Agenda item

Report of the Director of Children’s Services. To be introduced by the Cabinet Member for Children, Schools, and Families.

 

Recommendation for the formation of a (PLV) Pan-London Vehicle for Commissioning which will bring local authorities together in a new jointly owned legal vehicle to plan and commission provision for London children.

The Cabinet Member for Children, Schools, and Families introduced the report which made a recommendation for the formation of a (PLV) Pan-London Vehicle for Commissioning which would bring local authorities together in a new jointly owned legal vehicle to plan and commission provision for London children.

 

The Cabinet Member highlighted the national and London wide shortage of Children’s Home provision for children and young people with very high complex needs with local authorities currently facing weekly costs, per individual, ranging from £10k to £50k. London Councils had been working for several years to develop these proposals for this complex cohort which would be provided in London and would help children and young people stay local to their families.

 

This provision would be jointly owned by London authorities and they would share the risks and benefits.

 

The Cabinet Member added that the DFE were providing the £50m for establishing this provision and £3m for compiling the final business case.

 

London boroughs would each contribute £20k per year for the first 5 years but the benefit of this provision to children and families would far exceed the investments.

 

In response to questions from Cllr Hakata and Cllr Connor, the following information was provided.

 

-       With regards to the confidence in the proposed governance arrangements: the Cabinet Member referred to appendix 1, which contained the legal structure and the membership of the vehicle. The Cabinet Member further highlighted that this vehicle would be a company limited by guarantee, which safeguarded against the potential for insolvency. It was noted that these arrangements could further enable other provision, aimed at supporting small cohorts of particular complex vulnerable, children, and young people, to be added to this model and, overall, this public sector model was helping meet a London wide local authority need.

 

-       That over 20 local authorities across London were currently taking a similar report through their Cabinets. The final number of local authorities opting into this agreement would be fully known at the end of the financial year. Once the sign up was complete, this would inform who was on the governing board.

 

-       The Director for Children’s Services advised that the calculated number of 20 places that would be provided at this future provision was reasonable.

 

Cllr Connor would be provided with a written response on weekly unit costs for secure placements.

 

RESOLVED

 

 

1. To agree that Haringey Council becomes a member of a not-for-profit company, limited by guarantee, provisionally to be known as the Pan London Vehicle, to develop and then oversee the running of London’s secure children’s home provision for a five-year period from 1^st April 2023 to 31^st March 2028, with a breakpoint after three years.

 

2. To note that by the three-year breakpoint period, the refreshed business case will have been developed as well as the service pricing structure, commissioning approach, operating model, practice model and the SCH’s location will have been confirmed.

 

3. To note that once the PLV has launched, membership of the PLV will be at a fixed annual cost of £20K (subject to inflation adjustment), unless an alternative model for funding the PLV, that does not require annual subscription, is agreed by members during the development phase and

 

4. To agree to collaborate with other PLV members on future joint commissioning Programmes.

 

5. To commit in principle to joint oversight and risk/benefit sharing of the secure children’s home provision, through the PLV, for a five-year period to 31^st March 2028 (with three-year break point), that includes the build, service development and service commissioning phases; and

 

6. To note that the commitment in paragraph 2 shall be subject to ratification after the revision of the SCH business case; and shall be renewable on a ten yearly cycle thereafter, with breakpoint after five years.

 

7. To delegate authority to Director Children’s Services, after consultation with the Director of Finance, the Lead Member with the relevant portfolio responsibilities, and the Council’s Monitoring Officer:

 

8. To agree the final legal documents required to set up, join and run the PLV and enter into all the legal agreements, contracts and other documents on behalf of the Council required to implement and run any aspect of the PLV arrangements up until the three-year breakpoint period; and

 

9. To note that in advance of this first break point this matter shall be reported to Cabinet for its further consideration.

 

Reasons for decision

 

Children with particularly complex needs, including those who are at significant risk of causing harm to themselves or others, including risk to life, can be placed in a secure children’s home when no other type of placement would keep them safe. Children placed in SCHs are likely to have experienced a number of placements that have broken down, missed a lot of education, have unmet emotional and physical health needs and have suffered a great deal of trauma in their lives. SCHs provide a safe place where these very vulnerable children can receive the care, education and support that they need. A secure children’s home is a locked environment, where their liberty is restricted, and they are supported through trauma aware and psychologically informed integrated care, health and educational services.

