Children's homes commissioning plan

Children's homes commissioning plan

1 Children’s homes commissioning plan Authors: Kirsty Barrett, Ann James and Joanna Roberts Services for children and young people

2 Contents 1. Introduction ___ 4
1.1 Background ___ 4
1.2 Outcomes ___ 5
2. Legal and policy context ___ 5
2.1 Legal framework ___ 5
2.2 National policy ___ 6
2.3 Local policy and strategic objectives ___ 7
3. Commissioning principles and process ___ 8
3.1 Enabling commissioning framework ___ 8
3.2 Outcomes based approach ___ 8
3.3 Value for money ___ 9
3.4 Equalities ___ 9
4.

Current services ___ 10
4.1 Overview ___ 10
4.2 National data comparisons ___ 10
4.3 In-house residential ___ 11
4.4 Independent residential homes ___ 14
5. Costs and benchmarking ___ 18
6. Needs analysis ___ 19
6.1 Profile of children and young people placed in children’s homes ___ 19
6.2 Placement pathways and histories ___ 21
6.3 Needs of young people in children’s homes ___ 24
6.4 Demand and forecasting ___ 25
6.5 Child in care overall trends (March 2013 ___ 27
6.6 Children’s homes placements trends ___ 30
7. Stakeholder feedback . 33

3 7.1 Views of children and young people ___ 33
7.2 Views of practitioners ___ 35
8. Research and good practice ___ 37
9. Challenges and potential for improvement ___ 41
9.1 Rising numbers and reducing budgets ___ 41
9.2 Complexity of needs ___ 42
9.3 Relationships and behaviour ___ 43
9.4 Involving children and young people ___ 44
9.5 Children who do not stay ___ 44
9.6 Moving on from children’s homes ___ 45
10. Commissioning recommendations ___ 46
10.1 Resources / budget ___ 46
10.2 Commissioning recommendations ___ 46
10.3 Options appraisal ___ 46
10.4 Indicative timetable ___ 47
Appendices Appendix 1 – Voice young people living in Bristol children’s homes Appendix 2 – Research messages: children’s homes Appendix 3 – Children’s homes research report summaries Appendix 4 – Draft outcomes matrix Appendix 5 – Equality impact assessment

4 1. Introduction 1.1 Background Bristol City Council is reviewing how it commissions placements for looked after children to make sure there are the right type of homes available for all children and young people in our care. Our objective is to commission a range of quality, local placements that achieve good outcomes for children and young people and provide value for money. To achieve this we have already done the following:  Established a new arrangement for purchasing placements from Independent Foster Agencies  Reviewed our in-house foster service to identify improvements and steps to increase the number of placements it provides  Developed a commissioning plan for specialist accommodation and support services for young people with higher support needs under which new and revised services will start from December 2013.

The other work on-going to achieve the right balance of placement types includes:  Reviewing specialist educational needs (SEN) provision in the city and developing a plan to make sure we have provision, in the right locations, that meets children’s needs. This will include consideration of what residential schools provision we need to commission.  Developing a commissioning plan for services that provide short breaks to disabled children and their families, including residential short breaks.  Consultation on this draft commissioning plan will start in December 2013.  Setting up a specialist foster service for 7-11 year olds with complex emotional difficulties and challenging behaviour1 .

Establishing a parent and child assessment scheme to provide specialist foster placements and quality parenting assessments. This plan sets out how we intend to commission children’s home placements for children and young people in care. It does not deal with the commissioning of residential placements in Registered Special Schools or residential short breaks as those will be the subject of separate plans. It also does not cover secure placements. We will consult on this plan in November and December. We will then revise the plan, taking into account consultation feedback and invite the council’s Cabinet to adopt the plan, probably in February or March 2014.

1 This will be a multi-dimensional treatment foster care (MTFC) scheme and is being partly funded by the DfE as part of the DfE’s Evidence Based Intervention Programme.

5 1.2 Outcomes Across all types of placement for looked after children, we intend to commission placements that enable children to achieve their potential by providing them with stability and supporting them to achieve positive outcomes, both short-term and long-term. We will expect placement providers to focus on the outcomes below. Be safe  Stable placements close to young people’s families  Children and young people will report that they feel safer and happier than they did six months ago  Fewer children will go missing from care  Care leavers at 19 will live in suitable accommodation Be healthy, socially engaged and a successful learner  Improved educational attainment  Fewer fixed term exclusions from school  Reduced offending and anti-social behaviour  Care leavers at age 19 will be in education, employment or training  Less problematic drug and alcohol use  More involvement in regular organised activities Be supported  Children and young people will report that they have someone to talk to about things that upset them 2.

Legal and policy context 2.1 Legal framework Registered children’s homes are covered by legislation and regulations and can only be provided to children who are in the care of the local authority. The following applies:  Children Act 1989 Part 3, ss. 20-22 set out the circumstances under which the local authority must look after a child and provide that child with accommodation. These provisions also require that local authority makes sure there is sufficient local accommodation, with foster carers and in children homes, to meet the needs of its looked after children and other children it has a duty to accommodate.

