongside. The providers work with us to try and bring those beds back on line as soon as possible.”
According to Crowther, Plymouth has been able to make the approach work due to the importance placed on strong relationships between providers and different parts of children’s services.
“You have to keep working at it – our contract is called Caring in Partnership to remind everyone that this goes beyond a contractual arrangement, so you have to keep working at that relationship and keeping it going and challenging each other but also sticking up for each other as well,” she says.
The director of children’s services has twice yearly online meetings with the children’s homes managers, where they can talk directly to her about their experiences or any issues.
There is also a children’s homes forum where providers, whether block contract or non-block contract, come together to meet with social work managers and the police.
Every fortnight the council has a “catch-up” with Keys Group, the main block contract supplier.
“We have contract monitoring but it’s not the traditional ‘widgety’ monitoring, it’s very conversation based, about problem solving and sharing the risk together,” Crowther says.
“It works well but relies on commitment from our social work colleagues, and managers, child and adolescent mental health services, the looked-after children nurse, and the virtual school head. They are really committed to wrapping around these providers.”
Plymouth is due to renew the block contracts this year when the current five-year contracts (an initial three years followed by two optional single-year extensions) are up.
“There are practical and emotional benefits to the arrangement,” Crowther says. “We have beds in Plymouth which are ours and we have prevented some children from having to leave the city. We have seen children go onto being fostered, or independent living, or going back to their home safely.
“They can stay at school in the city, they can stay with their CAMHS (child and adolescent mental health services) support, they can carry on seeing their friends and family, all of those practical things to help them stay here and grow up here.
“Every child we get to keep here and not send hundreds of miles away feels like an achievement.”
IMPACT
As the block contract providers have the security of knowing that beds will be paid for, they are able to offer weekly prices which are below the usual market rates. The average fee paid for beds under the block contract is £45,000 lower per child per year than placements not included in the arrangement.
Data provided by Keys Group indicates that their homes on the block contract with Plymouth are performing better than homes under other arrangements in the wider area. Of the group’s homes in Plymouth 78 per cent are rated “good” or above by Ofsted, compared with a figure of 64 per cent across the South West generally.