 

Across London, a relatively small number of children require a secure welfare placement, which is very high-cost provision and despite their complex needs, these children are often placed the furthest from their home local authorities, an average distance of 192 miles, which impacts detrimentally on children who lose contact with family and the community. Additionally, the loss of local contacts and pathways in education, training and employment has a negative impact on their development post-placement.

 

Further, there is a national shortage of provision and places are often not available when referrals are made so children are then placed in less suitable but higher cost alternatives. This shortfall in provision is particularly acute in London where there is not any Secure Provision – over three years London referred 295 children to Secure Provision but only 159 received places. The majority of requests (72%) are for children from Black and Minority Ethnic groups, well in excess of the London comparable profile of 41%. The current arrangements are exacerbating poorer outcomes for this group and racial disparities.

 

Pan-London analysis pre-Covid (eight-month period October 2017 to May 2018) highlighted that an average of 21 London children were in Secure Welfare provision at any one time.

 

Snapshot data taken at the end of each month, in the period between December 2021 and September 2022 shows that there is, on average, 12 of London’s children in a secure welfare placement at the end of each month – this includes 3 children each month who are living in a secure welfare provision in Scotland - over 450 miles away. Although this looks like a fall in numbers compared to pre-Covid, in the same period, the data shows that 29 referrals were made but a placement was not offered. In a September 2022 survey, London local authorities reported that due to the known shortage of provision, they often do not make a formal referral at all. This indicates that the national shortage of provision is impacting even more of London’s children than the data suggests.

 

Of a sample of 50 ‘alternative to secure’ placements reported in a September 2022 survey, 17 related to children with a deprivation of liberty order in place. Instead of being placed in a secure children’s home, as required by the court order, these children were placed in settings that are not specifically designed to keep them safe and 10 of these placements were in unregulated settings or in provisions that are not legally registered to operate as a children’s home. This means these vulnerable children would be at risk of not receiving the care, education and support that they needed.

 

Financial data provided by London local authorities in the September 22 survey shows that the average cost of a secure welfare placement has increased; the average being £7K per week in 2019, rising to £10.5K per week in 2022 and some local authorities have paid up to £25K per week for secure welfare placements in that period. In the same period, local authorities have also paid up to £30K per week for placements made as an alternative to secure.

 

The numbers of children are too small, and the investment required too great for any one local authority to run its own provision, but there is potential for a pan-London approach, which would enable the benefits to be shared whilst also jointly managing the risks of developing such provision. A pan-London approach also fits with recent reports from the Competition and Markets Authority (https://www.gov.uk/government/publications/childrens-social-caremarket-study-final-report/final-report) and the Independent Review of Children’s Social Care (https://childrenssocialcare.independent-review.uk/) which recommended multi-authority approaches to develop greater understanding of need, engage with the market and stimulate new provision.

 

The need for provision was also highlighted through Her Majesty’s Chief Inspector’s Annual Report to Parliament (2020) which stated –

 

The national capacity of Secure Children’s Homes remains a significant concern, with approximately 20 children awaiting a placement on any given day and the same number are placed in Scottish secure units. This increases pressure to use unregulated provision. Provision is not always in the right place, so that some children are placed a long way from their home and family.

 

The Association of London Directors of Children’s Services (ALDCS), working with NHS England and the Mayor’s Office for Policing and Crime (MOPAC) commissioned a review in 2018 of the use of Secure Children’s Homes by London’s children and young people. This review provided detailed evidence of the need for provision in London, which has informed this report.

 

There is also a shortfall of high-cost low incidence provision in London, estimated as at least 225 places, which drives up costs resulting in overspends across London local authorities which exceed £100 million. The Competition and Markets Authority highlighted the lack of suitable local provision nationally, but particularly in London citing – ‘lack of placements of the right kind, in the right place…materially higher prices…and providers carrying very high levels of debt.’

 

Alternative options considered

 

The Association of London Directors of Children’s Services (ALDCS), London Councils, NHS and London Innovation and Improvement Alliance (LIIA) have expressed unanimous support for the development of secure children’s home provision and developed a business case for secure children’s home provision in London. This business case has formed the basis of a successful bid to Department for Education and funding has been allocated to develop the required provision for London children.