The Children's Homes Regulations 2001 (amended by the Children’s Homes (Amendment) Regulations 2011) set out how children’s homes should be managed so that they offer children reliable, safe and stable care.

6  The National Minimum Standards for Children’s Homes are issued by the Secretary of State under section 23 of the Care Standards Act 2000. Together with the Children’s Homes Regulations they form the regulatory framework for the conduct of children’s home providers. Minimum standards do not mean standardisation of provision. Instead, the standards are designed to apply to the wide variety of different types of children’s homes.

They aim to enable, rather than prevent, individual providers to develop their own particular ethos and approach based on evidence of the most appropriate way to meet the child’s needs.

Children Act 1989 Statutory Guidance and Regulations set out the functions and responsibilities of local authorities and partner agencies under Part 3 of the Children Act 1989. In particular the following volumes describe how local authorities should carry out their responsibilities to children in care and in children’s homes: o Volume 2: Care planning, placement and case review o Volume 5: Children’s Homes 2011 – Statutory guidance on the Children’s Homes Regulations 2001 (amended) o The guidance is issued under section 7 of the Local Authority Social Services Act 1970 and is addressed to local authorities but is also relevant to providers of children’s homes.

The Inspection of Children’s Homes Framework 2013 sets out the framework and guidance for the inspection of children’s homes. 2.2 National policy The Government sees rresidential care as an important placement option for looked after children, stating that ‘children’s homes need to offer young people in their care a positive, warm and caring environment so that they can flourish and achieve their potential’. In September 2010, alongside the revised regulations detailed above, it established a programme of work to support the residential care sector and encourage continuing improvements in the quality of residential care for children.

This included induction standards for those working in children’s homes and revised qualification and workforce development measures.

More recently, in response to the Report of the Office of the Children's Commissioner's inquiry into child sexual exploitation in gangs and groups, and the All Party Parliamentary Group joint inquiry report on children who go missing from care, the Government has consulted on changes to the Regulations. These changes aim to increase accountability for and oversight of decisions to place children in homes at a distance from their responsible authority and to strengthen the inspection framework for children’s homes.

In September 2013, the department for education published its second data pack on children’s homes.

Current research supports Bristol’s strategy to have local responses to children in care in so far as is reasonably practicable, including the

7 provision of sufficient children’s homes places for those whose needs cannot be met in a family placement. 2.3 Local policy and strategic objectives The council’s Children’s and Young Peoples Services is undergoing a series of changes to respond to two major challenges:  reductions in Government funding, and  the rapidly growing number of children in Bristol, more of whom are disabled and / or have special educational needs. These change activities are combined with the “Children First” programme and are focused on helping children and young people to be safe and achieve their potential.

We are working alongside our partners to make the changes.2 Our commissioning priorities are set out in the Children’s Specialist Commissioning Plan 2012-20153 . These priorities are: (i) Support children to remain safely with their families Securing sufficient accommodation requires a whole-system approach that includes early intervention and prevention services to support children in their families. We must be effective by focusing our work on those families most at risk of requiring increasing levels of service provision, including care.

(ii) Improve outcomes for children in care and care leavers Children do better in well-matched stable placements. We will build upon our trusted and confident relationship with the market to deliver an increased choice of quality placements that are able to meet the needs of our children locally. (iii) Achieve value for money and reduce spend through effective cost management We will listen to what children and families tell us is effective, and work with our partners and the market to deliver more with fewer resources. We will work both locally and regionally, on a strategic and operational level to ensure that the placements we commission deliver more effectively.

Expenditure will be controlled and monitored against delivery of outcomes. 2 Information about the Children First programme is available on the council’s website http://www.bristol.gov.uk/page/children-and-young-people/changes-children-a nd-young-peoples-serviceschildren-first 3 https://www.bristol.gov.uk/sites/default/files/documents/children_and_young _people/about_bristol_child_ and_young_people_service/Children%27s%20Specialist%20Commissioning%20Plan%2 02012-15_0.pdf

8 3. Commissioning principles and process 3.1 Enabling commissioning framework Strategic commissioning is the process by which the council identifies strategic outcomes and priorities in relation to people’s assessed needs and designs and secures appropriate services to deliver these outcomes. Services can be provided in-house or by external providers. In order to guide and standardise strategic commissioning practice, the council has developed the Enabling Commissioning Framework. This includes a comprehensive set of guidance, templates and checklists for use in all commissioning processes which will support public, private and voluntary, community and social enterprise (VCSE) organisations to better engage in commissioning processes and secure contracts.

The Enabling Commissioning Framework is based on four key elements: Analyse – understanding the service priorities, values and purpose, the needs they must address and the environment in which they operate. Plan – identifying the gaps between what is needed and what is available, and planning how these gaps will be addressed within available resources. Do – ensuring that the services needed are delivered as planned, to efficiently and effectively deliver the priorities, values and purpose set out in the commissioning plan.

