No Silver Bullets but CareCubed Children's Can Help

No silver bullets exist for the fragile children’s care market but having CareCubed in place can help local authorities and providers start addressing the issues.

The issues in the children’s social care market were recognised in both a Competition and Markets Authority (CMA) report last year and several independent reports over the last two years. In the past decade, the numbers of looked after children have risen from 68,000 to 83,800. Analysis carried out recently by the County Councils Network found per person spending on children’s services had doubled in the same period, with children’s and adults social care services consuming 65 per cent of the budgets of councils with social care responsibilities across England. A Local Government Association survey carried out in November 2023 found that English councils paid for more than 1,500 placements costing £10,000 per week or more in 22/23.

The CMA report highlighted several key findings around the children’s care market, one of which was the recognition that some of the largest providers of children’s placements are making higher profits and charging higher prices than expected, putting a strain on local authority budgets. In addition, it pointed to scarcity of suitable placements and high levels of debt being carried by some large providers, which could disrupt the placement of children in these provisions.

While there is no silver bullet, local authorities are recognising the benefits of using the CareCubed tool to work alongside providers and other health care partners, such as Integrated Care Boards (ICBs), to help start moving the market towards a place that is fair and sustainable.

CareCubed is a tool which enables commissioners to see the variance between ‘price’ and ‘cost’ and start to have conversations with providers about packages, outcomes, and future placements. Nik Jones is an Account Manager at iESE who works closely with clients in the children’s sector. Before joining the CareCubed team, Jones amassed 25 years’ experience in the health and social care sector, including as branch manager for a company which provides support for young adults with learning difficulties. Recently, he’s been working on a pilot programme with three local authorities on their children’s commissioning where they have looked at providers in their market and identified where they could forge strategic partnerships. The pilot has seen some encouraging results.

As part of the pilot, there has been an increased focus on joining up the commissioning processes between adult and children’s services, especially for the transition teams as children start moving towards exiting a service. “What we are trying to encourage, and we are starting to see, is that all age commissioning is the future to help avoid Section 114s. If you are managing budgets effectively in adults service but then hemorrhaging money in children’s, it is futile, and all that work has gone to waste,” explained Jones.

He said CareCubed makes it possible for the transition team to use CareCubed for the cohorts of children coming towards transition age to work with their strategic partners in advance. Adjacent local authorities partnering to provide services can be effective as lots of children and young people in care face contextual issues in their local area which means local placements can carry more risks than out of borough. “They can say ‘we know these young people are coming. This is the type of provision they will require to meet their needs, and this is the area or region that we need to see those services to have maximum impact’ and then they can go to the providers and say: ‘can you do this?’. By modelling a provision in CareCubed with all the details and scenarios they can set up those provisions and make sure the right people are living together with the right support. All of this could happen much earlier than it currently typically does. There is a huge benefit for everyone, both for the council and potential cost savings, but also for the young people themselves.”

As part of the pilot, iESE also worked with one local authority to help it run a joint-funded placement through CareCubed, which was jointly funded by health care partners. The authority then presented the findings to the ICB panel, leading to significant savings for both the council and the ICB. iESE hopes and expects that analysing and negotiating these type of care packages through CareCubed will become more commonplace in future. “We ran the case through CareCubed to see if we could work out a fair split. It resulted in both parties being happy that they were funding the packages correctly,” Jones added. Another way CareCubed can assist the children’s market is through modelling in-house services, which is something local authorities are increasingly doing. “There are solutions, but these are medium to long-term, there is no silver bullet. CareCubed doesn’t fix everything, but it is a fantastic starting point. Everyone needs to be responsible for changing what is going on in the market. Currently, it is unsustainable, and many more councils will face bankruptcy if it continues,” he concluded.

For more information about CareCubed Children's, please visit: www.carecubed.org