 

As well as ALDCS members, a range of stakeholders were engaged throughout the development of the business case including:

 

London Councils’ Executive, Leaders’ Committee and Lead Members;

·         Society of London Treasurers;

·         Local authorities (children’s social care and youth offending teams);

·         Central government (Department for Education, the Mayor’s Office for Policing and Crime, OFSTED, Ministry of Justice);

·         Clinical experts and practitioners within the field of children’s services and health;

·         Third sector organisations delivering children’s services and

·         Children and young people with lived experience of SCH.

 

The proposed provision will be designed specifically for London, with purpose-built accommodation. This will reduce the risk of beds needing to be held vacant after a high-risk child is placed there in order to maintain a safe environment. The provision is being designed with co-located step-down facilities with wrap-around support, which is an innovative approach to supporting the children post-placement. This will enable a smoother transition and a return to the family or to the most appropriate long-term placement that will meet the child's needs. This will also prevent use of emergency placements following a 72-hour placement in secure, when the local authority may not have enough time to identify best next placement or prepare child and family for safe return home. This can lead to placement breakdowns or return to care, which incur avoidable costs and impact detrimentally on outcomes for the child.

 

The business case to address the need for Secure Welfare Provision, considered a range of options as listed below –

·         Do nothing

·         One small Secure Children’s Home (8-12 places)

·         One large Secure Children’s Home (20-24 places)

·         Two small Secure Children’s Homes (8-12 places each)

·         Enhancing existing resource

·         Specialised community team

·         Step-down facility

·         Specialised open facility

 

These were evaluated through stakeholder engagement and assessment against the following criteria –

 

Impact on early intervention and prevention

·         Accessibility of a secure placement

·         Continuity of care and relationships

·         Care and education in the placement

·         Transition from secure to community

·         Value for money

·         Initial investment

·         Deliverability

 

This options analysis has led to the recommendation for Secure Welfare Children’s Homes provision for London with capacity for 24 placements, alongside facilities for step-down accommodation and support to support the children after placement. The key reasons are summarised below –

·         Provision for 24 places would meet the demand in London

·         Step-down provision would enable better exit planning and work to take place to support children and young people within the community, reducing the likelihood of repeat placements in secure welfare

·         Step-down facilities will enable more holistic support to be provided to prevent unnecessary transitions into secure provision for children and young people on the edge of a secure placement

 

The following options were rejected for the reasons given:

·         Enhancing existing resource - rejected due to the complexity of allocating resource to disparate CAMHS, social care and YOT teams across London and the lack of a joined-up approach across London.

·         Specialised community team - rejected due to the risk of duplicating the role of Community Forensic CAMHS teams and fragmenting care pathways.

 

In February 2022, DfE confirmed the funding to take a proposal forward for Secure Children’s Home provision in London with 24 places, alongside stepdown provision. The step-down provision will provide for much improved transition after placement. Over £3 million has been allocated for development, with capital of over £50+ million expected subject to completion of the development phase. The development funding is currently being held by the London Borough of Barnet on behalf of all London local authorities. DfE is reviewing progress against gateway milestones, one of which is the commitment of local authorities in London. This report seeks that commitment.

 

The DfE development grant will cover the PLV’s costs during the development period, therefore local authorities will not be required to make a financial contribution to the running of the PLV until the SCH provision launches. During this development phase, PLV members will work collaboratively to agree how the SCH provision will be run and managed. This includes:

·         developing and approving the pricing strategy and revenue model for generating financial income;

·         developing the practice model and operating model including but not limited to:

• the approach to working with children, young people and their families,
• safeguarding and risk management arrangements,
• quality assurance arrangements,
• the commissioning approach / staffing model,
• the process for managing referrals and placement allocation.

·         Inputting into and approving a refreshed business case which will

• revisit and update the ‘case for change’,
• provide up to date and well-developed costings, informed by the final model of practice and operating model,
• identify the benefits that will be delivered by the new model (financial and non-financial),
• consider the most suitable route for appointing a service provider.

 

During the development period, member local authorities will also explore alternative models for covering the cost of running the PLV that does not require annual subscription.