Review – reviewing the delivery of services and assessing the extent to which they have achieved the purpose intended.

More information about the Enabling Commissioning Framework is available on the council’s website: http://www.bristol.gov.uk/page/enabling-commissioning 3.2 Outcomes based approach An outcomes based approach is not overly prescriptive in the specification about the services to be provided. Instead the procurement process will specify the outcomes being sought and the service users who will be eligible for services. This approach aims to support innovation but, in such a highly regulated area, there will inevitably be areas that must be subject to detailed specification and agreement about how services will be delivered.

Any procurement processes will include an assessment of whether the proposed service is likely to address the needs of relevant young people and enable them to achieve any outcomes identified (see p.2 above). The assessment will be based on evidence provided about the specific approach and its

9 appropriateness for the relevant young people. The strength of evidence base will be critical to the chance of success. Throughout the contract period, commissioners will work together with providers positively and constructively to achieve outcomes for young people using the services. The quality of services and achievement of outcomes will be evidenced through reporting processes and regular monitoring. Proposed outcomes are set out in this document. 3.3 Value for money The general duty of best value requires the council to “make arrangements to secure continuous improvement in the way in which its functions are exercised, having regard to a combination of economy, efficiency and effectiveness.”4 This means that we must consider overall value, including economic, environmental and social value, when reviewing service provision.

The aim of commissioning is therefore to achieve value for money, i.e. services that deliver the best balance between economy (cost), efficiency (degree of output) and effectiveness (outcomes and results). 3.4 Equalities This commissioning plan aims to tackle discrimination and promote equality for all groups. We have done an initial equality impact assessment that we will consult on during the consultation period (see Appendix 5). Providers will be required to demonstrate their commitment to providing an inclusive environment that is equally effective in meeting the needs of all protected characteristics.

Providers will also be required to comply with the s.149 Equality Act 2010 public sector duty to have due regard to equality objectives. Contract monitoring will include comparing outcomes for children and young people in different equality groups. We will expect providers to take action to address any significant differences for particular groups.

4 Section 3(2) Local Government Act 1999

10 4. Current services 4.1 Overview In the period April 2012 and August 2013, we had between 43 and 56 of our looked after children living a residential care each month. These included children and young people placed in children’s homes, residential schools and secure units. We looked closely into the cases of those young people living in children’s homes during the period October 2012 and April 2013, a total of 41 young people. Of these, 35 were placed in one of our council-run homes. The other six young people were placed in six different independent children’s homes.

We carried out a review of our in-house children’s homes as well as the independent homes we use regularly. The findings of those reviews are set out below. We also considered how successful we are at finding suitable, local placements for our looked after children, compared to other local authorities as well as the price we pay for placements, compared to national averages.

We concluded that our in-house services provide good value for money and give us a level of control over local services that is very important. This control means that we are able to find local children’s homes places for nearly all young people who need them. However, two of our in-house children’s homes have “adequate” Ofsted judgments and require improvement. This plan sets out other improvements we want from our in-house homes. 4.2 National data comparisons Bristol is performing well, compared to other local authorities, both in terms of placing looked after children within our local authority boundary and in the price we pay for children’s homes placements.5 See section 5 for cost comparisons.

At 31.3.12, Bristol had placed 5% of its looked after children in children’s homes compared to 7% nationally. Of those children, Bristol managed to place a higher proportion of children within its border than any other local authority in the country: 97% compared to 54% nationally. We are also successful in making best use of the homes located within our boundary -- 73% of the children living in children’s homes in our local authority area were in the care of Bristol, compared to 55% nationally. This is likely to be a reflection of the fact that a high proportion of the homes in our area are run by the council.

This gives us a high degree of control over local provision enabling us to make sure that local homes take our children, even where they may have challenging behaviour(s) or complex needs.

5 National data taken from DfE Children’s Homes Data Pack 13 September 2013

11 At 31.3.12 there were ten children’s homes in the Bristol local authority area of which six were local authority homes and four were private or voluntary homes. The majority of Bristol young people (85%) were placed in Bristol City Council children’s homes. Nationally only 28% of children’s homes places are in local authority run children’s homes. Of Bristol’s five in-house children’s homes, the latest full Ofsted reports for each home as at August 2013 show that August 2013 three (60%) were rated “good” by Ofsted and two (40%) were rated “adequate.” None were rated “outstanding” or “inadequate.” Nationally 15% of children’s homes were rated “outstanding”, 57% “good”, 24% “adequate” and 4% “inadequate.” Bristol children’s homes, with five places each, are slightly smaller than the national average for local authority children’s homes (5.8 places), but larger than the national average for private and voluntary children’s homes (4 places).

Nationally there were 101 (6%) homes registered for just one place and 239 (14%) for two places. 4.3 In-house residential Bristol City Council has five children’s homes each with five beds. One is designated as an independence training unit and tends to house older teenagers preparing to leave care and live more independently. However, older teenagers also live and prepare for greater independence in the other homes too. In April 2013 the council closed Capgrave Crescent, which was a children’s home for 11–14 year olds with the intention children and young people in the 11-13 age group should live in foster placements, not children’s homes.

