Introduction

1. The Governance Committee, at their meeting of 10 March 20054, received a report from the Director of Social Services on items referred from the last meeting: contracting for children's services; the approval of Regulation 38 foster carers; and financial irregularities, with particular reference to one home for older people. It was agreed at that meeting that further work should be carried out on the first item, that a tighter procedure was required that allowed the Committee to be satisfied before a child is placed, in an emergency, with foster carers under Regulation 38 of the Children Act 1989 and that a new training process should be developed for internal (i.e. Social Services Department) inspection of residential care homes. The purpose of this report is to update the Committee on action that has been taken since then to address these issues.

Contracting for children's services

2. Concerns had been expressed about one particular supplier of temporary staff to the County Council. It was reported to the last meeting of this Committee that some of the concerns had been resolved and that the agency's position had been regularized through the Council's contract with Manpower as the sole supplier of temporary staff. The agency had become a `panel vendor' (ie sub-contractor) to Manpower. One issue apparently remained unresolved - that a member of staff of the Social Services Department was a director of the company - however a company search carried out by Internal Audit in May 2005 revealed that this directorship had been resigned on 31 March 2004. Nonetheless, discussion with the Council's manager of the Manpower contract in the County Supplies Department revealed Manpower's concerns over the performance of the agency and the Social Services Department's Management Team, on 21 April 2005, resolved to cease using them forthwith. This decision was conveyed to the contract manager and thence to Manpower.

3. Staff supplied by this agency were only being used by one County Council children's home and were being used simply because of the great difficulties experienced in securing permanent members of staff. Immediate cessation of this source of staff would have left the home with insufficient staff to provide the level of cover required by national minimum standards thus exposing the County Council to regulatory action while closing the home could have left the children placed there at still greater risk. So the decision was taken to allow a gradual reduction in reliance on staff from this agency.

4. Exploration of the circumstances of this one particular agency gave an opportunity to review the safeguards for vulnerable service users and for the County Council built into the Manpower contract. To this end, a meeting was held of Social Services, County Supplies and Internal Audit staff on 18 April 2005. A detailed specification for the service to be provided by Manpower (and its panel vendors) was reviewed together with an addendum referring specifically to care workers. This is included as Appendix 1 to this report. The key points to note are that:

· All staff are checked with the Criminal Records Bureau (CRB);

· Increasingly, staff are given appropriate training including the Team-Teach method of restraining challenging young people;

· Staff are supplied with a `worker profile', including key information about them, which they are expected to make available for Social Services managers to photocopy and retain;

· Staff are given information, prior to their assignment, about the unit to which they have been assigned;

· Manpower employ a specialist social care staff manager who oversees their team recruiting temporary staff (a joint County Council/Manpower recruitment campaign is currently under discussion);

· Emphasis in the first year of the contract has been given to establishing a good working relationship between Manpower and Social Services managers and between Manpower and their panel vendors;

· Quarterly review meetings are held involving management representatives of each Social Services care group, Manpower and the County Supplies contract manager.

5. A protocol has been put in place for the County Council to audit Manpower and for them to audit their panel vendors. The latter includes such factors as accuracy of invoices and general reliability, which itself includes a number of elements including responsiveness, short notice availability of staff, consistency of staff and provision of worker profiles. Auditing of the panel vendors' processes is about to start and will cover training, CRB checks, maintaining records, insurance etc. This will eventually be included in a scoring programme along with `quality of staff'. This will yield ranks, with a view to using the best panel vendors more often and the worst less often or `delisting' them. The first results of Manpower's quality assurance work in relation to their panel vendors has recently been made available to the County Council.

6. The conclusion drawn from this review was that the contract with Manpower for the supply of temporary care staff to the Social Services Department, at the end of its first year, was satisfactory and working increasingly well. Accordingly, the Department's Management Team, on 21 April 2005, resolved to remind all managers that they must always contact Manpower whenever the need arises for temporary staff (rather than contacting panel vendors directly), that they must always ask to see new workers' worker profiles and must keep a photocopy on file and that they should keep accurate records of working times of temporary workers and check invoices against them. This reminder, by way of an email to all social services managers, was issued on 28 April 2005. In addition, agreement has been reached with the County Supplies Department that the Social Services Department would be notified of any units who persist in ordering temporary staff other than through Manpower.

