Brighter Pathways
North Ayrshire Council · 14 November 2024
Back to Integration Joint Board — 14 November 2024 and its agenda
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Integration Joint Board 14th November 2024 Subject: Brighter Pathways: Re-Modelling Care Options Purpose: To provide an update the IJB on the work of the Brighter Pathways transformation work which was to address: 1. Current pressure on placement availability and accommodation for care leavers. 2. To shift the balance of care from high-cost external residential resources to family-based care or internal residential resources. 3. To build capacity and provide more local resources and choice to young people who require to be looked after with increased family-based care. Recommendation: The Integration Joint Board are asked to: • Note the progress and ongoing work of the Brighter Pathways Programme. Direction Required to Council, Health Board or Both Direction to: - 1. No Direction Required X 2. North Ayrshire Council 3. NHS Ayrshire & Arran 4. North Ayrshire Council and NHS Ayrshire & Arran Glossary of Terms NHS AA NHS Ayrshire and Arran HSCP Health and Social Care Partnership 1. EXECUTIVE SUMMARY 1.1 The Brighter Pathways transformation programme has been progressing since April 2024 with the establishment of a Programme Board which provides appropriate governance and representation across a range of agencies and is supported by a dedicated Programme Manager. The transformation and service developments are being delivered through focussed workstreams focussing on the following areas: 1. Housing and Throughcare 2. Fostering and Kinship 3. Education including Residential School Placements 4. Internal Children’s Houses – Model of Care 5. Early Intervention and Crisis/Intensive Support Pathways 6. Strategic Needs Assessment/Data/Workforce 7. Best Practice Models and Research
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This report provides an update on progress since the last update to the IJB in May 2024. The workstreams are at various stages and position papers with recommendations for areas of improvement and developments are being considered. 1.2 Positive progress has been made in focussing on the immediate opportunities to identify alternative care options for children and young people in residential care and there has been positive movement. The longer-term systemic changes required to our local care system are being developed in parallel, updates on each of these areas are provided in the report, noting that many of these remain as active areas of work with many expected to bring forward proposals and outputs in March 2025. 1.3 The work of the Brighter Pathways Programme Board is closely aligned with The Promise development plan and the work of the Corporate Parenting Steering Group which is responsible for overseeing the six Corporate Parenting duties, ensuring that each corporate parent upholds the rights and safeguards the wellbeing of Care Experienced people. 2. BACKGROUND 2.1 Children’s Placements “Looked After Children” …at 18 per one thousand of the local 0 to 18 population, North Ayrshire still has one of the highest national rates of looked after children and young people, ranking fourth highest in Scotland. The national rate for children looked after is 12.3 per one thousand. Over the last couple of years there have been notable decreases specifically in children and young people being looked after at home, with friends/relatives, and with foster carers. However, the number of formerly Looked After young people requesting to stay in their placement under Continuing Care is increasing. In September 2024 there were 55 young people in these placements, which is one of highest rates in the country. This will likely increase further as young people are choosing to remain in their care setting longer and up until aged 21. Overall, the number of Looked After Children has steadily reduced over the last few years but the numbers in residential care have not followed the same trend, and the number of requests for Continuing Care has increased significantly. This reflects the decline in foster care provision and a reliance on residential care. Positively the number of Kinship placements has increased over the same period. The graph below illustrates the movement/trends from 2018 until September 2024.
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2.2 External Residential Care/ Care & Education At present there is a significant overspend associated with Children’s Residential Placements, both within the HSCP and Education. The overspend predominately relates to costly external Residential Placements. There are currently 31 full time external placements. These placements are costly and do not always deliver the best outcomes for children, young people, and their families. The HSCP acknowledges that some children will always require more specialist resources due to their needs and complexity, and in some situations an external residential placement will be unavoidable. Proactive work is underway to identify those young people where there may be opportunities to bring them back from External Residential Care. In September 2024, the service identified 6 young people where it was deemed to be in their best interests to leave their current external placement and either return to an internal children’s residential placement, transition to independent living or to be rehabilitated back to the care of a family member. As a result to date, 3 young people have moved on from external placements, 2 more are planned to exit their residential placement by the end of November 2024 and one young person is currently waiting the allocation of a tenancy. The charts below illustrate children in internal residential and those in external residential care. These evidence the structured approach to categorising and ongoing review of the support needs of young people in care and projected length of time they require to be accommodated, which support future planning and to give an indication of the scale of moves which may be possible.