Location and facilities The remaining homes are located across the city: MAP REMOVED FOR PUBLICATION The council’s children’s homes are well-maintained and generally unobtrusive in their neighbourhood. The homes have a similar range of internal spaces: including large kitchens combined with dining areas, lounges, computer/games rooms and so on. Each home has a minimum of one staff office where confidential records are kept. The young people’s bedrooms are standard single sized rooms and, with the exception of one home where each bedroom is en-suite, have shared bathroom and toilet facilities.

The focus of activity is usually the kitchen area or lounge areas. Repair and maintenance of the internal areas of the homes is both planned and responsive. The homes tend to be repaired as and when needed.

12 Below, the total spends for repairs and maintenance (both planned and responsive, including grounds), is summarised. 12/13 Spend G £12,229 H £18,425 J £12,434 K £30,029 L £17,927 TOTAL £91,044 Staffing Each house is staffed as follows: Bristol Grade Job Title FTE Posts BG12 Unit Manager 1 BG10 Ass Unit Manager 2 BG8 Residential Worker 8 BG7 Admin 1 BG1 Domestic 1 There are more female than male staff: Home % of Male Staff % of Female Staff G 29 71 H 23 77 J 31 69 K 46 54 L 23 77 Average 30.4 69.6 Quality Home Ofsted judgment (latest full report as at August 2013) Overall effectiveness comments G Good Provides good standard of care to young people.

The care each young person receives focuses on their individual needs and abilities. Young people form sound relationships with the experienced and stable staff team and the

13 Registered Manager. H Adequate The home is managed by an experienced manager and staff group. Young people form positive relationships with their staff team and the Registered Manager. Young people say they are satisfied with the quality of care that they receive and say that they feel safe and are looked after well. The improvements required relate to safety precautions in case of fire, smoking, storage of medication, checking visitors, monitoring visits, supervision of staff and improvements to the physical conditions of the home. J Good Young people receive a good quality standard of individualised care from an experienced enthusiastic and stable staff team.

Young people are very positive about the quality of care they receive and feel safe. Good role models and excellent relationships facilitate positive attachments between young people and the staff team.

K Good The home provides an excellent level of care and outcomes for young people are good. Young people speak very positively about the care and support they receive. Shortfall in the quota of care staff with a first aid qualification. L Adequate Lower levels of staff due to departures and unforeseen absence of permanent staff members. Still maintains stable and effective relationships with young people. Young people say they feel safe and well cared for. Several matters have been raised for improvement. They relate to recording of physical interventions and debriefing following incidents of physical restraint or challenging behaviour, staff supervision and appraisals, notifications, safe recruitment and vetting of staff, consultation with young people and providing the children’s guide in different languages.

14 Occupancy rates The table below shows averages for 2012-2013. Children’s home % beds allocated by unoccupied G 26% H 12% J 16% K 4% L 11% As part of this review, we have been thinking about children who have an allocated bed but who do not always stay. Can we meet those children’s needs in a different way and utilise our children’s homes for those who really need the service? 4.4 Independent residential homes National framework agreement As a sub-regional consortium, Bristol City Council, Bath & North East Somerset, Gloucestershire County Council, North Somerset Council, Wiltshire Council and South Gloucestershire, have a sub-regional framework agreement for the placement of Children and Young People in Residential Care Homes.

There are 37 providers on this agreement and children are placed using the national children’s homes contract. We spot purchase placements from providers on this agreement when they are required.

The sub-regional consortium began to use the framework agreement in February 2012. The agreement expires in January 2015, with the option of a one year extension to January 2016. Children’s homes used In the last year, Bristol children have been placed in eight independent children’s homes. The information provided by each of these homes is summarised below: Home A A is a spacious home offering high-quality accommodation and care in Bristol. It is registered to provide residential care and education for children with Autistic Spectrum Disorders, physical and emotional behavioural difficulties.

It is registered for young people from the age of 8 to 18, male and female. The approach is stated

15 as holistic and child-centred with care programmes and packages tailored to each resident's specific needs. Home B B is part of a large national provider of independent children’s homes. It is a registered children’s home for boys and girls with emotional and behavioural difficulties, between the ages of 10 and 17 upon admission but may continue to provide for young people above this age if it is part of an agreed care plan. It can accommodate up to four young people for up to 52 weeks per year, however at the time fo asking, accommodation was being restricted to two young people. Home C C is also a home delivered by a large national provider.

It is a medium to long term residential home for children and young people who require accommodation for the period of time they have to live away from their families. Although the home can cater for boys it currently specialises in providing residential care to vulnerable girls who exhibit challenging and debilitating behaviour Home D D is one home in a group of homes with education, providing a residential service for the care of up to four children and young people (boys and girls) aged between 8 and 18+ years (with a maximum five year age difference) who have a care history and who may also present with emotional, psychological, behavioural, personality or social difficulties, especially attachment disorders.