Contract compliance

7. The issue of contract compliance, particularly in relation to domiciliary care providers, was also mentioned in the previous report. The opportunity has since been taken to review mechanisms for minimizing risks to vulnerable service users and to the County Council. Those currently in operation include:

· Only using organizations approved by the Commission for Social Care Inspection (CSCI) who inspect against national minimum standards put in place by the Care Standards Act 2000;

· Requiring domiciliary care organizations to give all service users a copy of their company brochure and complaints procedure (producing such a procedure being a Care Standards Act requirement);

· Operating a Departmental complaints procedure which is drawn to the attention of all service users, described in the `So what do you think?' leaflet and highlighted in the Department's guides to residential care and to care at home, all published both on paper and on Hantsweb;

· Communicating with the CSCI on regulatory issues - either referring issues of concern regarding organizations to them for further investigation or receiving notifications of intention to take regulatory action;

· Operating an Adult Protection Policy, introduced in 2003, which, amongst other things, requires all care providers to: develop a policy and guidance related to abuse of service users; make all staff aware of it and of how to report cases of suspected abuse; report allegations of abuse to the appropriate regulatory body. These requirements are now part of the Social Services Department's standard contract with care providers;

· Carrying out individual reviews by care managers after one and six months;

· Aggregating the reviews in relation to individual providers and sharing the resultant knowledge amongst care managers (service purchasers) in all areas. This body of knowledge has built up over the past twelve years, is sensitive to quality changes and has resulted in changes in purchasing patterns as a result;

· Carrying out user satisfaction surveys, particularly in relation to block contract services, which represent about 20% of the volume of services purchased;

· Requiring close liaison between care managers and local finance staff over invoice accuracy.

8. This system of ensuring contract compliance is seen as being both proportional and effective in view of:

· the scale of the enterprise (around 150 providers being used on any one day to provide care for 5,000 service users in Hampshire);

· the need to avoid adding substantially to costs;

· the undertaking given to care providers, when new community care arrangements were introduced in 1993, that they would not be subject to a regime of double regulation by the official regulator and by the service purchaser.


However, there are four improvements that could be made and are being pursued:

· Developing a more systematic approach to gaining feedback from service users about their satisfaction with the services - in both quality and quantity terms - provided for them and from care managers. Discussions have started with the Corporate Communications Team about ways of gaining this feedback.

· Improving the quality of the information generated by the existing user satisfaction surveys. The Social Services Department's Performance Management Unit has been asked to suggest better questions for including in these surveys.

· More systematic use of `consumer audit' - evaluative work carried out by organizations representing consumers of social care services.

· Exploring with the CSCI ways of improving the flow of information from the regulator to Departmental commissioners about service providers where there are concerns. Though recent improvements have been noted, an approach has been made to CSCI suggesting a joint exploration of ways in which this can be further enhanced.

These initiatives will have to be discussed with the care industry's representative bodies - the Hampshire Care Association and the Hampshire Domiciliary Care Association - before they are finalized and introduced.

Regulation 38 foster carers

9. Most (around 70%) children looked after by the County Council are placed with foster carers. Of these, the greatest number (around 80%) are placed with County Council foster carers or approved carers supplied through independent fostering agencies. The remainder are placed with family members or friends under the kinship care scheme. Kinship care is limited to those people who have a close - as defined in law - relationship to the child.

10. Regulation 38 of the Children Act 1989 enables the local authority to place a child who is on a care order or an interim order with an unapproved carer who is not related in a way defined and acceptable in law (eg a more distant family member or a friend) in an emergency, for up to six weeks, at the end of which time they must have been approved as foster carers, or the placement should cease.

11. The County Council has a kinship care (Family and Friends) scheme using informal arrangements whereby a child is brought up by relatives, for example grandparents, older siblings, aunts and uncles, or friends. The initiative, approved by the Executive Member for Social Care on 30 October 2003, is built on the findings of a research project which indicated that such placements produce good outcomes for children. They keep children safe, last longer, are culturally appropriate and promote positive identity. They are the placements children say they would choose and they say they feel loved and wanted when cared for by family or friends in their kinship network. The Department of Health-commissioned research was carried out in Hampshire and one other local authority in 2001, under the auspices of the Family Rights Group. The report, `Growing up in the Care of Relatives and Friends', was published by the Family Rights Group in June 2004.

12. The objective of the scheme is to increase the opportunities for children, who cannot live with their birth parents and who would otherwise enter the care system, to be brought up within their extended family and communities, for the duration of their childhood. The County Council assesses and supports these care arrangements, where necessary giving financial support, to ensure these children's needs are met and their kinship carers are enabled to care for them. A Public Service Agreement (PSA) target for Family and Friends care in Hampshire, to increase the number of children so placed as a percentage of those children achieving permanence out of the public care system was agreed. Information included in the report to the Executive Member for Social Care on 30 October 2003 made it clear that not only does Family & Friends and kinship care arrangements provide better outcomes for children but also represents good value for money for the local authority.

