Contact: Graham Wright, ext 7263

1 Summary

1.1 The Best Value Review of Looked after Children (LAC) Services covers nine different services that together provide a range of support for looked after children. As at 31^st March 2001, there were 945 children `looked after' full-time by Hampshire County Council.

1.2 In 2000/01, the budget for the Children and Families sector was £32 million with an actual spend of £34 million, i.e. a net overspend of £2 million. The actual overspend for LAC services for 2000/01 was approximately £3 million.

1.3 It was agreed that, rather than reviewing each service individually, six key issues, identified in the scoping report, would be examined to develop options for improvement. As a result of this, six Issue Groups were formed as follows - Care Placements, Staffing, Finance, Communication, Management Information and Consistency.

1.4 LAC services need to be seen in the wider context of the assessment of need of vulnerable children and families in Hampshire, and the ways in which preventative and support services for children in need (CIN) are to be developed over the coming years. Best Value Reviews of Children in Need in the Community and of services for Children with Disabilities (CWD) are scheduled over the next two years, and will complement the current review. To that extent it has been necessary to limit the scope of the LAC Best Value Review.

1.5 A review leader and two project managers have managed the review. A review team consisting of internal and external stakeholders has met on a monthly basis since the beginning of the review. Prior to producing the scoping report, two stakeholder workshops, (one internal and one external) were held to identify issues and a challenge group was set up from the external stakeholders participating. The challenge group has also met monthly to ensure that challenge was integral to the review.

1.6 The four C's of Best Value: challenge, compare, compete and consult have been addressed mainly in the six issue groups. The issue groups undertook a number of exercises which; challenged the way services are delivered, compared performance across areas and with other local authorities, consulted with children, parents, other agencies and other local authorities and examined the internal and external market.

1.7 The review findings identify that the department performs well when measured against some of the national Performance Indicators. However significant efforts will be required to reach those standards where we fall below the average. Particular issues have been identified that require specific recommendations for improvement. The main issues are centred upon care placements and the workforce.

1.8 A number of options were developed based on the findings and presented to the Social Care Policy Review Committee (PRC). The options ranged from delivering no services to Looked After Children to making radical changes to the services. It was agreed at the PRC that options that would lead to improvements at no additional cost and at additional cost should be `worked up' into the improvement plan.

1.9 In the improvement plan, which is attached as Appendix A, there are six main outcomes for the services that should enable children to achieve maximum life chances and to be securely placed with carers capable of providing safe and effective care for the duration of their childhood. These outcomes were derived from the overall results of the exercises undertaken as part of the review and the national Quality Protects objectives. Each outcome has a series of recommendations for action ranging from developing a strategy for `Family and Friends care' to appointing additional reviewing managers to undertake statutory reviews.

1.10 The recommendations for action should enable LAC services to improve outcomes for children and meet the expected national standards.

1.11 The original Best Value review project brief is attached as Appendix B.

2 The Service under Review

2.1 A `looked after child' is a child who, following an assessment of need and in order to protect the child and to safeguard and promote his/her welfare under the 1989 Children Act, Section 20, has been provided with accommodation by the local authority or where, under Section 31 of the same Act, the court has made an order placing a child in the care of the local authority. Children become looked after for a number of reasons including abuse, abandonment, beyond parental control, loss of a parent or where the local authority agrees with the parent that it would be in the child's best interests to become looked after. The Best Value Review of Looked after Children Services covers nine different services that together provide a range of support for looked after children.

2.2 Those services are:

Foster Care

Family Link

Residential Care

Adoption

Family Centres

Care Management

Adolescent Support

Commissioning

Care Leavers Support

2.3 The total number of looked after children, in March 2001, was 1139 including children receiving respite care and 945 excluding respite care. The total budget in 2000/2001 for all children's services was £32 million, with a projected overspend at the time of £2 million. The split between the spend on Looked after Children's Services and Children in the Community Services requires further investigation because budget allocation is not determined in that way.

2.4 Current estimates suggest that £17m is spent on LAC, representing 53% of the C&F budget. Added to this is a further £1.5m for looked after children with disabilities - a further 5%, totalling 58%. Included in these figures are the estimated costs of fieldwork for LAC.

2.5 Total numbers of the staffing establishment across all sectors in the department stood at 3,410 full time equivalents (FTE) in February 2001. Of these, approximately 800 FTE work in the child care sector. Approximately 30 staff work in Headquarters including 10 staff in the Commissioning Team. There are 65 Team and Unit Managers. Approximately 200 staff work in the child care field work teams. These staff will be working with both looked after children and children in the community. 164 staff work in residential homes for children including respite care homes. Approximately 100 staff work in Family Centres and the remaining 300 work in a variety of settings including the Youth Offending Teams, the Family Placement teams, the Early Years Teams and Disability teams.

2.6 The Children and Families sector is being remodelled and a new staff structure has been produced which is attached in Appendix C.

3 The Review Process

3.1 The members of the review team were as follows:

Graham Wright	Review Leader
Mamie Branthwaite	Project Manager
Angela Harris	Project Manager
Phil Thwaites	Health
John Heath	Education
Duncan Savage	Best Value Corporate team
Maureen Edwards	Social Services
Jo Littlemore	Staff representative
Helena Datta	Independent sector
Paul Chambers	Finance

3.2 The review team met regularly on a monthly basis from March 2001 to the present and will continue to meet until February 2002. Councillors were allocated to the review prior to the election and were invited to attend a review team meeting. After the election and the introduction of the new cabinet structure the councillors allocated to the review changed.

