- Review of Sufficiency Strategies in London
- Ellie Suh and Lisa Holmes, Rees Centre, Department of Education, University of Oxford (October 2020)
Local authority sufficiency strategies articulate how councils meet their duty to provide accommodation and support for looked-after children. This study examined the sufficiency strategies for the 33 London authorities to look at sustainability initiatives and to inform collaborative approaches across London and provides a high-level analysis on commissioning strategies across London boroughs.
Among cost and budget pressures councils identify high-cost low-incidence placements as a common cause of pressure. However, there is no clear or consistently applied definition of this terminology.
Several London councils were aware that their approach to the use of residential provision – where children considered to be difficult to place were at times “escalated” as a last resort – was a contributing factor to that increased cost pressure.
Most councils reported an increase in the numbers of older children with more complex needs coming into care. This was also identified as being a likely factor in the increasing use of higher cost placements.
Although there are common factors influencing demand across London councils, collaboration on commissioning is limited to local or sub-regional level operating through framework agreements or dynamic purchasing systems. Councils also work with similar portfolios of provider organisations; a substantial overlap in the procurement decisions and provider engagement across London authorities is evident.
Limited supply, especially in relation to residential homes for children with complex needs and requiring specific and specialist support, leads to a high cost of placement with councils' purchasing decisions being based on availability of placements rather than evidence they are effective in delivering good outcomes. Ofsted ratings of homes is the most relied-upon indicator for monitoring placement quality and children's outcomes. This leads to concerns among local authorities about quality of provision. Many London authorities found the current market environment with limited supply to be a substantial challenge for meeting their sufficiency duties.
The authors identify areas of opportunity based on this analysis. They suggest that residential care placement could be rationalised with a clearer strategic vision of how, when, and why residential care should be used. Further, there may be alternatives, perhaps family-based environments, for example fostering, that would be viable environments for some children currently placed in residential care. A review of placements to identify potential step-across to fostering opportunities, supported by in-depth assessment of children's needs is suggested by the authors with reference to similar approaches used elsewhere around the country that report positive improvement in children's outcomes and more efficient use of public resources.
Although the preference of councils for in-house, council-owned provision is clear in London sufficiency strategies, the report notes that reliance on provision from the independent sector is substantial and changing the mix of available services is not a short-term task. The need for effective procurement and market engagement is therefore clear.
Finally, the authors advocate for the establishment of a knowledge sharing system at a pan-London level. This would be needed to support a pan-London approach to commissioning that would be justified due to the concentration of the looked-after population relative to the size of the geographical area. It would be used to enhance commissioning capability and market intelligence, to collectively evaluate trends and further develop sufficiency strategies.
Implications for practice
- Rationalising the use of residential care requires strategic vision based on a clear understanding of current use of provision and exploration of alternative options.
- An increased focus on assessing children's needs is needed to improve the evaluation of effectiveness and value for money of commissioned services.
- Improved information systems in relation to pan-London activity is proposed. This would include assessment of current capacity, analysis of trends and anticipation of the impact on future demand and capacity.
- Consolidate multi-authority, sub-regional collaborations for improved cost efficiency and market engagement.
- Formulate a pan-London response to managing highly probable high-cost provisions.
- Strengthen related programmes such as early help, other integrated services for looked-after children. Look to models of developing practice elsewhere including No Wrong Door (North Yorkshire/Children's Social Care Innovation Programme).
Wider implications
Although this study was focused on London authorities, the challenges and trends described are likely to be recognised elsewhere in the country. I have previously written about the increasing fragmentation of regional commissioning efforts, which appears to head in the opposite direction to these recommendations. We recommend further study of collaborative commissioning to help to identify what works and what gets in the way of successful cross-authority commissioning.
It is also evident from our surveys of independent provider organisations that sufficiency statements are not as influential on provider strategies as perhaps may be expected. The wide variety of approaches and content of sufficiency statements is not experienced as helpful by providers looking to understand local authority strategies at a more granular level.