13. The Audit concern was not with the Family & Friends/kinship care scheme but with delays that had been experienced in carrying out the assessment process for those emergency carers referred to in paragraph 10. The law allows 6 weeks for the assessment to be carried out, after which time the carer either has to be approved or the child removed. This was not always achieved. Since the Committee's last meeting, the following steps have been taken to improve the situation:

· a spreadsheet has been set up to track all cases in the approval process;

· the highest priority has been given to approval work;

· notification procedures have been tightened up to ensure that assessments start immediately a child is placed;

· the Service Manager (Family Placement) has met foster panel chairs to agree the processing of these approvals at the beginning of each panel meeting (all applications to foster are considered by a panel);

· this agreement has been communicated to operational service managers and their teams;

· an agreement to notify operational managers every time the Family Placement Team are asked to carry out a Regulation 38 assessment has been concluded in order that extra measures can be put in place to ensure proper supervision and the child's safety if the timescale of 6 weeks is exceeded.

14. The result of these actions is that the number of children being placed in these situations in an emergency has been reduced significantly. Regulation 38 checks have to be completed within a very tight timescale. In the event of checks not being completed, the panel is asked either to make a recommendation pending a successful check coming through (the agency concerned can usually give a preliminary view that there are not likely to be any contra-indications) or the carer is not approved until checks are received and the child is removed. The latter is a very rare occurrence.

15. For the Committee's information, Appendix 2 shows the checklist used for prospective foster carers. This list contains thirteen checks that are carried out, six of which are required by law, the other seven are required by the Social Services Department as matters of good practice. Kinship carers are subject to the first six, Family and Friends carers to the full set of thirteen.

Financial irregularities at a home for older people

16. Since the last meeting of the Committee, training has been commissioned to help service managers consider financial management issues, such as personal monies, imprest accounts and amenities accounts, when carrying out their regular inspection visits to units. The objective of the training was to equip service managers better by ensuring that they had the knowledge and skills to quality assure financial integrity and good practice in managing these accounts.

17. A planning meeting, involving Social Services managers, Internal Audit and staff from the Social Services Devolved Finance Unit was held on 13 May 2005. This meeting recognized that there were many concurrent processes and complementary practices in place. One area, where Learning Disability Services had made significant progress, was the quality monitoring of in-house residential services. This had taken the form of newly developed monthly monitoring visits that also met the requirements of Regulation 26 of the Care Standards Act. Other sectors were trialing this process and finding it helpful. It was evident that many issues arising from audit compliance were included in these monitoring visits. With some minor adaptations, this process could easily address the fuller requirements of Audit rather than creating a whole new cumbersome process overlaid on top. Further discussion suggested that the learning disability process should be considered as a departmental standard, particularly as it also addressed other key areas, such as Health & Safety and Investors in People monitoring.

18. It was agreed that the County Manager (Operations) for Learning Disabilities would set up a short-life working group and, working across all Adult and Older Persons sectors, develop an agreed standard of monitoring for in-house residential units that met the requirements of CSCI, Internal Audit and other key areas that were audited and avoided duplication. An initial meeting is scheduled for 19 July 2005. This was only intended to cover in-house residential visits but it was recognized that consideration could be given to extension to day services.

19. Workshops were run on 15 and 17 June 2005 for twenty-three service managers with statutory inspection responsibilities. The development of the training materials was co-ordinated by the Hampshire Learning Centre with input from the Social Services Devolved Finance Unit and Internal Audit. The stated objectives for them were that service managers should be able to:

· clarify the expectations of their role in relation to the management of finances within an overall quality monitoring approach;

· update their financial audit skills and knowledge;

· identify any support issues and training needs to support effective implementation of quality finance audit;

· identify how finance will fit in with the wider quality monitoring approach.

20. The workshops were well received. Although initially many attenders were unsure if the training was going to be relevant and whether they need attend, the feedback was that they had learnt quite a few things and found the workshops helpful both in terms of hearing from finance about how accounts should be managed, hearing from Internal Audit about details of the audit process and also having a chance to share information with colleagues. They felt that there was also a need for similar workshops and training for unit managers, staff members and administrators.