Home E E provides a residential service for two young people aged 8 years to 18 years who need to be looked after by the local authority and who require a clear and planned stable placement. As the age range implies, we acknowledge the importance of clear structured planning for young people who will eventually need to move on towards independence and the environment and supportive structures in place facilitate this effectively. E is ideally situated for those young people who require an intensively supported placement away from peer group and other adverse influences. Home F F is a residential children’s home for 11-17 year old boys and girls and provides care for five young people.

Currently, it accommodates male placements only. All young people placed exhibit social difficulties and are receiving support in addressing an underlying lack of communication skills, awareness skills or self-esteem that is contributing to these difficulties. Most of the young people at F also display forms of challenging behaviour, are very vulnerable and are placed for their own welfare. Some young people may experience other developmental delay, emotional or cognitive difficulties.

Home G G provides a specialist integrated day and residential service for children and young people between the ages of eight and 19 years who have a diagnosis of an autistic spectrum condition. Residents may attend G school or other educational provision in the locality. There are currently 22 pupils on roll, most of whom are boys. Almost all

16 pupils are in Years 8 to 13. All pupils have a diagnosis of an autistic spectrum condition and have a statement of special educational needs. Home H H is a home in Bristol that was established to provide medium to long-term care for young people who are looked after, whether on a voluntary accommodation basis or by virtue of a care order.

It provides child centred residential care for young people, enabling them to achieve their potential in a safe and stable environment. Based in the South West of England and Wales, We offer professional support to young people who often experienced neglect resulting in behavioural and emotional difficulties option.

Geographical spread of out of authority providers used: MAP REMOVED FOR PUBLICATION Quality Home Ofsted judgment (latest full report as at August 2013) Overall effectiveness comments A Good The standard of care provided at the home is strong with good robust recording systems in place. Good personalised care ensures young people feel valued and are treated as individuals. Staff are valued and demonstrate a good understanding of safe working practices. Young people confirm they feel safe and happy at the home and bullying is not an issue. B Good Young people make good progress in relation to their starting point on admission to the home in all aspects of their care, well-being and education Young People have a committed, effective, stable staff team who are appropriately trained and proactive at meeting the needs of the young people.

Young people are happy at the home and support the staff Leadership at the home is strong and the manager is aware and understands the areas which require further development C Good The service has a positive impact on developing

17 young people’s personal development, physical and emotional health. Each young person is valued, treated fairly and is supported to reach their full potential. Approach to behaviour management has helped develop young people’s personal control and anger management; this results in good relationships and decreasing incidents of risktaking behaviour.

The home is well organised and managed, and strengthened with an experienced and competent care team. D Good This home provides an excellent quality of care to young people, who are at the centre of all that the home does. Care is delivered in a highly personalised way which meets young people's needs and enables them to make good progress and stay safe. This totally child-centred approach is led by the very hands-on manager, and determines everyday living in the home. There are some shortfalls in relation to monitoring, training, supervision and appraisal. These are particularly relevant as the home is poised to admit new young people and recruit new staff.

E Good Good - Young people progress well at this home because they receive personalised and wellplanned care.

Young people, staff and a social worker were very complimentary about the standards of care in the home. Young people say they feel safe and secure in the home. Leaders and managers understand the strengths and areas for development of the home and have plans in place. F Good Taken from School Inspection (ESTYN, Wales), as no residential inspection found (CSSIW also do not ‘grade’ on first inspections, which this would have been). Behaviour is managed well; and proprietor ensures that C&YP have access to a wide range of appropriate specialist support services. G Adequate Adequate - In July 2012, the full inspection of the home judged its overall effectiveness to be good and did not identify any problems.

This interim inspection found that the home has made satisfactory progress since then, because it has maintained the quality of care and outcomes for young people.

Since the homes last full inspection Ofsted

18 agreed to a minor variation to its categories of registration to reflect that it is currently a home for children with learning disabilities as well as emotional or behavioural difficulties. H Good Good - Young people living in this home benefit greatly from enthusiastic, committed and experienced staff. Outcomes for young people are outstanding because staff are persevering and energetically supportive. Young people confirm that their views are genuinely sought and acted upon. Educational needs are very well met with young people making extraordinary progress.

5. Costs and benchmarking Costs of children’s home placements The average gross weekly unit costs set out below are the total cost of the placement including SEN and NHS contributions. The net costs to social care exclude those SEN and NHS contributions.

The average price Bristol pays for children’s homes placements is relatively low compared to the national average6 . We pay £2,361 per week for a place in one of our local authority children’s homes, whereas the national average cost of a local authority placement is £4,135. For independent children’s homes placements, BCC pays an average of £3,271, whereas the average nationally for independent homes is £3,800. The weekly net cost we pay in Bristol for a council children’s home place (£2,361 excluding management costs and costs of buildings repairs and maintenance) is broadly similar to that of the “care only” cost we pay for an independent children’s home placement (£2,473).

