1 Summary

1.1 The purpose of this report is to apprise this Committee on the work that is currently being undertaken by a sub-group of Members looking into children's residential care provided by Hampshire County Council.

1.2 Corporate Strategy

This item is relevant to three of the aims within the Corporate Strategy

_ Aim 1 - Maximising Life Opportunities;

_ Aim 5 - Improving Services;

_ Aim 6 - Developing Councillors and Staff.

2 Background

2.1 Since September 2003 a sub-group of the Policy and Review Committee have been meeting to examine issues facing services for children looked after in Hampshire, the project focussing specifically on children's residential care.

2.2 The sub-group comprises of:

· Cllr Wride (chair)

· Cllr Banks

· Cllr McNair-Scott

· Cllr Frankum

· Cllr Chapman

· Cllr Holden-Brown

· Cllr Ludlow

· Cllr Hindson - Executive Member for Social Care (observer)

· Steve Love - Assistant Director, Children and Families (advisor)

· Gill Horrobin - Service Manager, Strategy, Children Looked After (advisor)

2.3 Terms of reference for the sub-group were agreed as follows:

· To explore models of residential care (excluding those for disabled children);

· To identify the specific purpose of the residential units;

· To examine staffing levels and training;

· To look at how the service is funded;

· To identify achievements of children looked after in residential settings.

2.4 Members agreed, as part of their work, to visit the department's residential units in order to compare and contrast models.

3. Residential Provision in other Local Authorities/National Research

3.1 In order to compare and contrast, Members felt it important to research provision in other authorities and advice was sought from the Social Services Inspectorate (SSI) regarding appropriate authorities. Further work is required looking at other authorities in order to gain a wide perspective. West Sussex is one authority that Hampshire is already working with in developing placements for those young people with very challenging needs and is a neighbouring authority, so will be a good authority to contact.

3.2 Sir William Utting, who led the Safeguards Review in 1997 (People Like Us) has recently reflected upon changes over the last decade in residential care and concludes that a national strategy for residential services is required that enables them (the service) to play their proper part in a comprehensive strategy for children looked after.

3 Role and Purpose of Hampshire's Children's Homes

4.1 Successful delivery of residential services, in line with the agreed role and purpose, depends upon a number of complementary developments in other service areas of the children and families sector, e.g. the effectiveness of the County Family Placement, Permanence and Reviewing Services and family support services, all of which form key elements of the remodelled children and families sector. The primary aim of the service is to ensure that those young people in residential placements are there because it is the best choice to meet their needs.

4.2 Since the implementation of the Care Standards Act 2000, in April 2002, all of the department's residential units have had to be registered with the National Care Standards Commission (NCSC). Preparatory work had been carried out in Hampshire to ensure all our units were `fit' for registration, i.e. they all met National Minimum Standards for Children's Homes. These standards are the tool by which residential unit's quality of provision is measured during inspections carried out by the NCSC.

4.3 Since implementation of the Children Act 1989, significant research, both nationally and locally has been carried out into residential care to examine which key factors improve quality of care and subsequent outcomes for young people. Some key factors are as follows;

· The size of the unit, small being preferable (between 4-6 residents);

· The quality of line management support for the unit;

· Clarity for staff and other key stakeholders about the unit's primary function.

4.4 The residential strategy within Hampshire, as part of the preparation for the Care Standards Act, was required to reduce the number of beds in each unit, and refine the primary functions, ultimately separating out short and long term needs. All units (excluding Swanwick Lodge secure unit) reduced from 8 to a maximum of 6 places.

4.5 A reduction of twenty residential places have been permanently lost to the in-house sector since April 2002 as a result of NCSC requirements. A further reduction was caused by the temporary closure of two units, Woodend and Cambridge Rd, it being anticipated that their premises and physical condition would not be capable of meeting the new standards. This created additional placement pressures. Cambridge Rd has recently re-opened (Feb. 2004).

4.6 Current profile for the County

Core and Cluster Units (Short-Term , up to 6 months)

Bournemouth Road, Chandlers Ford (6 beds)

Glendalyn, New Milton (6 beds + 1 emergency bed)

Cypress Lodge , Basingstoke (5 beds)

Stonecroft, Havant (6 beds)

Cambridge Rd, Aldershot (6 beds) - re-opened February 2004

These short-term units are district units and are designed to provide residential care as part of a range of family support services i.e. promoting rehabilitation back home.

The primary function of the Core & Cluster units is as follows:

`To provide and co-ordinate a range of community based and residential; services designed to improve family relationships and prevent the need for the child/young person to leave his/her home except for planned periods of short-term and ideally part-time residential care.'

Specialist Units (Long-Term, up to 2 years)

Crossways, Old Basing (6 beds)

Godbey House, Hayling Island (6 beds)

Milesdown, Winchester (6 beds)

The Mead, Odiham (6 beds)

Crossways and Godbey House are registered for children aged 9-12 years and Milesdown and The Mead are registered for young people 13-17 years.

