Children's Residential Provider engagement
Current arrangements
The Authority currently delivers 12 children's homes (7 x 6 bed mainstream homes; 3 smaller 3 bed homes; a 4 bed Adolescent Support Unit; and a short term crisis/ reception unit). In January 2021, it was agreed that the in-house children's residential service will be reshaped and expanded to 16 children's homes:
- 3 x 4 bed Adolescent Support Units (to provide outreach support and respite residential provision for families of young people on the edge of care to prevent unnecessary entries into care);
- 36 mainstream placements in 6 x 6 bed homes;
- 15 placements in smaller homes (5 x 3 bed homes)
- 2 x short term crisis/ reception units
Regulated agency children's home placements are currently sourced via the following mechanisms:
a) Through a block contracting agreement, which has been in place since November 2019. Three providers have been commissioned to deliver a total of 24 block contract beds (8 block contract beds each - including a mix of mainstream, complex and solo placements). The number of beds delivered through the block contract agreement has the potential to be further increased (up to a maximum of 50 beds) based on need and individual provider performance.
b) Via Lancashire's Flexible Agreement, which has been in place since August 2016 and runs until August 2022. 35 residential providers with homes inside or within 20 miles of LCC boundaries are included on the Flexible Agreement. The Flexible Agreement is 'closed' meaning that new providers to the market have been unable to join. This engagement exercise is seeking provider views on what the current commissioning arrangements should be replaced with from August 2022.
c) Lancashire is also named on the Placements North West Dynamic Purchasing System (DPS), which is used to source placements not able to be found through the block contract or Lancashire Flexible Agreement.
d)Where the above options have been unable to source a placement, off contract providers are contacted and placements are spot purchased on an individual basis.
Placement analysis
The Authority made 200 children's home placements for 147 young people (aged between 9 and 17) in a 12 month period (1st December 2019 to 30th November 2020).
Age
- 48% of all children's home placements made were for young people aged 14 and 15.
- 29% were for young people aged 13 and under (14% were aged 13; 11% were aged 11 and 12; and 4% were aged 10 and under).
- 22% of placements made were for young people aged 16.
- 2% of placements were for young people aged 17.
| Age Range | Number of placements made | % of total placements |
|---|---|---|
| Aged 10 years and under | 7 | 4% |
| Aged 11-13 years | 24 | 11% |
| Aged 13 | 27 | 14% |
| Aged 14-15 years | 95 | 48% |
| Aged 16 years | 42 | 22% |
| Aged 17 years | 4 | 2% |
| Total | 200 |
Provider
- 30% of placements (60) were made into a Lancashire County Council run children's home.
- 70% of placements (140) were made with agency children's home providers (38 providers in total). 59% of agency placements made were with 8 providers (82 placements), with 23% made through block contracting arrangements (19 placements).
- 65% of the agency placements made outside of the block contract arrangements in the 12 month period were with providers on the Lancashire Flexible Agreement (79 out of 121 placements). Only 40% of the providers on the Flexible Agreement made a new placement for a Lancashire child during the twelve month period (14 out of 35).
- The majority of the remaining agency placements made (over 70%) were with providers who had not been able to apply to be part of the Flexible Agreement as they were not operational back in 2016 (30 out of 42 placements).
| Commissioning Arrangement | Number of agency placements made | % of total agency placements made |
|---|---|---|
| Block Contract | 19 | 14% |
| Lancashire Flexible Agreement | 79 | 56% |
| Spot Purchased (off contract) | 42 | 30% |
| Total | 140 |
Placement Type
- 49% of all children's home placements made were classified as 'mainstream' i.e. able to be placed in a larger (4-6 bed) home (97 placements). The remaining placements made were either into short term crisis provision, required whilst a period of assessment was undertaken or a suitable placement could be found (23 placements) or were made into a smaller sized home which could provide a higher staffing ratio or additional support/ services (80 placements).
- 39% of agency children's home placements made were into larger, more 'mainstream' provision (55 placements). 54% of agency placements were made into smaller sized homes which could provide additional support/ resources (76 placements), 13 of which were solo placements.
- 39% of short term crisis placements were made with agency providers (9 out of 23 placements).
| Placement Type | Number of total placements made | % of total placements made | Number of agency placements made |
|---|---|---|---|
| Mainstream | 97 | 49% | 55 |
| Smaller home (higher staffing ratio or additional support) | 80 | 40% | 76 |
| Short term crisis placement | 23 | 12% | 9 |
| Total | 200 | 140 |
Location
- 54% of agency children's home placements were placed in Lancashire County Council's boundaries. 40% were placed in other North West local authorities (20% in the neighbouring authorities of Blackburn with Darwen, Blackpool and Cumbria; and a further 20% in either Liverpool City Region, Greater Manchester Combined Authority area or Cheshire).
- Only 10 children's home placements made were outside of the North West region.
| Location | Number of agency placements made | % of agency placements made |
|---|---|---|
| Inside Lancashire | 74 | 54% |
| Placed in other North West Local Authorities | 56 | 40% |
| Outside of North West | 10 | 7% |
| Total | 140 |
Placement Duration
- The average duration of agency children's home placements, which ended between April and November 2020, was just under a year (339 days). The average duration of all agency children's home placements which were in place between April and up to the end of November 2020 (both current and ended) was over 14 months (435 days).
- 15% of agency placements (which ended between April-November 2020) had ended within the first month; 33% had lasted less than three months; 55% had lasted less than 6 months and 70% had ended within a year.