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RED: Young people likely to remain in care until 21, either due to Permanence Orders or requests for Continuing Care. AMBER: Young people with no significant changes to care plan, but efforts will continue to support their return to family or independent or supported living. GREEN: Young people who have the potential to return home or transition to independent living. 2.3 Financial Impact The financial resources associated with Children’s Residential Placements are substantial and represent a significant pressure on the Partnership’s available budget. In 2024/25, the budget for external residential places amounts to £6.4m and it is projected at Month 6 (September) that the year-end outturn will be in the region of £8.5m. A non-recurring budget increase of £4m was agreed by the IJB for 2024/25 and it is currently planned to reduce this over the next 2 financial years as the Brighter Pathways programme achieves success. The future years budget setting process will require consideration of the appropriate budget aligned with the assessment of possible moves for young people, financial modelling is being worked through to inform this. It should also be noted that many of the external places are commissioned through frameworks managed by Scotland Excel and that significant inflationary increases have been agreed during 2024/25, well in excess of the budget provision which was made to support the implementation of the Living Wage within Children’s services. It is currently estimated that contract inflation has added £0.339m to the cost of these places. External placements are costly and are not necessarily the best outcome for all young people, Children’s Services as part of the Brighter Pathways work are clear on our ambition to exhaust all other alternatives for children and young people with
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future External Placements being the last resort or required because of specific individual circumstances. 3. WORKSTREAM UPDATES Areas of progress from workstreams: 3.1 Throughcare and Housing Workstream The workstream acknowledged that significant improvements were necessary to improve the process and joint working between social work and housing, to ensure young people leaving care were allocated suitable and appropriate housing when they were ready to leave their care setting. There have been situations where young people in residential care were approaching 21 years of age and there was no allocation of housing, or a transition plan, for these young people. To address these issues, social work and housing colleagues will revise the Housing Protocol to include clear processes for care leavers in terms of housing allocation, and an escalation process if there is a delay in young people receiving a housing offer. Housing and Throughcare are having regular meetings to discuss young people’s housing applications and track progress or delay. A draft version of a revised Housing Protocol will be completed by February 2025. There have been developments and an update to the supported care scheme as an alternative option for UASC and young people moving on from residential care, or an alternative to residential care for young people over 16. It is hoped that the new website and digital approaches to recruitment of carers will lead to more interest in supported care for young people over 16, which could support some young people to move on from residential care. The programme board and PSMT have also agreed an increased allowance for supported carers. The workstream is also considering models of supported accommodation which support young people over 16 to move on to independent living, with appropriate support. This would provide a stepping stone for young people moving on from care to equip and prepare them for independent living. There have been discussions with providers and proposals for a commissioned service for six young people. This would be targeted for young people from external and internal residential care. Options continue to be explored and considered through the programme board. 3.2 Foster Care Our aspiration is that children who require alternative care are best placed in family- based care and we require several new foster carers to meet the current demand for children of all ages.
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The biggest challenge facing the fostering sector today is the retention and recruitment of high-quality foster carers who can meet the needs of children in care. A lack of available foster carers, in the right place at the right time, means children are missing out on vital support. Children in need of care are at risk of being moved away from their communities, hobbies, siblings, having to change schools and leave behind what is important to them, which has a detrimental impact on their wellbeing, stability and development. The Fostering Service has lost 59 interim carers over the last two years, this is due to resignations, de-registrations and change of role of carers. The service has a target to recruit six new carers per year, however this has not been achieved over the last five years. The service has only recruited two new interim foster carers this year and there are no pending new approvals in 2024. The service has seen a significant reduction in the number of enquiries from potential foster carers and is currently at the lowest number for five years. Within the foster care workstream, recruitment of foster carers was a priority area that required urgent attention. There have been consultations with the Council Advertising Network, an organisation who specialise in supporting public bodies with digital marketing campaigns. They have extensive experience and specialise in Foster Carer recruitment campaigns, and digital user experience, and have expertise in this area. The organisation currently delivers campaigns for 40 local authority fostering services throughout the UK. In Scotland, Fife Council have also recently begun collaborating with the Council Advertising Network on digital advertising. They have had remarkable success in increasing their number of enquiries (64 enquiries in first 3 months of 2024), however we are, as yet, unsure of how many of these have been converted to approved foster carers. There have been testimonies and information from other Local Authorities who have worked with Council Adverting Network who have increased their enquiries and led to an increase in the number of approved quality foster carers. This proposal would assist in the recruitment and approval of foster carers and would potentially lead to cost savings if we increased fostering resources. This would also prevent children being placed within high-cost external providers. Average annual placement costs are : • Internal fostering provision £23k. • External fostering provision £60k. • Internal residential provision £125k • External residential care £248k Evidence has shown that traditional advertising from Local Authorities most often drives potential fosterer carers to internet search engines such as Google, where they will look up fostering in North Ayrshire. Invariably, this leads them straight to the independent agencies rather than our current website, and we miss out on potential carers.