All the long-term units serve all geographical areas of Hampshire and are designed to support young people whose needs are so complex they need longer timescales in order to move on appropriately.

The primary function of the long-term specialist units is as follows:

`To provide a settled period of residential care with therapeutic emphasis and multi-agency involvement, to help children and young people recover from experiences which have rendered them vulnerable to significant emotional and mental health problems and disruption of primary relationships.'

Swanwick Lodge secure unit. Designated under the Secure Unit Regulations as a regional and national resource.

4.6.1 At present, Glendalyn has one emergency bed. This is designated for emergency admissions out of office hours as part of a contingency plan whilst other resources are being developed for this purpose. Providing emergency accommodation for adolescents is a challenge and family placement at present is not in a position to fully meet the needs of the service. The service comprises one bed at Glendalyn, for use specifically out-of-hours and after other resources have been used, any vacant beds within the National Children's Homes (NCH) Remand Fostering Resources and standby foster carers who, as part of a rota within a district, receive a standby payment to be available for part of a week to take emergencies. In practice, Glendalyn is the resource most used. This does cause disruption for the young person being placed and for those already in placement at the unit.

4 Staffing

5.1 A key part of the residential strategy identified a need for increased staffing levels in order to manage the service competently and safely. The short-term core and cluster units and long-term specialist units are now profiled to have 13 and 14 full-time equivalent (fte) staff respectively, plus a manager and ancillary staff. The principle of one extra staff member in long-term units is to allow greater flexibility if night waking staff are required at key times, depending upon very challenging needs of residents.

5.2 The staffing profile of the units also provides for a structure which includes new, inexperienced staff to qualified senior staff so that there is a mix of staff on duty, including shift leaders and there is a professional route for progression. It also comprises of an assistant and deputy manager to support management responsibilities. A typical staffing profile comprises of:

Registered Manager	1
Deputy Manager (qualified)	1
Assistant Manager (qualified)	1
Grade C's	5
Grade B's	3
Grade A's (new inexperienced)	3

5.3 Due to the increase in staffing profiles, two national recruitment campaigns and subsequent local campaigns have focussed upon recruitment to the residential sector in order to bridge the gap between old and new profiles. This has required substantial investment by Recruitment Options and others. It has taken time to bridge the gap, with the challenge specifically being the recruitment of senior qualified social workers.

5.4 The current vacancy rate within the residential sector is 9.5%. Of this proportion, 37% are senior vacancies, i.e. assistant or deputy manager posts (statistics as at March 2004).

6. Budgets

6.1 Higher staffing ratios have led to substantial increases in budget allocations for every specialist and core and cluster unit. Staff account for approximately 90% of a unit's budget.

6.2 Work was also carried out to equitably distribute non-staffing allocations to every unit. These include budgets for utility costs, travel, food, clothing etc.

6.3 An average unit budget is £390k, with the total revenue budget for the sector (mainstream units) of £3.7m (including full year's budget allocation for Woodend and Cambridge Rd). Allocations are based upon a 5% staff vacancy rate with funding at mid-point of the salary scale. This immediately puts units under pressure as staff turnover rates are low in the sector, with a high proportion of staff at the top of their scale.

6.4 There are a range of additional pressures due to increased sickness costs, increased training costs and increased number of extra care packages required for some young people with very complex needs resulting in high risk behaviours (needing even higher staffing ratios).

7 Identified Issues

7.1 A high proportion of young people with no full-time school places (current statistics show that 62.5% of residents in the units are not receiving full-time education - statistics as at Feb. 2004)

7.2 In some cases a lack of assessment of some young people's needs prior to placement which has, on occasions, resulted in an inappropriate placement.

7.3 Concerns about the level and variety of experience of some Registered Managers.

7.4 Difficulties in the management of challenging behaviour due to issues around recruitment of staff at appropriate levels which has led to some concern about the skills mix/experience of staff on duty at times.

7.5 Concerns that the legislative framework (Children's Homes Regulations around Permissible Forms of Control and Prohibitive Measures) sometimes has an impact on how staff can respond to young people's behaviour.

7.6 Lack of multi-agency `ownership' generally regarding young people in placement (a protocol between Education and Social Services has recently been signed which will address some education issues. The sub-group is examining how our residential units could work with the Youth Service day centres for young people out of school).

7.7 Travel costs, specifically in relation to use of taxis (further examination required).

8 Conclusions

8.1 Issues explored by Members are complex and in need of further examination in order to respond fully to the terms of reference.

8.2 It would be premature to make any firm conclusions as yet, with the publication of the Children Bill on the 4 March 2004.

8 Recommendations

8.1 That Members of this Committee extend the period of time the sub-group is scrutinising residential care by a further 6 months in order to:

1. Allow sufficient time to address the issues raised;

2. Examine in more detail the outcomes for those children and young people receiving support from the department's residential services;

3. Consider the implications of the Children Bill

Section 100 D - Local Government Act 1972 - Background Documents

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.

NB the list excludes:

1. Published works

2. Documents which disclose exempt of confidential information as defined in the Act.

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