- 17% of agency placements (which ended between April-November 2020) had lasted between 1-2 years and 12% had lasted more than 2 years.
- 22% of all placements (both current and ended) during this time period had lasted between 1-2 years and 18% of all placements had lasted more than 2 years.
| Duration of agency placements that ended between Apr-Nov 20 | Number of agency placements | % of agency placements that ended between Apr-Nov 20 |
|---|---|---|
| 7 days or less | 4 | 4% |
| 8-14 days | 4 | 4% |
| 15-30 days | 8 | 8% |
| 31-60 days | 10 | 10% |
| 61-90 days | 9 | 9% |
| 91-180 days | 23 | 22% |
| 181-365 days | 16 | 15% |
| 1-2 years | 18 | 17% |
| 2 years+ | 13 | 12% |
| Total | 105 |
| Duration of all agency placements (current and ended) between Apr-Nov 20 | Number of agency placements | % of agency placements both current and ended |
|---|---|---|
| 0-30 days | 25 | 10% |
| 31-90 days | 36 | 14% |
| 91-180 days | 42 | 17% |
| 181-365 days | 48 | 19% |
| 1-2 years | 55 | 22% |
| 2 yrs+ | 46 | 18% |
| TOTAL | 252 |
Cost
- The average weekly cost of an agency children's home placement for a Lancashire young person has increased by almost £400 in the last 18 months.
Hard to Find Placement Searches
- 59 placement searches during 2020 were considered to be 'hard to find'. 54% of these searches resulted in an agency placement.
- 65% of 'hard to find' placement searches referenced emotional or mental health needs
- 63% of 'hard to find' placement searches referenced aggressive, threatening or violent behaviours
- 49% referenced risk of harm to other young people
- 44% of hard to find placement searches referenced self-harm behaviours
- 40% of hard to find placement searches referenced damage to property
- 36% referenced risk of child sexual exploitation
- 20% of hard to find placement searches referenced sexualised behaviours and a further 20% referenced sexually harmful behaviours.
- 15% of hard to find placement searches requested a solo placement.
Provider feedback
Please see feedback below from 3 Providers who are either on Lancashire's children's home block contract or part of Lancashire's Step Down into Fostering arrangements:
Step Down into Fostering Provider
We have a long history of working with Lancashire County Council through their Fostering Framework for general fostering and more recently working collaboratively to step young people down from residential children’s homes. The approach and attitude adopted by commissioners in the LA is a large part of what has made our work with them such a success and why we continue to invest our time and energies into an organisation that is open, transparent and realistic about what is required to work in genuine partnership with the independent sector. It's not all been smooth sailing, there have been times when we have needed to challenge each other’s thinking or highlight areas of difficulty, preventing us achieving our shared goals. The openness to overcoming these challenges together strengthened the partnership through listening and talking together, learning and supporting each other and drawing on what we can each offer only enhances what we have been able to deliver for Lancashire children and young people. For any organisation that wants to be part of real change and impact for children, in genuine collaboration and partnership with an LA, then I cannot advocate highly enough that Lancashire County Council is an LA with which to achieve this.
Children's Home Block Contract Provider
"There are lots of really positive things to say about working with Lancashire's commissioning team. Staff are always a pleasure to engage with, are truly helpful and deliver support in an efficient, friendly and professional way.
As a small provider, the relationship with Lancashire is allowing us to grow, and there is considerable support with this, including providing supportive statements for planning applications etc. There is support around helping us to understand the culture of Lancashire County Council but also helping children's social care to understand our culture, ethics and goals, which as a new provider is invaluable.
There is transparency in referrals and assistance whenever required. There is an understanding and support around group risk and we have worked well together to make the best use of our block contracted beds."
Children's Home Block Contract Provider
We are committed to close working partnerships with those local authorities who contract with us on a long term basis. We are selective as to which local authorities we enter into long term alliances with as we need to feel confident that we are able to work with any particular LA. We have turned down the opportunity to bid for a number of block contracts where we felt a mutually beneficial partnership might not work. We are therefore especially pleased with the success of our block contract with Lancashire whose desire to work in partnership is the same as our own.
We are experienced enough to recognise that such committed collaborations are only successful if both parties are responsive, transparent and have open lines of communication so any ‘bumps in the road’ can be quickly addressed in the spirit of true partnership. We have worked hard to maintain and grow the close working relationship we already had with the members of the ART team and Commissioners. Our Referral Team pride themselves on early communication of any potential problems such as placement breakdown so block bed usage is maximised.
Regular meetings at a senior level have been well established and continue to help us to develop both the block and associated Framework business with the Authority. We recognise LCC as a major partner and therefore prioritise LCC referrals in order to support sufficiency by aiming to maximise as many places in our homes in the county for young people from Lancashire.
As an organisation we are constantly learning, striving for excellence in every service we provide. We believe passionately in consistent positive development. This means developing bespoke services for partners, transparent consultation, reflection, action planning and implementation are all equally vital in our on-going commitment to service development and quality improvement.
As such we are fully committed to developing services which support Lancashire’s commissioning preferences. This approach is particularly pertinent when a long term block arrangement exists. Our block experience with Lancashire has influenced our strategy in terms of the acquisition of smaller sized properties in the region which means we can cater for more complex referrals within the county footprint and thereby improving and assisting the Authority’s sufficiency targets for local placements. We will consult with and inform Lancashire in terms of future acquisitions to ensure that our partnership continues to be successful.