Placement type Average gross weekly unit cost Average net cost to social care BCC children’s home £2,361 £2,3617 BCC placements with independent children’s home (with no SEN funding)8 £3,131 £3,131 BCC placements with independent children’s home (with lower level of SEN £2,865 £2,352 6 The Bristol OOA calculations exclude two very costly placements of over £6,000 per week. 7 Unit cost calculated for 2011-12. There are also repairs and maintenance costs of c.£58/week and management costs of c.£45/week – these should be added to provide a true total cost per unit. 8 Averages calculated from payments made in February 2013

19 funding, £1,058 of less)9 BCC placements – average of all independent children’s home placements10 £3,271 £2,473 Local authority children’s home - national11 £4,135 NA Private / voluntary children’s home - national12 £3,800 NA BCC foster care (excluding kinship)13 £403 £403 BCC placements with independent foster agencies (IFAs)14 £756 £756 6. Needs analysis 6.1 Profile of children and young people placed in children’s homes We considered the information we held about all young people we had placed in children’s homes as at October 2012, to get a snapshot. At this time there were 41 young people placed in children’s homes (including in-house and out of authority placements, but excluding those placed in residential special schools).

We have compared the local data with national data contained in the Children’s Home Data Pack published on 13 September 2013 by the Department for Education. Demographics All the young people we had placed in children’s homes were aged 13 or more. The ages of the children are set out in the graph below. The mode (the age that appears most often) is 15 years, which is the same as the mode nationally for children living in children’s homes.

Overall, 54% of the young people were boys and 46% girls. Nationally, 63% of children’s homes residents are male. The majority, 71%, of the young people were of 9 As above 10 As above 11 Source: Children’s Homes Data Pack, DfE 13 th September 2013 12 As above 13 Unit cost calculated for 2011-2012 14 Unit cost for April-July 2013 taken from A30 IFA analysis CHIPS report

20 White British descent and 29% were non-white British. This broadly reflects the proportions in the Bristol child population. Race No. of young people Any Other Black Background 1 Black - Sudanese 1 Black African 1 Black/Black British/Somali 1 Caribbean 2 Other - Afghan 1 Other - Iranian 1 White & Black African 1 White and Black Caribbean 3 White British 29 Total 41 90% of the young people in residential care spoke English as their first language.

First language No. of young people Arabic 1 English 37 Farsi 1 Pashto 1 Somali 1 Total 41 Disabilities and SEN 24% of the young people in residential care had a diagnosed disability as follows: Disability No. of young people Autism/Asperger’s 2 Behaviour difficulties 2 Hearing impairment 1 Learning difficulties 4 Unspecified disability 1 Total 10 39% of the young people had a Statement of Special Educational Need (SEN) or a Statutory Assessment for SEN underway. The vast majority of the young people’s SEN category was Behavioural, Emotional and Social Difficulties (BESD).

21 6.2 Placement pathways and histories Reason for entry into care The majority (56%) of young people placed in children’s homes entered care as a result of abuse or neglect. Entry into Care Code Description No. of young people N1 Abuse or Neglect 23 N2 Child's Disability 0 N3 Parental Illness or Disability 1 N4 Family in Acute Stress 2 N5 Family Dysfunction 8 N6 Socially Unacceptable Behaviour 4 N7 Low Income 0 N8 Absent Parenting 3 None Unknown 0 Age at entry into care Analysis of all children in care at 31.10.12 shows that of young people living in Bristol children’s homes and semi-independent supported accommodation, over three quarters were aged 11 or over when they first came into care: Age in years % of young people 0-5 6% 6-10 17% 11-15 42% 16 and over 35%

22 Previous placement Over one third of the young people in children’s homes previous placement was another children’s home. Over one quarter were previously placed with foster carers. Slightly less than a quarter moved from their family home to a children’s home. Code Previous Placement Type No. of young people % of young people FP Relative or friend in LA boundary 1 2.4% From Home 9 21.9% H5 Residential Accommodation 1 2.4% K1 Secure Unit 1 2.4% K2 Children’s Homes & Hostels 15 36.6% P1 Placed with own Parents 1 2.4% Q2 Placement with Foster Carer 11 26.8% R1 Residential Care Home 1 2.4% R5 Young Offenders Institution or Prison 1 2.4% TOTAL 41 Placement stability The table below shows the number of placements for each young person as at October 2012.

The young person with 6+ placements had a total of seven placements, three in secure units, two in residential care homes, one in a children’s home and one with the NHS. National data suggest that Bristol placing a young person in a children’s home is used more as a last resort compared to the national picture. This is consistent with our policy of placing children and young people in a family setting wherever possible.