3.3 Two stakeholder meetings, one internal and one external, were held in April and May 2001. The Excellence model was used to identify the areas for improvement across the services. The results of those meetings helped to determine the scoping report and it was decided that the review would focus on specific issues rather than particular services. Attendees at the external stakeholder meeting were invited to attend a challenge group.

3.4 The challenge group was then set up, facilitated by the project managers and composed of representatives from users, carers, other agencies and the independent sector. The members of the group were as follows:

Emily Joslin	Care Action Team
Rob Ericsson	Care Action Team
Deborah Hobbs	Carer
Sue Salter	Voluntary Sector
Helena Datta	Independent Sector and representative on the review team
Dawn Couzens	Foster Carer
Mary Mullix	Health

A representative from the NSPCC and Education were invited but were unable to attend.

3.5 The challenge group met monthly from June 2001 to the present. The challenge group discussed and challenged the review process throughout the review. They were given the same information as the review team and were able to influence the direction of the review and comment on the outcomes identified by the review.

3.6 The scoping report went to the Best Value Panel in May 2001 and it was agreed by councillors that there would be six issue groups to take forward the review with the review team steering the issue groups.

3.7 The six issue groups were Finance, Staffing, Care Placements, Communication, Consistency and Management Information. They were chaired by members of the review team and the Social Services Children and Families strategic managers.

3.8 The issue groups met from July to September 2001 and their findings were reported to the review team. Their findings were the basis of the options appraisal report that was taken to the Policy Review Committee in camera on 16^th November. Their reports taken altogether with the work of the challenge group cover the four `C's and the themes of Sustainability, Crime and Disorder, E-Government and Equalities.

3.9 Results of the review exercises

3.9.1 CHALLENGE

3.9.2 The challenge group influenced the review process. They assisted the review team in identifying the issue groups and helped to formulate the terms of reference for those groups. They also were part of some of the issue groups and were involved in the consultation exercises.

3.9.3 In terms of challenging the aims of the services, the Quality Protects initiative lays down the overall objectives for looked after children and therefore it is incumbent on these services to try to meet the objectives set out in Quality Protects. Similarly the reasons why the services exist are laid down by statute. We are required to provide accommodation for looked after children and we are required to look after children where the courts direct that we should or where we consider it to be in the child's best interests to do so. However the type of accommodation i.e. care placements and how we decide whether it is in the child's interests, which is based on competent staff's judgement and interpretation of the law are more open to challenge.

3.9.4 The biggest challenges therefore have come in the areas of care placement and staffing. In terms of care placements, the issue group for care placements challenged the way we presently deliver services. For family placement, there is a problem in recruiting and retaining in-house foster carers. Hampshire does not pay as much in allowances as the Independent Fostering agencies (IFAs) nor does it provide the same level of support to foster carers as some of the Independent Fostering agencies. Our in-house unit costs are lower than external unit costs. However this is partly because we are not paying as much and partly because some independent foster carers get more support, which costs more. Additionally, at present we spot purchase almost all our external foster care, albeit some are under service level agreements. If more family placements were block purchased or in the form of flexible contracts, the unit cost would reduce as this could give a percentage reduction in the fees that we pay to an independent agency.

3.9.5 For residential services, the challenge has been to look at the residential strategy and assess whether it will meet the needs of looked after children who require accommodation in a residential setting. Initially it appeared that in-house residential unit costs were much higher than external residential services. This led to a discussion about whether it would therefore be more cost effective if residential services were purchased externally. However after more work trying to compare like with like, it would seem that if children with disabilities residential services are not included in unit costs then the unit costs internally and externally are still at variance but it would be precipitous to suggest that externalising services would be more cost effective. More work needs to be done in this area including more comparisons on outcomes for looked after children.

3.9.6 The care placement issue group also looked at where children were placed and very few are placed with Family and Friends carers although research shows that children do better in those placements.

3.9.7 The second important issue is staffing. It was found in the staffing issue group that the Children and Families sector had a much higher sickness level than average in Social Services, low morale and a high vacancy rate. The sickness level in the children and families sector as compared with the average for Social Services as a whole is 12 days average per year compared with 8.4 days. A Mori poll of Social Services staff in 2000, showed that 56% of staff felt morale was low or poor and only 4% of staff at SO1 grade, which includes main grade social workers, expressed job satisfaction. The vacancy rate in Children and Families sector was at 38% during the summer 2001. A major challenge for the sector is to improve recruitment and retention and ensure that staffing levels are sufficient to improve the outcomes for looked after children.

3.9.8 Another challenge within staffing is in relation to training of staff. There is a problem about releasing staff to attend training, either to sign up for courses or once nominated unable to attend due to pressure of work. At present results from exit questionnaires show that 70% of staff felt that they did receive adequate training although 47% felt that promotion and opportunities were not adequate. The National Training Strategy has set specific qualification targets for all social care and social work staff including the post qualifying child care award for all social workers and the NVQ4 for managers. As a result pressure on training will increase and there is concern about ensuring that Hampshire has enough qualified and trained staff in the future.

3.9.9 There is a further challenge about staffing relating to communication with staff. In the 2000 MORI poll 64% of staff felt that communication was poor. While 83% of staff felt that there first line managers were interested in them, 69% felt that senior managers were not in touch.

3.9.10 Communication with users is also challenging for Social Services. The issue group on Communication found that the voice of the child is not coming through meaningfully and that work with users is fragmented and piecemeal.

3.9.11 The consultations of staff, users, parents, carers and partner agencies also provided challenges to the way the services are delivered. Generally the consultations show that children and parents do not feel sufficiently involved in the planning of individual care packages for children or in the overall planning of services.