21. Progress will now be monitored through Internal Audit outcomes over the next six months.

Recommendation

22. That this report be noted.

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 or confidential information as defined in the Act.

None

Appendix 1

CONTRACT FOR THE PROVISION OF TEMPORARY WORKERS

SPECIFICATION

ADDENDUM

MINIMUM REQUIREMENTS FOR THE SUPPLY OF TEMPORARY WORKERS

ENGAGED IN THE PROVISION OF CARE SERVICES

The Contractor shall be held responsible to ensure the following minimum requirements are applied to the supply of temporary workers engaged in the provision of care services.

General

1 The Contractor must ensure a system exists to enable temporary care workers to have contact with a supervisor or manager for consultation, support and advice, and must be given the opportunity to resolve any issues and identify how training needs may be met. These sessions must be recorded.

2 Temporary care workers must be given a full explanation of all the Contractor's policies and procedures along with copies of all written procedures, including emergency telephone numbers.

3 The Contractor must ensure a system exists which protects temporary care workers from harassment, including sexual harassment, by ensuring they are able to make representations in confidence and that their representations will be taken seriously and appropriate action taken by the Contractor to prevent further harassment.

4 Every temporary care worker must show an identity card which includes a photograph which is a likeness of them and has been signed by an authorised person of the Contractor.

5 Temporary care workers should show sensitivity, flexibility and a caring attitude in accordance with the Contractor's Equal Opportunities policies to enable them to communicate effectively with all service users. This must be demonstrated and evidenced as part of the recruitment process.

6 Temporary care workers must not act as signatories to wills or other legal documents , nor accept gifts of any kind except with the written authority of the Contractor. They should also not be involved in any financial transactions with service users unless this is clearly an essential part of the Service provided and all relevant procedures are followed in this respect.

7 Temporary care workers must be given advice on contagious diseases, including AIDS and Hepatitis B.

8 The Contractor shall be held responsible to ensure a record is maintained of all staff, including details of address, qualifications, training received and required, annual leave and sickness.

9 In addition to reporting accidents or incidents using AIRS, the Contractor must also have a system for recording any accidents or incidents which happen either to a temporary care worker or service user. This record must be countersigned by the nominated manager and any action required or taken must be recorded. The system must also include procedures for notifying appropriate accidents to the HSE.

10 The Contractor shall be held responsible to ensure temporary care workers are given appropriate induction and ongoing training consistent with the range and complexity of the work which they are expected to undertake. Guidelines for the appropriate training are given below.

(a) For work in Children's Residential Homes

(b) For Work in Older Person's Residential Homes

Appendix 2

CHECKLIST FOR PROSPECTIVE FOSTER CARERS

(STATUTORY AND GOOD PRACTICE CHECKS)

1. SSD records - all authorities where applicants have lived in last five years, or before this if they (or a member of their household) have ever applied to a local authority to foster or adopt, and for applicants living in another local authority - consult with and take into account views of local authority in which applicants lives. (STATUTORY CHECK)

2. OFSTED / Registration and Inspection unit / Independent agencies - all previous requests or applications to foster/adopt/register as a childminder/day care provided or children's home. (STATUTORY CHECK)

3. CRB check - on applicants and all those over 18 in household, plus regular visitors to household. (STATUTORY CHECK)

(Renewed every 3 years)

4. GP - full medical - on both applicants (See notes). (STATUTORY CHECK)

( Renewed every two years)

5. Probation - CA15 )

NSPCC - CA15 )

Education - CA15 (only if they have children) ) (STATUTORY CHECK)

Health Visitor - CA15 )

6. Personal references x 2 - form & covering letter. (STATUTORY CHECK)

7. Children's schools/playschools where applicants have

school aged children. (GOOD PRACTICE CHECK)

8. Employer's reference. (GOOD PRACTICE CHECK)

9. Ex-partners - where children of relationship or significant relations i.e. married/co-habiting that has ended in last five years.

(GOOD PRACTICE CHECK)

10. Relatives/extended family/adult children (use personal reference letter and form). (GOOD PRACTICE CHECK)

11. SSAFA - Separate checks to Army, Navy & RAF if they were ever part of the forces. (GOOD PRACTICE CHECK)

12. Consider approach to relevant embassy or SSD in County for applicants who have lived/worked abroad. (GOOD PRACTICE CHECK)

13. Witness testimony covering letter and form - to be used where appropriate to provide additional evidence for core competencies (applicant to take

responsibility for providing these). (GOOD PRACTICE CHECK)