Number of Placements % of BCC young people % Nationally 1 14.6% 29% 2 19.5% 25% 3 12.2% 15% 4-5 24.4% 16% 6+ 29.3% 15% Placement duration Of those placed in Bristol children’s homes, 51% of placements lasted longer than one year. The following pie chart shows the duration of the placements within Bristol

23 Children’s Homes up to June 2013. As at this date, the majority of children and young people (32.5%) had been in a children’s home placement for 0-6 months. Duration % of young people 0-6 months 32.5% 6-12 months 22.5% 12-18 months 12.5% 18-24 months 20% 2-3 years 5% < 3 years 7.5% Move on placements The pie chart that follows shows where young people moved on to from their children’s home placement.

24 The highest percentage (35%) of young people moved on to independent living with formalised support (i.e. supported accommodation with Youth Projects or 1625 Independent People). Four young people moved on to a foster placement with a relative or friend, but no young people moved on to unrelated foster care. 6.3 Needs of young people in children’s homes Range of needs and presenting behaviours The case files of young people in Bristol children’s homes identifies that they have a range of needs and behaviours including: Possible sexual exploitation Drug and alcohol use Offending Running away and sleeping rough Violence, anger and verbal abuse directed at others Victim of violence (parental and from others) Witness of violence including domestic violence Possible sexual assault Potential to harm younger children Poor mental health, anxiety, emotional instability Obsessive tendencies, including a fascination with blades Experience emotional, physical and/or sexual abuse Low self confidence Vulnerable Personality disorder Feeling unsafe and overwhelmed Findings from research See Appendices 2 and 3 for more details.

Our research review indicates that generally young people in children’s homes in the UK are getting older, with 14-15 years old now being the typical age. Local authorities report that there has recently been a growth in complex needs, and that more young people now need specialist support. The young people in children’s homes tend to have more severe attachment issues following multiple breakdowns of previous placements and significant emotional, social and behavioural difficulties. They were six times more likely to have mental health problems compared to other looked after children, and three quarters were reported to have been violent or aggressive in the past six months, with the same proportion reported to have put

25 themselves at risk. Children in children’s homes were also more likely to have low levels of educational attainment compared to their peers. Some young people preferred to live in a children’s home and actively rejected foster care. There may be a number of reasons for this, most often related to attachment difficulties of some sort but also a desire to display loyalty to their own parents or previous negative experiences of being fostered. 6.4 Demand and forecasting Population projections by broad age band The Bristol population of children aged 0-5 years increased significantly between 2000 and 2012 as shown in the graph below.

Projections indicate that numbers in the 5-11 year age band will continue to increase significantly. However, the numbers in the 12-18 age band are not projected to increase until around 2018 (see graph below). As this is the age group that tends to be placed in children’s homes, we do not expect an increase in demand for children’s homes places to result from population increases in the next five years. However, we will continue to monitor this and revise our forecast projections as appropriate.

26 General children in care population The past year has seen the number of children in care in Bristol rise from 685 to 720, an increase of 5% compared to a 2% increase nationally.

Bristol’s child in care population has grown more rapidly in recent years, catching up with the national average in terms of rate of increase. It is helpful to look at the rate per 10,000 as detailed in the table below which shows that Bristol’s rate has not changed significantly over the past five years whereas the national rate has increased by 9% and by 6% amongst statistical neighbours. It is worth noting that Bristol’s rate is still relatively high and when compared to the Core Cities the rate per 10,000 has grown in the face of a reducing average. Children in care per 10,000 at 31st March15 2009 2010 2011 2012 2013 % change Bristol number of children in care 650 645 680 685 720 +11% Bristol rate per 10,000 of the under 18 population 82 80 84 78 82 0% 15 Taken from DfE Statistical First Release data in September 2011 for years 2009-2011; in September 2012 for 2012 and in September 2013 for 2013.

27 Statistical neighbours average rate per 10,000 72 77 79 77 76 +6% Core cities average rate per 10,000 92 97 96 88 88 -4% England average rate per 10,000 55 58 59 59 60 +9% The table below shows how Bristol is ranked in comparison to the rate per 10,000 of both Core Cities and Statistical neighbours. In addition to the demographics of the city, a number of factors have influenced this changing pattern including changes to the statutory framework, case law decisions, the outcome of recent Serious Case Reviews and potentially the impact of welfare reform, given that there is a close correlation between deprivation and referrals to social care, including children entering care.

6.5 Child in care overall trends (March 2013) Length of care: The number of children looked after for more than 12 months increased slightly from 484 in 2012 to 495 – a rise of 2%. Entry and exit: In 2012/13, 299 children entered care during the year and 269 left care (a net gain of 30). This is a 10% increase in the number of children entering care, compared to 2011/12. Adoptions and SGOs: In 2012/13, 9.3% of the population exited care with either an adoption order (23 children) or Special Guardianship Order (31 children). As this is a new indicator, we are unable to report on the trend compared to the previous year.