3.9.12 The Management Information issue group challenged the lack of management information policy or procedure. Although there is a recording procedure, compliance in recording is not high. Only 64% of Essential Information Records (Part 2) forms are complete. Only 15% of Care leavers data is available. Only 40% of staff felt confident to check accuracy of data on CCMS. A new software package is being developed at present which should help to improve compliance and accuracy but it is essential that once there are improvements in data recording, the management information derived from the data is actively used in the planning process.

3.9.13 CONSULT

3.9.14 Consultation is a key part of the Governments wider modernisation agenda for public services and also links into the commitment of the County Council to involve users and carers in developing and planning services as well as all other stakeholders. It also reflects the commitment to community and citizenship and is fundamental to Best Value.

3.9.15 The key groups for consultation were Staff, Looked After Children and their Parents/Relatives/Carers and other professionals working in Children's Services. A Communication Group was set up comprising of managers and staff working within the Department as well as an independent sector provider manager and a member of the Care Action Team. The group examined what consultation/communication was already happening and then undertook a series of consultation exercises within the review. The findings from these sources would form the basis of the recommendations for improvement.

3.9.16 Consultation processes incorporated into the review

3.9.17 Current Consultation/Links with other work

Staff Consultation exercises outside the review were used to inform on communication issues and the climate within the organisation . Findings from the MORI poll and the remodelling consultation exercise were incorporated into the findings.

For Looked After Children recent work had been undertaken by the Quality Protects officer and the Complaints officer visiting the majority of our Children's Homes and circulating a questionnaire to Looked After Children to highlight use of the complaints process. An evaluation of the Reviewing Systems for Looked After Children undertaken in April 2001 was also considered as well as work on individual consultation within Family Group Conferences. A report was produced by the Care Action Team (CAT) on progress at local area level to listen and hear young people's issues. The Family and Friends Kinship Care Project work undertook an extensive consultation exercise with children, carers and social workers and those key findings were incorporated into the review.

3.9.18 Consultation within the Review

A series of internal and external stakeholder events were held prior to scoping and key issues for improvement emerged regarding communication and consultation.

A survey was undertaken for staff working in the Children and Families sector and at the same time review team members visited teams in the local areas to gain direct feedback . A telephone survey was undertaken in the New Forest area.

A Consultation Event was held on the 22^nd September 2001 attended by 40 Looked After Children from across the County. The objectives of the Event were to give Looked After Children an opportunity to participate in the review, to hear their voice and for them to express what being in care means for them. At the same time it provided an opportunity to consult with children and young people on how to make the complaints process more accessible. Elected members attended and participated in the day.

A telephone survey of 19 parents/relatives was undertaken to find out their involvement in the review process and care planning and how information is shared and how they are involved in the decisions making process .

17 partner agencies across the County incorporating Health, Education, private and voluntary sector organisations were contacted by telephone to ascertain their view on the way Social Services communicate information in order to enable them to contribute effectively to the welfare of children in the care system and to identify what would improve communication and joint working in service developments.

3.9.19 Results of Consultation

3.9.20 Staff

Overall, staff reported that communication is poor, with a lack of involvement and information sharing. Morale is low and there is a feeling of not being valued by senior managers.

3.9.21 Looked After Children.

User consultation has not yet been embedded in the mainstream of policy or practice in the department and children and young people are not effectively involved in key decision making processes that affect them. However individual consultation in Family Group Conferences give an opportunity for greater involvement in decisions, deliver the concept of partnership and improve information sharing and communication.

3.9.22 Children expressed a need for more information about their placements, the range of services/support available, and that they should be consulted about how information is presented to them and that information should be in an appropriate format to meet their needs. They feel inadequately prepared for reviews, the paperwork is inadequate and there is a lack of clarity over the purpose of the review. The parents interviewed also expressed dissatisfaction over the lack of commitment to reviews by Social Workers, and they also sought more information about their rights and responsibilities.

3.9.23 The Consultation Event was well received and confirmed that there are Looked After Children who welcome the opportunity to meet other LAC and utilise a range of media to express their views. The two keys issues which surfaced as being common to a number of children were of bullying in the residential homes and having to share a bedroom in a foster care placement. The personal nature of some of the concerns raised firmly highlights the importance of reviews in looking at issues relevant to individual children.

3.9.24 The role of the CAT team in getting social workers to understand what it is like to be in care through training days for social workers by CAT members are beneficial. What was highlighted was the importance of listening to children and to act on what they are saying.

3.9.25 In more general terms the consultation within the Family and Friends Carers project highlighted; lack of information, lack of knowledge about Family and Friends care and lack of wider family participation with children not being involved in their care planning and relatives not treated as valued partners as issues for improvement.

3.9.26 Partner agencies indicated inconsistent information, lack of procedures, staffing levels and not enough joint working and joint training as areas for improvement. The importance of evidenced based practice, staff morale, shared information, greater consistency and involvement of users and carers in service planning were raised throughout the review.

3.9.27 COMPARE

3.9.28 There are a large number of performance indicators nationally for Looked After Children services. Hampshire's current performance on all the relevant indicators is shown in the conclusion but in terms of comparison, three indicators were chosen. They reflect; the key outcomes for children of stability and having clear care plans, and also key issues that were identified in the stakeholder meetings about care placements and consistency. They were also indicators that have been collected for more than one year and therefore can show performance over time. The indicators are short term stability, long term stability and reviews being held on time.

3.9.29 Long term stability does not include children placed with parents. Hampshire does have a high number of children on care orders who have been placed with their parents for more than two years. If these were included in the long term stability figures the results would be quite different. However, there is a strong argument for not including them, as if children have been with their parents for more than two years it is highly debatable whether they should still be looked after and the fact that they are suggests that there may be some work that should be done to end their care orders. Finally all the data on the indicators has to be treated with caution in terms of accuracy.

