Can a regionalised approach to care placements fix the broken market?
Updated: Sep 8, 2022
Laura Power-Wharton looks at the Care Review’s recommendation to create ‘Regional Care Cooperatives’ and argues that we must think differently as well as build on existing successes from regional work in children’s services. A version of this article was first published by the MJ.
The Independent Review of Children’s Social Care pulls no punches about the issues facing the market for children’s care placements: a shortage of homes in the right places, weak market oversight, exorbitant costs, and eye-watering profits for private providers.
The Review is clear that change is urgently required.
However, it says that this cannot be achieved within an already overwhelmed system and instead recommends that ‘the commissioning and running of children’s homes, recruitment and training of foster carers, must be moved into new Regional Care Cooperatives.’
What are Regional Care Cooperatives (RCCs)?
The proposed ‘Regional Care Cooperatives’ are new local authority-owned bodies that would bring together functions currently performed at a smaller scale by individual councils. It is envisaged that their roles would include:
a duty to provide sufficient social care placements in an area
running new public sector fostering, residential and secure care services
commissioning not-for-profit and private sector-provided care for children
The regional scale of these new bodies would mean a wider choice of homes for children closer to where they live, as well as enabling councils to ‘take back control’ through a better understanding of need and investment in long-term provision. The Review says that there should be 20 RCCs established by 2025.
Whilst a regional approach to care could be transformative, it is not a new concept. A recent example of regional working on a similar scale is the national programme of Regional Adoption Agencies (RAAs), which has seen local authorities joining up their services and the number of adoption services fall from 152 to 32.
So what lessons can RCCs learn from the RAA programme about the benefits and pitfalls of working regionally?
Building relationships and structures across a region takes time. The Care Review is right to be ambitious but if RCC are to be successful, the process of change needs to go at the right pace. It must allow time and space to build trust between local authorities and meaningfully engage with stakeholders, especially children and young people. The suggestion that the Government should select one or two lead Authorities within each region runs the risk of local authorities disengaging from the process and feeling as though they are being ‘done to’. This makes the suggested deadline of 2025 challenging.
Delivering short-term savings should not be the main driving force for collaboration. The starting point for change should be to improve quality and better long-term outcomes for children. Ambitious short-term cost savings are unlikely to be realistic and partners should focus on a longer term reorientation of the market, for example around a greater diversity of provision, reduction in spot purchasing and end in inter-authority competition for placements. Where early savings were identified in establishing RAAs, this didn’t necessarily result in a cashable saving but enabled improvements to be made elsewhere in the system.
Establishing an accurate budget will be key to ensure the Regional Care Cooperatives are not set up to fail. A sharp focus on getting the finance right from the outset, and strong governance processes that accommodate budgetary fluctuations, will be key to ensure RCCs are seen as ‘fair’, supported by all partners, and do not find themselves flapping around for cash to plug gaps. Disentangling budgets will not be easy given that many councils overspend on placements and may leave partners with a sense that they are winner or losers in the process.
A national programme needs to allow for regional variation. The models implemented for adoption vary significantly due to regional differences, including existing relationships and partnerships, the size and strength of adoption teams and the political environment in which they operate. Central government dictating a specific model will not cater for these differences. What was key for RAAs was that they were required to adhere to some fundamental design principles, including pooled budgets and a clear line of accountability, but were given flexibility within these parameters.
Data and processes for information sharing need to be part of the foundation of RCCs. If we are to understand sufficiency of placements within a region, data needs be shared across partners including residential homes and Independent Fostering Agencies. Digital tools can enable this, but it will only be achieved by partners trusting each other.
What is clear is that serious thought needs to be given to how RCCs are progressed, ensuring that regionalisation builds on what already exists and genuinely improves the care that children receive.
How RCCs and RAAs work together will be fundamental to this. The Review states that the functions of RAAs should be integrated into RCCs and should result in fewer than 32 entities in total. But while bringing functions together makes sense from a sufficiency and permanence perspective, we must be careful not to jeopardise the progress already made.
Some RAAs may be interested in expanding their scope into ‘Permanence Partnerships’ and others may be keen to join up with their neighbours to cover a larger geography – but there won’t be a one-size-fits-all solution. We would be cautious about changing the partnerships that RAAs have worked hard to implement before their intended benefits are fully realised.
If we are to achieve the ambition of ‘the right homes, in the right places’, and give children the loving environments they need and deserve, RCCs need to learn from existing regional approaches. This means being able to both think differently and carefully building on existing collaborations to preserve what works.
To discuss any of the issues raised in this article, or to learn how we can help you, contact firstname.lastname@example.org.
Catch up with our webinar held on 8th September 2022 exploring the idea of Regional Care Cooperatives here.