Age: The composition of the children in care population by age has not changed significantly over the past year. It is the oldest age group of 16 and 17 year olds that Year Bristol Number of children in care Bristol rate per 10,000 National Average Rate per 10,000 Ranked against Statistical Neighbours (rank 1 to 11) Ranked against Core Cities (rank 1 to 8) 2009 650 82 55 2nd 7th 2010 645 80 59 4th 6th 2011 680 84 59 4th 6th 2012 685 78 59 5th 6th 2013 720 82 60 3rd 6th

28 has seen the greatest change over a longer period but has not changed significantly with the 2011/12 figure. The proportion of children in care aged under twelve months has fallen slightly, while the proportion of children in care aged 5 – 9 has increased slightly. It is the oldest age group (16 and 17 year olds) which has seen the greatest change, with a one-third increase between 2009 and 2013. Bristol has a higher percentage of Looked After Children aged 10-17 than the England average. Gender: At 31 March 2013 the ratio of girls to boys in the children in care population was 49.5% to 50.5% respectively, very similar to the ratio in 2012.

This compares with the national average in 2012 of 56% boys and 44% girls. There has been a steady increase since 2009 in the number of girls looked after in the age bands 10- 15 and 16-17.

Legal status: 64% of children in care are subject to either an interim or full Care Order, slightly higher than the national average of 59% and above the average of 52% for local authorities in the South West. A lower percentage of children are accommodated on a voluntarily basis under Section 20 of the Children Act 1989. Ethnicity: The pattern of ethnicity of the Bristol children in care population is largely unchanged over the past year. In comparison with the Bristol Schools Census of January 2013, children in care at 31 March 2013 were slightly more likely to be white and slightly less likely to be Asian.

Placement types: The percentage of children living with Bristol foster carers (including kinship) has increased from 53% in 2012 to 59% in 2013, and the percentage of children living in fostering agency placements reduced from 25% to 22%. This is in line with Bristol’s stated placement strategy. Similarly to 2012, 10% of children in 2013 lived children’s homes or residential special schools.

29 Place type 2009 % 2010 % 2011 % 2012 % 2013 % Children's home 21 3% 28 4% 35 5% 33 5% 41 6% FC in Bristol (Agency) 25 4% 37 6% 55 8% 58 9% 62 9% FC in Bristol (LA) 180 28% 202 31% 205 30% 201 29% 239 34% FC outside Bristol (Agency) 75 12% 86 13% 83 12% 93 14% 91 13% FC outside Bristol (LA) 102 16% 99 15% 88 13% 98 14% 94 13% FC rel / friend in Bristol 74 12% 64 10% 56 8% 53 8% 62 9% FC rel / friend outside Bristol 21 3% 18 3% 17 3% 25 4% 14 2% Hostel 15 2% 7 1% 11 2% 22 3% 12 2% Independent living 5 1% 6 1% 21 3% 11 2% 8 1% Other 36 6% 25 4% 36 5% 21 3% 29 4% Parents 37 6% 23 4% 16 2% 19 3% 13 2% Placed for Adoption 28 4% 23 4% 37 5% 26 4% 28 4% Residential School 15 2% 16 2% 12 2% 18 3% 17 2% Secure unit 5 1% 8 1% 1 0% 4 1% 1 0% Total 639 642 673 682 711 Distance from home: Of children newly looked after in the twelve months up to March 2013, 95% were placed within 20 miles of their home address.

This compares to 96% in 2012 and outperforms the 2012 national average of 84%. Placement stability: Bristol’s performance in terms of placement stability, both number of moves and long-term stability has remained fairly static over the past several years and is in line with the performance of Bristol’s statistical neighbours. Given that placement stability is such a key predictor of future outcomes for children, it is an area where Bristol wants to improve its performance as a way to both

30 optimise children’s life chances and contain placement costs16 . This table shows a slight improvement in performance compared to last year’s performance. Key Indicator (definitions at end of report) Annual Target Q1 2012-13 Q4 2012-13 Q1 2013-14 Progress Q1 to Q1 Stat Neigh 2011-12 England 2011-12 OPI401 (NI62) Stability of placement of looked after children: number of moves 10.5% 10.9% 77/704 9.6% 69 / 719 9.1% 66/724 10% 11% CY263 (NI 63) Stability of placement of looked after children: length of placement 72% 68.7% 171/249 71.4% 165/231 71.7% 167/233 70% 68% 6.6 Children’s homes placements trends In the last 18 months there has been a small decrease in the rate of placements into children’s homes.

The following graph shows that the number of placements into children’s homes since April 2012 appears to have decreased slightly in 2013 and has remained at about 43 since May 2013.17 The data is not included for November 2012 to February 2013 and for April 2013 as the introduction of a new case management system lead to some inconsistencies in data recording in this period. 10 20 30 40 50 60 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Total residential placements 16 See Demos Report: In Loco Parentis. Hannon, Bazalgette and Wood, 2010 and Loughborough university’s work on the Cost Calculator for Children’s Services 17 These figures are taken from BCC CYPS social care monthly briefings and are likely to be slightly inflated because they include some placements wrongly identified as residential.

Numbers include all placements in Bristol residential and non-Bristol residential excluding those made by the Care & After Team (which are unlikely to be placements into children’s homes).

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