3.9.30 In terms of consistency, those indicators were compared across areas and the results for September 2001 are shown below.

3.9.31 As the results show there is a wide variation across the county and this effects the overall Hampshire result.

3.9.32 The same indicators have also been compared over time as follows:

3.9.33 The above results show that for the performance indicator on short term stability we have deteriorated slightly and while we are performing well on this indicator we cannot be complacent. For longer term stability which we needed to improve, there has been a small increase but we must do more to ensure that placements are stable and that children are placed in appropriate placements that are supported sufficiently to prevent breakdown. For reviews completed on time, we must improve considerably and at present the results are not showing the required improvement.

3.9.34 Finally we come to comparisons with other local authorities as shown below:

3.9.35 For short term stability Hampshire is clearly performing well and slightly above the national average and shire county average. For longer term stability Hampshire is not performing as well as other local authorities and needs to improve. For completing reviews on time Hampshire is under performing quite considerably and needs to address this urgently.

3.9.36 The review looked at other local authorities in relation to the Best Value reviews they have conducted and how they communicated with users and staff. 12 councils were contacted and most were in the process of reviewing but three responded with information about their reviews.

3.9.37 Kensington and Chelsea used external consultants for their review and they felt the independence was useful. They have identified similar issues to this review in their review as regards care placements, unit costs, contracting and communication with staff. Lewisham have been using questionnaires with children and young people and they have been looking at ways to make consultation more meaningful. Bromley surveyed its looked after children and found a dissatisfaction with the review process and the need to promote a culture of user consultation amongst social workers. This has resulted in a web service called `Chatoline' which is integrated into the Council's website. It should improve access to information and social work teams to enable users to participate in new ways.

3.9.37 COMPETE

3.9.38 Significant responsibilities fall to a local authority when a child or young person becomes `looked after' which form statutory duties of care. These include care planning, monitoring and reviewing; tasks which cannot be carried out by other providers. In that sense there is no direct element of competition.Aspects of a local authority's responsibilities which are open to elements of competition include most significantly that of care placements.

3.9.38 Securing appropriate care placements is a critical factor in the achievement of good outcomes for looked after children. In common with other local authorities Hampshire Social Services operates in a mixed economy of care placement provision.

3.9.39 For the purposes of the Review these fall into `internal' and `external'. Internal provision for family placement is through Hampshire County Council Social Services own directly recruited and managed foster parents, whilst a range of operators (not-for-profit, voluntary, private, charitable and religious organisations) known collectively as IFAs make up the external provision.

In similar fashion, residential care is provided as an internal service by Social Services' own group of (currently ten) locally based children's homes (LBCHs), whilst a wide range of operators make up the external provision.

The size and extent of this mixed economy of care placements is considerable, both in terms of numbers of children looked after and expenditure.

3.9.40 In general terms, at any one time there are over 500 children placed with Hampshire County Council Social Services foster parents i.e. `internal' and 70 with IFAs ie. external provision.

Regarding residential care, some 75 children are in Hampshire's units, with some 122 Children in external provision, of which 28 are funded wholly by Social Services.¹

The group of approximately 90 children placed in external residential care who are jointly funded are in the main appropriately placed and this group who have a range of profound disabilities will be part of the forthcoming Children with Disabilities Best Value review.

It is the group of 28 children in external residential placements which form the most appropriate comparison for unit cost purposes with those in Hampshire's own residential care.

In terms of numbers of children placed in foster care, by far the larger percentage is with the Social Services Department's direct provision (up to 90%). For those in residential care the position is again one where internal provision is greater, though not to the same extent i.e. approximately 60 % are in internal residential care.

3.9.41 Factors to be taken into account in determining the relative merits of the different providers within these mixed economies of care, include appropriacy, quality, reliability, distance, delivery of care plan objectives, and cost.

Unit costs are an essential benchmark in terms of determining best value. Unit costs are reported by the Social Services Department to the Department of Health as part of central government's Performance Assessment Framework (PAF). The PAF performance indicators represent residential care unit costs overall i.e. amalgamating internal and external services and to that extent do not assist comparison; the same system is used for foster care unit costs.

There have been continuing difficulties in achieving the necessary clarity of cost and activity data, such that crucial information in describing the nature of competition in the mixed economy on the necessary `like for like' basis is neither routinely available nor reliable. This in turn militates against being able to propose significant shifts in the existing use of care placement provision. Whilst further work needs to be carried out in order to reliably inform the strategic direction of foster care and residential care, both in their relative use and between internal and external provision, it has now been possible to develop some comparative data on a `like for like' basis which assists an assessment of the competitiveness of the internal and external sectors.

The tables below describe the position for residential care and for foster care in terms of unit costs.

Residential

NB: 28 children in external residential placement not joint funded. 16 of the 28 have a disability. The table does not include any jointly funded placements.

Foster Care

66 children in external foster care not joint funded. 18 of the 66 have a disability.

3.9.42 It has generally been assumed that the use of external residential care is more expensive that its internal counterpart. However an analysis of those placements funded solely by Social Services in the independent sector challenges this assumption and exposes the often `hidden' costs involved in providing residential care `in-house', caused for example by variable occupancy rates, staff sickness and agency costs, special care programmes to support difficult or disturbed residents. At its most extreme the analysis reveals that internal residential provision can cost more than 30 % of its external counterpart.

There remains a range of factors which need to be taken into account and `costed' in a general sense in order to be able to arrive at a considered determination of the relative competitiveness of internal and external provision. These factors include location of unit relative to child's community, costs of social work transport and travelling time, quality of care, workforce matters (e.g. staff to resident ratio, experience, qualifications, training and development, reliability, cover), flexibility and responsiveness to crisis.

