Commissioning: Social care placements

Years ago I secured a post managing a placements team for a local authority. There was a requirement that the team had to search for placements in the council’s own care services before we sought permission to search in the independent sector.

On one occasion we were asked to find a home for a child with complex needs who attended a local special school as a day pupil. The request was sent out to our council foster carers and we were pleased to find a carer able to meet his specific communication needs. The problem however, was that despite still fostering for the authority, she had moved 40 miles away to a different local authority area. With no time left to consider alternative options, I was instructed to make the placement.

Several months later an independent provider shared information about a carer who could have met the child’s needs well. It transpired that the carer lived less than a mile from the child’s school and had been available at the time the child had been accommodated.

The child had to endure two hours of travel each day to get to school, he wasn’t seeing his family as regularly as he wanted and his social time with his friends had reduced. All because of the way we looked for placements. That simply wasn’t good enough for me.

It took me several months to persuade decision makers to allow the team to pilot a “level playing field” approach to placement finding where we could look at both options in the councils own services and in the independent sector at the same time. We successfully argued that finding the best match was the best way to meet children’s needs and that the team needed timely access to a wide choice of placements to do this.

Over the following two years we saw better matches, improved stability, a reduction in the use of emergency placements and social workers in the looked-after children’s team reported that they had more capacity. The knock-on effect for the council’s own in-house fostering service was that it went on to receive an “outstanding” Ofsted judgment.

There is widespread dispute about “in-house first” policies. In his 2018 review of foster care, Sir Martin Narey referred to the policy as “entirely sensible”. I’d argue the review did not delve into this area deeply enough.

If all potential options have been considered and both the local authority and an independent provider can equally meet a child’s needs, then it is understandable that a local authority would choose to place the child in their own services. However, if all potential options have not been considered, the local authority cannot be assured that it has identified the best available match for the child.

The debate is not new – over the past two decades, there have been numerous references to the need for a level playing field (see below).

Despite the call to improve access to a choice of care placements, a significant number of authorities continue to restrict initial searches to care services they run.

We are however, starting to see some shift in policy and practice. For example, Lancashire County Council says its adoption of a level playing field approach to placement finding has “led to a significant reduction in the number of hard-to-find fostering placements per month”.

Regardless of whether there is a shortage or excess of care placements, a key principle has to be that our policies and procedures ensure the right decisions can be made for individual children. It’s hard to argue that a level playing field is not in the best interests of children. It would improve matching, which would improve stability and that, in turn, will deliver the much-needed efficiencies for the public purse. It is also likely that improved stability would have a positive impact on the morale of carers and contribute to reducing high carer turnover, building much-needed capacity in residential and foster care. We need to see strategic commissioning better informed by good social work practice, and that means coming from a position whereby meeting the needs of individual children is paramount.

In the forthcoming review of social care, it would be good to see local authority placement procedures independently reviewed, and better consultation with care-experienced people regarding their views on placement choice and what difference this would likely have made to their lives.

PAST ATTEMPTS TO LEVEL THE PLAYING FIELD

• 2003 – The Choice Protects Partnership referred to the need for local authorities to introduce systems that increased the choice of placements.
• 2004 – PricewaterhouseCoopers described the lack of a level playing field as “an economic barrier”, stating in 2006 that the need to address this was “paramount”.
• 2006 – Lord Laming’s Placements Working Group highlights the need for a “level playing field”.
• 2010 – Thinktank Policy Exchange says moving to a level playing field would “allow for greater choice for children from the beginning of their time in care”.
• 2010 – Then children and families minister Tim Loughton, speaking in parliament, calls for a level playing field, adding: “What is important is what the best and most appropriate outcome is for a child”.

Marie Tucker is a social care consultant