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Special Report: Innovative, cost-effective assessments in times of cuts

Clare Jerrom takes a look at an innovative evidence-based assessment model that could save local authorities vital funds - as children's services face dwindling resources and a shortfall of £3.1 billion by 2025 to operate at current levels.

As it emerged last month that one in four local authorities plan to reduce their spending activity in children's services in 2019, it begs the question of how vulnerable children are to be protected going forwards without compromising the quality of the services they receive?

Significant funding pressures, coupled with a growing demand for services and a lack of preventative services which have been pared back in times of austerity, are resulting in a "perfect storm" for children's services as they face the future trying to protect children at risk and experiencing abuse and neglect with diminishing funds.

Indeed, the Local Government Association, which represents 370 councils in England and Wales, has revealed that children's services face a £3.1 billion funding gap by 2025 just to continue operating at current levels, placing councils under a huge amount of strain.

Children First revealed just last month the extent of funding pressure on children's services.

Legal challenges

According to The State of Local Government Finance Survey 2019, which the LGiU and The MJ have run since 2012 and which revealed 24 per cent of councils planned to “reduce activity” in children’s care services:

  • Children’s services and education is the top immediate financial pressure for the second year running (36% of councils), ahead of adult social care (23%).
  • Almost one in 10 councils are anticipating legal challenges this year due to reductions in service provision.
  • Over half of councils (53%) plan to dip into their reserves this year.
  • Eighty four per cent of councils say it is a high priority or essential to explore other sources of income and eight in 10 councils are considering commercialising council services to raise extra money and over half want to sell off council assets.

Jonathan Carr-West, Chief Executive of LGiU said: “Uncertainty piled upon uncertainty: we have been running this annual survey with the MJ since 2012. We know that council funding is broken. Eight out of 10 of those people leading English local government tell us it is unsustainable.

“This year we see that we are no closer to finding a solution. Councils are making do by increasing council tax as much as they can, increasing charging and dipping in to their reserves. And even with these desperate measures they are having to reduce spending; not just on vital place-shaping services like leisure, libraries and parks but in core life-saving areas like social care and children’s services."

Immense pressure

In January, new figures showed that a total of 133 out of 152 councils (88 per cent) were forced to spend more money than they had planned to on children’s social care in the last year (2017/18). This amounted to an overspend of £806 million. 

The LGA said the number of councils spending more than they budgeted for indicates the immense pressure they are under to support vulnerable children and young people.

This comes against a backdrop of an increase in demand as latest figures show that the number of looked after children continues to increase to the highest level since the 1980s, with a total of 75,420 children in the care of councils in England.

The LGA says that the support necessary to keep children safe from immediate risk of harm can be extremely expensive, forcing councils to cut or end vital early intervention services which can help prevent children from entering care in the first place.

At the same time, the number of children supported through a child protection plan to keep them safe from harm increased by more than 2,700 over the past year - the biggest annual increase in four years, and an 84 per cent increase in the number of children on plans over the past decade.

To further compound the issue, the LGA revealed this month that the amount local authorities have spent supporting unaccompanied asylum seeking children has almost doubled in four years.

Councils spent £77 million supporting unaccompanied asylum seeking children in 2014/15 and this rose by 95 per cent to more than £152 million in 2017/18. The figures also reveal that the number of asylum-seeking children and young people in care in England under 18 rose from 2,760 in 2014/15 to 4,480 in 2017/18.

Councils have also seen an increase of more than 50 per cent in two years in unaccompanied children leaving care when they turn 18, but remaining the responsibility of the local authority. There were 4,660 unaccompanied children leaving care in 2016, which went up to 7,130 in 2018.

Child tragedy

Given health visitors have voiced concerns of a child tragedy, it is remarkably unlikely that social workers are not fearing the same. Four in 10 health visitors reported fearing a child tragedy at some point because they are so over stretched.

While there is no single solution to the dilemma facing local authorities, until further funding is promised which council leaders hope will be forthcoming in the Spending Review, councils are being forced to look to cost-effective, yet high-quality services to support children. This is one of the reasons that WillisPalmer has gone on to launch its Multi-Disciplinary Family Assessments which aims to carry out bespoke assessments using a broad range of experienced professionals in the family home. Such intensive intervention means the assessments are carried out within a relatively short time-frame - eight weeks - and, as they are carried out in the family home, thus reduces the need for local authorities to pay costly residential fees.

Sir Martin Narey's review of residential care found that in 2016 there were 5,300 children living in residential children's homes at a cost of £750m a year. This means the cost per child of being in residential care for a year is £141,509.

Further analysis from the Personal Social Services Research Unit found the cost of placing a child in a local authority residential home to be £4,036 per resident per week in 2016-2017, which would place annual costs at £223,912 per child.

As a result, any method of saving local authorities much needed funds while providing an expert service is considered highly desirable, as councils are clear that they do not want to compromise the quality of services.

Multi-disciplinary

Under the MFA, the assessment is led by a social worker but with input from clinical, educational or forensic psychologists, child and adolescent psychotherapists, mental health practitioners and family support workers.

The entire assessment plus report is produced within eight weeks and includes 100 hours social work and 100 hours of family support. The family will be observed throughout every day activities and interactions and should there be any risk, 24-hour monitoring can be put in place through trained family support workers.

The process begins with an initial meeting of all the professionals involved to plan the format of the assessment followed by a meeting with the family to discuss the programme of intervention. Three weeks later, the WillisPalmer multi-disciplinary team and all professionals involved with the family will meet to share progress. A final meeting takes place after six weeks where the findings will be shared with all professionals involved with the family and the findings and recommendations will be presented to the family. The evidence-based final report with clear recommendations and conclusions will be produced after eight weeks.

Keeping families together

MFA has numerous benefits including:

  •  Intensive nature reduces delays.
  • Carried out within eight weeks reducing uncertainty for families.
  • Keeps families together at home in natural surroundings.
  • Dynamic and flexible.
  • Bespoke to the needs of the family.
  • Evidence-based.
  • Multi-disciplinary.
  • Input from various professions reducing risk of multiple reports.
  • Saves the local authority money during times of austerity.

Indeed, WillisPalmer estimates that moving children and their parents or carers to a residential unit, away from familiar surroundings and their communities, could result in a cost of £54,000 for a parent/child placement. Thus, the £25,000 cost of MFA means local authorities are making a saving of 57 per cent or, in cash terms, £31,000.

One team manager said: "The service provided by WillisPalmer has been nothing less than excellent. Communication has been prompt and efficient, with phone calls when necessary. we as an organisation would most certainly continue to use the services provided by WillisPalmer when needed."

Learn more about our MFA service.

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