The revised in-house residential care strategy, which has been devised by the Social Services Department and awaits implementation, needs to be evaluated in this context of competition overall, and to include the type of provision and outcomes as well as numbers of places.

3.9.43 It has been generally assumed that external foster care (IFAs) are more costly than Hampshire's own provision and the degree to which this is true is born out by the unit costs analysis. On the face of it an IFA place costs up to 66 % more than its in-house equivalent.

3.9.44 Two significant factors characterise the foster care market, which have been experienced to a greater or lesser extent by all local authorities: the increasing difficulty in recruiting and retaining foster parents to in-house services and the increase in the use of the independent sector. There has also been an associated rise in the numbers of children and young people with profound emotional disturbances and challenging or disruptive behaviour who require foster care. It is becoming increasingly accepted that the link between the first two characteristics are not necessarily causally linked; in other words in-house foster parents leaving are not in the main the ones being recruited by the IFAs.

3.9.45 Hampshire's experience is reflected in a recent national survey of IFAs by The Centre for Research on the Child & Family at UEA. Significant factors from the survey include:-

· 60% of the IFAs reviewed were established in the three years between 1996 and 1998 at a time when local authorities had increasing difficulties in (their own) foster care recruitment.

· 60% of IFAs employed social workers who were appointed directly from local authority Social Services teams.

· Five times as many foster carers joined rather than left the IFAs in a 12 month period.

· 33% of the IFAs foster carers came from a local authority and a further 50% had no previous fostering experience.

· In general, rather than IFAs being seen as `poachers' from local authorities, they could be seen as `rearers' of foster carers.

· Many people in the IFAs had given up their "day job" as social workers, teachers, nurses, counsellors and youth workers to become foster carers. There is a connection between relevant work experience and maintaining good quality placements.

· Whilst IFAs increasingly develop a specialist service profile or `niche', strong evidence exists of IFAs being used predominantly for teenagers alone and in emergencies where no local authority internal placement was available. Such a pattern is considered suggestive of crisis driven, poorly resourced local authorities.

3.9.46 In terms of developing a better understanding of the implications of the comparative unit costs, at least three factors are significant and will influence an interpretation of best value.

· The weekly fees paid by Hampshire (the unit cost) are within the national mean average. Most IFAs pay their foster carers about 50% of the total fees charged to local authorities ie. about £100 per week more than Hampshire foster parents receive, even taking into account any future uplift to 100% NFCA rates.

· IFAs provide their foster carers with round the clock support, with respite care and training.

· IFAs typically make available additional health, education and other specialist therapies and support as part of the service.

· IFAs provide currently a necessary, well-resourced and competent service for a small number of Hampshire's looked after children, the high cost of which in absolute terms needs to be subject to a more in-depth analysis, and the implications for the recruitment, retention and development of Hampshire's own foster care service seriously considered.

3.9.47 Contracting

It is acknowledged that contracting policy and practice is poorly developed in the Children & Families sector compared to Adults and Older Persons. This is both illustrated and compounded by the lack of a dedicated Contract Officer and Support Services resource.

All external residential care placements, including those funded on a shared basis, are arranged as a `spot purchase'. There are historically no standard contracts with the independent sector which are used uniformly. There has been little or no formal monitoring of contracts aside from the statutory care planning and case-holding responsibilities.

In the external foster care sector up to 40% of the placements benefit from a discount accruing from limited block purchase and service level agreement arrangements with some of the providers.

Whilst it is clear that a `sellers' market' has developed in both the external residential and foster care sectors, there is still opportunity for a purchaser of the size of Hampshire to exert influence in terms of price, flexibility and range of services included.

The establishment of dedicated contract support could be self-funding over time, as well as developing the `intelligent purchasing' most needed in an organisation the size and complexity of Hampshire. It has not been possible for Hampshire and neighbours in the southern region to implement the regional standard contract developed through the Association of Directors of Social Services (ADSS). It would be both viable and possible for the department to implement this alone, although with reduced benefits.

3.10 Supplementary issues

3.11 Sustainability

The review team involved the Environmental Challenge Team in the review process and attended workshops on Sustainable Development. At the centre of Sustainable Development is the concept of ensuring a better quality of life for Looked After Children by creating a more inclusive society.

The key themes for Looked After Children's Services are Social Inclusion, Travel and Transport, Improving Health and Social Well Being ,Purchasing and Procurement and Community Cooperation. Crime and Disorder is dealt with separately.

3.11.1 Social Inclusion

The review has highlighted the need to expand user and carer involvement and consultation and has set out details in the Improvement Plan to assist in this.

An objective in the Quality Protects Management Action Plan Year 4 is to ensure that children in need gain the maximum life chance benefits from educational opportunities. Hampshire's current performance indicator for Care Leavers Educational Attainment for 2000/01 - % young people leaving care with at least 1 GCSE is 62.6% compared with England's Average of 36.8%.

Key elements of the LAC Strategy highlight the need to develop adolescent support services to reduce the number of children being looked after and the length of time children remain in the care system.

3.11.2 Travel and Transport

Hampshire's current performance that relates to number of children placed more than 20 miles from the Council area is 83 compared to an average of 46 for England.

3.11.3 Improving Health and Social Well Being.

One of the Quality Protects objectives is to ensure Looked After Children gain maximum life benefits from Health Care. The performance indicator average % with Health items is 17.3% for Hampshire, compared to 65% for England.

By involving Health colleagues in the stakeholder events, the review team and challenge group the review has sought to promote a partnership approach to ensure improved working relationships and sharing of information.