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At present, when Googling ‘Fostering North Ayrshire,’ the first three results returned are for Barnardo’s, Foster Plus and FCA Scotland. This will vary at any given time, however because the Independent Fostering Agencies (IFA) pay to ensure they are high in the rankings, we will always appear behind at least some of them. A digital advertising campaign employing the same techniques as the IFAs could help us to counteract this problem and would put the service on an equal footing with independent providers. The programme board and PSMT have approved the funding for the Council Advertising Network to support foster care recruitment. This development will also provide a separate webpage for the fostering service that will improve user experience and journey, alongside targeted digital recruitment strategies that have proven to be successful, with increased recruitment activity and conversions to approved quality foster carers. 3.3 Revised Fostering Schemes To further address the recruitment and retention issues of foster carers in North Ayrshire, work is ongoing to devise new fostering schemes which will replace the two schemes that have been in place since 2011. There has been consultation and feedback from current approved carers on the rewards and challenges of foster care and any areas that would provide better support and prevent them considering leaving fostering. The feedback from carers will be used to inform the new fostering schemes in North Ayrshire. It is anticipated that the new fostering schemes will be implemented in March 2025. 3.4 Education including Residential School Placements This workstream is still in its preliminary stage and the next step will be to provide a position paper and recommendations and actions for improvements. Education colleagues and social work staff have been sharing information on supports to children on the edge of care, or children who require additional support or specialist educational resource and scoping out barriers and opportunities and how best we can support children and families. The workstream has collated data to ensure any recommendations are evidence and data driven. The initial discussions have focused on improved joint working between social work and education and how we can fully utilise internal resources to prevent children requiring external education and care placements. 3.5 Internal Children’s Houses – Model of Care This workstream will review the current model of care within internal residential houses to inform any redesign or change to the delivery of high-quality residential care within North Ayrshire. This workstream is also in the initial stages and a position paper will be completed in March 2025 with recommendations.
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It is recognised that our internal houses are currently significantly challenged because of high numbers of young people supported, with a current focus on moving on young people where we can, we expect to stabilise the houses and thereafter have the opportunity to assertively review the model of care. 3.6 Early Intervention and Crisis/Intensive Support Pathways Within this workstream we have mapped out all of the services within North Ayrshire from education, third sector and social services, to analyse any gaps and explore how families become aware of services provided out-with the partnership. There is also some caution regarding some services that have short term funding, and the impact this will have on children and families who are supported by the services when the funding ends. The focus of the group has been on early intervention and early help to prevent children requiring support from the partnership and statutory services. There will also be a focus on crisis and intensive support to children and families to sustain children with their parents/carers and prevent children being accommodated, or their family- based care placement disrupting. There has been benchmarking with other Local Authorities to explore alternative models for crisis and intensive support to consider new ways of working or change to current services. There will be a position paper and recommendations presented to the programme board by March 2025. 3.7 Strategic Needs Assessment/Data/Workforce Within the workstream there is ongoing collection of data from numerous sources, Public Health, SCRA, Education and HSCP data analyst. A paper will be produced by March 2025 with the current and future demographic and data to inform future resources and staffing levels. The workstream will project and model likely future need of care settings for children and young people. 3.8 Best Practice Models and Research The focus of this workstream was on residential care and family-based care, data was indicating that there was a high number of children in internal residential care and external residential care, who had previously been in kinship care and internal foster care provision. Furthermore, there was also a number of children in external residential care who were previously cared for within internal children’s houses. The workstreams focus is on how best we can support foster carers, kinship carers and internal residential houses to better support children and young peoples with complex needs and behaviours, with an objective to sustain their placement and provide better outcomes and prevent escalation to external high-cost resource. To date the following areas have been progressed:
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• Psychological consultation and clinical support to one of the residential houses as a pilot to support staff to manage specific children’s behaviours. This will be evaluated and considered for other houses and for children in foster care. • New referral process implemented for referrals to Rosemount (crisis/intensive support service) for children in foster care whose placement is fragile and at risk of disrupting. The new referral process was to address the following: • Intervention and role clarification. • Touch points, sharing of information, progress/difficulties. • Mechanism to review and measure intervention. • Prevent duplication of role. • Less confusion for carers/clarity of different roles. • Increased joint working. There is ongoing work within this workstream and a position paper with recommendations will be produced by March 2025. 4. PROPOSALS 4.1 For the IJB members to be fully aware of the areas of progress and ongoing activity of the Brighter Pathways transformation work. 4.2 Anticipated Outcomes • Scrutiny and oversight of all external residential placements • To improve local resources and range of choices for young people leaving care. • To improve long term outcomes for young people/ care leavers • Review current service provision to ensure it meets current context, changing landscape and demographic of young people and families. • Support innovation in supporting children to remain in family-based care, with parents, foster carers, or kinship carers. • Review and analyse the effectiveness of the preventative, early intervention and community-based supports for children, young people and families. 4.3 Measuring Impact The Project Board will be tracking the progress of work plans or developments within the workstreams. There will be analysis of data and a needs analysis to project future demands for supports and services and how services need to be delivered. This will be an ongoing process that will review all young people within internal and external residential resources and their pathway to a supported community-based alternative or independent living.
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5. IMPLICATIONS 5.1 Financial As part of the programme of work there will be recommendations for short term investment and future re-alignment of financial support in specific areas with a view to longer term financial sustainability for the IJB. As noted, whilst financial outcomes are not the main driver for the change programme which is focussed on quality outcomes for young people and families, there is an underlying overspend in external residential placements which requires to be addressed. Recognising the work and time required to make the changes, the IJB provided for an additional £4m of resource as a budget pressure in 2024-25 to support this cost pressure, with an expectation of this reducing over time. 5.2 Human Resources Any possible impact on staff due to re-modelling or service redesign will be explored fully in the workstreams and project board and affected staff, and Human Resources will be consulted. 5.3 Legal There is legislation and policy that govern looked after and care experienced children and young people and the programme of work will adhere to the legislative frameworks and relevant policies and regulations. Legal services will be consulted on any legal matters that arise throughout the programme of work. 5.4 Equality/Socio-Economic The aspirations of the programme board are in line with the vision of The Promise to address the inequality of outcomes experienced by our children and young people who have been, or are in, the care system. If the ambitions of The Promise are realised, not only will there be improved outcomes but also a reduction, and ideally, an elimination of the inequity that exists between care experienced children and young people and children and young people with no experience of care. 5.5 Risk The programme board has a risk log to identify any identified risks from each service represented on the board. When trying to project and plan resources for looked after children there is an element of uncertainty as children who require alternative care are usually in a crisis situation and their admission to care is unplanned with limited opportunity to plan and seek appropriate resource. Trafficked young people are spontaneous arrivals and it is unknown how many we will need to support in the near future.
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The current care system we are operating with is under significant pressure with capacity issues within foster care and residential care and limited options to support care leavers. The risk of not embarking on the programme of work and transformational change, could lead to increased costs of external provisions and further overspend. 5.6 Community Wealth Building None. 5.7 Key Priorities The work of the Programme Board fully aligns and supports the work of: • The Promise – Plan 21-24. • The United Nations Convention on the Rights of the Child (UNCRC). • Kinship Care Strategy. • Getting it Right for Every Child (GIRFEC). • North Ayrshire Council’s Corporate Parenting Plan 2023-2026. • Children’s Services Plan 2023 -26. The proposal and recommendations support the spirit of The Children and Young People (Scotland) Act 2014, which outlines the need for appropriate accommodation for young people over 16 years of age, to support them to prepare for independent living. 6. CONSULTATION Throughout the programme of work there will be ongoing consultation and collaboration with service areas, national bodies, third sector colleagues and consultation and co-production with service providers, young people, families, and carers, many of whom are represented at the Project Board or through the Workstreams. Caroline Cameron Director, HSCP For further information please contact Elizabeth Stewart, Head of Service, Children, Families and Justice, on 01294 317727