3.11.4 Purchasing and Procurement

It has been identified within the Review that issues of managing and influencing the market have a significant impact for the local economy as well as enabling there to be a range and choice of services available for Looked After Children. Improvements in contracting and contract monitoring would make it possible, through more strategic commissioning, to improve sustainability within the mixed economy of care.

3.11.5 Community Cooperation

The review has involved and consulted with a diverse range of stakeholders to ensure their contribution to service improvements.

3.12 Crime and Disorder

3.12.1 In the County Council's Crime and Disorder Strategy there are six policy aims. The review specifically addresses three of these aims:

To minimise school exclusions, truancy, and under-performance by measures  including encouragement and support for learning

To divert young people away from crime and the risk of crime.

To deal effectively and speedily with young offenders.

3.12.2 The PAF performance indicator C24 looks at the proportion of Looked After Children who have missed 25 days or more of schooling during the school year. In 2000/01, the percentage was 8.5 compared with the national average of 12.1. The interim figure for September 2001 for Hampshire is 5.6%. This is clearly a very positive reduction. A number of initiatives that have been developed over recent months may have contributed to this including the development in Social Services of Adolescent Support services, which will be incorporated into the family support teams after remodelling, the mentoring scheme for care leavers, the introduction of Personal Education Plans (PEPs) and the development of the Behaviour Intervention Teams within Education and supported by Social Services.

3.12.3 The PAF performance indicator C18 looks at the percentage of children aged 10 and over who have been given a final warning/caution or convicted during the year for an offence committed while they were looked after. This is expressed as a ratio of all children in Hampshire, aged 10 and over, given a final warning or conviction. In March 2000, the figure for Hampshire was 15% (ratio of 5.76:1). This has reduced to a ratio of 3:1 in September 2001. This is a significant reduction and brings Hampshire more into line with the national average in England of 3:1 in March 2001. However this particular indicator is the subject of a Public Service Agreement (PSA) bid. The aim of the bid is to reduce the target even lower to a ratio of 2.3:1. If Hampshire is successful in the bid, the Government will award Hampshire a special grant.

3.12.4 A recent audit showed that in relation to offending levels a disproportionate number of children are in residential homes and that for children placed with foster carers, the offending levels are significantly lower. Hampshire Social Services have worked in partnership with the National Children's Homes on a scheme offering a foster care service to young people remanded from courts. Outcomes in relation to re-offending are very positive for young people placed in the scheme. Under the PSA bid the current scheme would be extended to provide 8 extra beds. The issue of the high number of children offending in residential homes will be addressed in the residential strategy.

3.12.5 The PSA bid will have an effect not only on diverting children away from crime but also of dealing more speedily with offenders and reduce re-offending.

3.13 E-government

3.13.1 The issue group on Management Information linked into the Corporate IT strategy on the development of the new Social Services software package (SCIS).

3.13.2 The development of this system could assist in the process of shared protocols for exchange of information with our partners, which would aid joined up working and the development of a partnership culture.

3.13.3 Improvements in organisational flexibilities can be gained through the improved use of information technology; the development of Social Services Direct and the opportunity for users and carers to access services on line are being developed.

3.13.4 The widening of the use of information technology by Looked After Children could improve communication and increase involvement of this hard to reach group. Several local authorities have developed the use of interactive programmes and are developing web services integrated into the local authority's website. There is a specific amount of funding available in the Quality Protects Year 4 MAP for improvements in the use of information technology for Looked After Children and Hampshire will be developing this resource through more computer terminals being available, training programmes and website development.

3.14 Equalities

3.14.1 The Best Value Review is linked into the Corporate Equalities Strategy and the review involved the Corporate Equalities Officer in highlighting issues.

3.14.2 The Staffing issues group identified that there is a need to improve how staff are treated with regard to fairness and equity; this includes the issue of consistency of practice across teams, areas and the county with regard to implementation of policy and procedures. These issues will be addressed through the department's remodelling which aims to improve communication, consistency, involvement and through implementation of the Workforce Plan aid improvements in standards and skills.

3.14.3 Issues of inequalities within the Hampshire Foster Care Service have been highlighted with regard to the comparison in fees and support given by Independent Foster Care Agencies which reflect poorly on the in house service.

3.14.4 In order to promote equality it is necessary to make information available in a range of formats in the most appropriate way, in order to help hard to reach groups such as Looked After Children, and increase involvement and participation. The review linked into the Quality Protects objectives i.e. 90% attendance of Looked After Children at reviews, 90% aware of the complaints procedure and also identified the development of a range of consultation processes for Looked After Children. This included a regular consultation event.

3.14.5 The ratio of the % of Looked After Children to the % of the total population from ethnic minorities for Hampshire is 2.2:1 and for England 1.9:1. Hampshire needs to examine the way in which it consults with children and young people from black and ethnic minority groups and to improve its recording of ethnicity.

3.14.6 Information for parents needs to be improved as does their participation and involvement in reviews. Support for the Family Group Conference model can improve the promotion of full participation by families in decisions regarding their children and in the planning and evaluation of services.

4 Member input

4.1 Members were allocated to the review prior to the election and attended a review team meeting. However after the election and the introduction of the new cabinet structure, the members allocated to the review changed. The new members were then invited to attend challenge group meetings and a number were able to attend. A member expressed interest in spending some time in an area office to observe the administrative tasks involved in delivering a service to Looked After Children.

4.2 Members were concerned particularly about the amount of administration undertaken by social workers. They also were keen to ensure that the recruitment and retention of staff is improved and that frontline workers were made a priority. Although Hampshire's performance on the short term stability of children's placements is nationally good, nevertheless members felt that there should be an even greater reduction in the percentage of children moving three or more times in one year. Some members also supported an increase in allowances for foster carers.

4.3 The nominated members made additional comments about the review. They were as follows:

That data about performance may not be wholly accurate or reliable

That the issue of corporate parenting needs to be reinforced to members

That it is essential to recognise the need to overcome emotional trauma suffered by many young people

That social issues can impact on looked after children activity levels e.g. new housing developments

That better links should be established with the improved Education Psychology service for residential managers and foster carers

That there should be detailed monitoring of school progress and attendance

That there may be benefits in building links with the local community e.g. youth clubs and youth workers

That links could be made with other Best Value reviews including Education Psychology and the Youth reviews.

4.4 Councillor Frankum visited Basingstoke Social Services Area Office on 17^th January 2002 to observe a social work team and gain understanding about the administrative processes undertaken in a team. She spoke to a team manager, two social workers and a team clerk.

4.5 Generally she felt that about 95% of the concerns expressed by the staff had been picked up in the review. It was clear that communication with staff, as identified in the review, is a problem, as some of the staff spoken to, did not feel that they had been informed about some key issues, which caused a feeling of being undervalued.

4.6 The major concerns identified were that there were not enough social workers, due in part to the high vacancy levels, not enough social work assistants to support social workers by undertaking the more routine tasks nor enough clerks to complete the volume of work generated by the social workers. Social workers tended to arrange meetings themselves when this could be an administrative task. Some social workers were doing photocopying and on occasions typing when hard pressed clerks did not have the time to do it. Additionally there was a vast amount of paperwork and forms to be completed, some of which was a duplication of information. When a child becomes looked after there are up to five hand-written booklets to be completed, some of which will repeat the same information e.g. the child's name, date of birth and address. Sometimes large families become looked after at the same time with as many as eight children in them. Much of the information for each child will be the same e.g. their address, their parents and their G.P. and all of this has to be completed for each child. Some of the duplication was felt by Councillor Frankum to be unnecessary. Much of the paperwork was hand-written, even where templates existed on the computers as social workers did not use the templates and clerks did not have time to type up the hand-written work. The social workers did not have a 'pc' each but generally shared one between two. When the new social care information system is introduced, training will be required to enable staff to use the system in the most effective and efficient way and to encourage a culture of IT use. Councillor Frankum noted that sometimes when the staff were booked on a training course they had to cancel due to an emergency. Additionally, due to lack of time generally, staff could not always even book on to a course.

4.7 A number of possible solutions were suggested including; using templates to reduce duplication, trying to introduce the new information system in a staged manner so that the training requirements could be met, clerks undertaking meeting arrangements, and administrators or social work assistants completing some of the forms, particularly if the forms could be on templates.

4.8 Councillor Frankum felt that the staff she spoke to showed respect and support for each other and was very grateful for the time they gave her.

4.9 She supports the report of the review and feels it is thorough and honest and feels that the recommendations will make a difference to the department and to the recruitment and retention of staff.

5 Lessons learnt

5.1 Given the extensive range of services and issues being examined under the umbrella of this review it was essential to have a committed Review Team membership that had allocated time to undertake the complex range of tasks outlined in the Briefing Reports for the Issue Groups. It is essential that the Best Value process is mainstream at strategic and operational level, that information is accurate and available for statistical analysis and that there are sufficient people available to take forward key tasks.

6 Conclusions

6.1 The review has identified across the services being reviewed the current performance level, using the PAF indicators. This is shown below.

6.2 Current performance level

6.3 Additionally comparative unit cost information has been developed as part of the review. For residential care in Hampshire's internal provision costs are approximately £95,000 p.a. compared to £71,000 for external provision. For Looked After Children in Hampshire foster care service costs during the period of the review were approximately £12,000 p.a. as against £35,000 p.a. in the external sector. For both the residential and foster care sectors the unit costs information needs to be treated with caution as they are still not direct like for like comparisons and are not sufficient in themselves to determine best value to its fullest extent.

6.4 The above information demonstrates that Hampshire has considerable room for improvements in performance across its range of services for Looked After Children.

6.5 The review considered a number of options for improving services. These were presented to the PRC as the five Best Value options ranging from no services for LAC to radical changes to the services. It was agreed that as the local authority has statutory obligations in relation to Looked After Children, the first option was not appropriate. The second option of no changes needed cannot be supported by the review findings. PRC determined that further work on the third and fourth options for improvement to the present services was its preferred way forward. Option five which suggested radical change and the externalisation of key services was not considered feasible because the sustainability of the mixed economy of care would be threatened leaving the department vulnerable to market forces.

6.6 The review has therefore worked on options three and four and been able to combine them into a single improvement plan. The plan has a number of suggestions for source of funding. They range from

(i) those that will require no additional funding,

(ii) those that can be funded by recycled resources,

(iii) those which require additional funding on a `spend to save' or opportunity cost basis and

(iv) those which require additional funding and would necessitate a growth bid.

The actual costs of the recommendations for actions are in the `cost/resource implications' column of the improvement plan.

7 Summary Recommendations

7.1 The improvement plan identifies outcomes, performance indicators, current performance, performance targets, barriers to achieving performance targets and actions. The outcomes are derived from Quality Protects and the results of the review. The performance indicators are largely national indicators, which have been identified as relating to the outcomes. The current performance is generally the latest figures sent to the Department of Health. The performance targets are those identified in the Management Action Plan, where appropriate and otherwise agreed within the review team after consultation with strategic managers. The barriers to achieving the targets fall broadly into the following categories; resource management, sustainability/market forces and response to legislation. The actions have been developed from the development of the options, presented to the PRC on 16^th November.

7.2 Below are the outcomes of the improvement plan with the actions grouped under each outcome.

1. Looked after children gain the maximum life chances from education, health and social care provision

Action	Cost/resource implications
1. Allocate lead responsibility for school places to a senior level in education	Within existing resources
2. Develop one continuing care agreement with Health	Within existing resources
3. Agree protocol for shared data with Health	Within existing resources
4. Appoint additional reviewing managers to review care plans on time and consistently across the county. Also to ensure that care plans identify services and progress actions that will meet the LAC's health, educational and social needs	To be funded from remodelling
5. Develop joint training with other agencies to improve joint working	Will require additional funding - to be costed

2. Through appropriate care placements looked after children are securely placed with carers capable of providing safe and effective care for the duration of their childhood

Action	Cost/resource implications
1. Develop a strategy for Family and Friends Carers	Within existing resources + possible PSA funds
2. Remodelled family placement teams to work up improvements in degree and type of support including out of hours to in-house foster carers	Within existing resources
3. Increase Family Support and Family placement	Within existing resources
4. Re-evaluating the residential strategy	Within existing resources

3. A competent and committed workforce within a participative and supportive management culture

Action	Cost/resource implications
1. Senior managers will be more visible and communicate more with staff	Within existing resources
2. Undertake regular staff surveys to evaluate the ongoing climate within the organisation	Within existing resources
3. Performance development and supervision policy is reinforced and monitored	Within existing resources
4. Managers must ensure that training and induction is integrated within performance development framework	Within existing resources

5. To improve the current vacancy level the field work staffing budget underspend should be safeguarded by the development of a more coherent strategy which ensures optimum use of the fieldwork staffing at budgeted levels Review current arrangements for covering vacancies or long term sickness with a view to reducing agency costs	Within existing resources + opportunity costs
6. Develop an improved recruitment and retention strategy which includes a number of enhancements to rewards and conditions and development opportunities	Will require additional funding - to be costed into the SSD Workforce Plan
7. To ensure that the Workforce Plan includes sufficient staffing levels (including administrative staff) to enable staff to deliver services and take up training opportunities without excessive work pressure	Opportunity cost bid initially funded from QP MAP 4 Grant
8. To develop a strategy for ensuring equal access to regional and national learning events together with a process for disseminating the learning	Within existing resources

4. Looked after children's individual needs and choices are met through maximising resources to deliver effective services that demonstrate value for money.

Action	Cost/resource implications
1. To ensure that transitional housing benefit is applied for where appropriate	Within existing resources
2. To pursue any alternative funding sources e.g. Public Service Agreements	Within existing resources
3. By examining the needs of LAC and the resources available in-house, identify the additional resources required from the independent sector	Within existing resources
4. Consider raising foster care allowances to NFCA rates	Will require additional funding - £360k to uplift
5. Maximise the development of block contracting and flexible contract arrangements with IFA's where appropriate and identify the range of specialist IFA services to reflect the needs of LAC	Within existing resources
6. To develop the Family and Friends carers strategy and implement it	Within existing resources + additional Government PSA funding
7. Appoint a contracts officer post to improve the contracting process to gain more beneficial contractual terms with external providers and by working with managers involved in purchasing services aid consistency	Additional funding of £37,000 p.a., - opportunity cost bid initially from QP MAP 4 Grant
8. The above post must ensure that all contracts meet the requirements of the amended Race Relations Act	As above

5. Users and carers are involved in planning; their individual care packages and the delivery of services

Action	Cost/resource implications
1. Social workers involve children and their families planning the individual's care	Within existing resources
2. Strategic Service Managers involve users and carers in planning services	Within existing resources
3. Appoint 3 key new posts to meet Government requirements to ensure that children and families participation is not fragmented and piecemeal. These are a children's participation officer, a parents' participation officer and a corporate children's officer	Additional funding of £100,766 p.a. -using QP grant for first 2 posts and SSD part payment for corporate post
4. The above posts should organise a promotional campaign to ensure children know their rights and how to use the complaints procedure, annual consultation events, promotion of Family Group Conferences, user and carer surveys, the development of a website and a reference group for parents	Additional Funding required - to be costed using QP grant as part funding
5. Evaluate the role of the Care Action Team and consider setting up a Young People's Council	Within existing resources
6. LAC consultation forms to be re-designed to make them more `user friendly'	Within existing resources

6. Services are planned to meet strategic objectives through accurate management information.

Action	Cost/resource implications
1. A Management Information Policy is developed for the department, including identifying a departmental lead and a children and families lead at senior management level	Within existing resources
2. Continue to implement the children and families auditing strategy	Within existing resources
3. Ensure there are sufficient administrative staff to input data	Within existing resources thru' remodelling
4. Developing the care management manual to ensure that social workers are clear about management information requirements	Within existing resources
5. Within existing resources, consider how best LAC and their carers could check the accuracy of personal information held on SSD databases	Within existing resources
6. All spend is linked to departmental objectives as identified in the commissioning plan and the QP MAP	Within existing resources
7. All new staff receive an induction pack with details of recording practice and management information requirements	Within existing resources
8. To ensure that the new Social Care Information System is introduced effectively to produce accurate management information in line with organisational and Government requirements	Additional funding required - part of SCIS development
9. Ensure that the data analysis of LAC (and related) data is clearly defined within the PMU responsibilities	Within existing resources
10. To work towards the development of a shared database between Social Service, Education and Health	Within existing resources

Section 100D - Local Government Act 1972 - background papers

The following documents disclose facts or matters on which this report, or an important part of it, is based and has been relied upon to a material extent in the preparation of this report.

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