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The Local Government Association and the members of the Children’s Services Development Group made up of the leading service providers, including SENAD, have collaborated on a project called ‘In it Together’.
The project recognises that local authorities have to operate within increasingly tight budgets but
highlights that through providers working with local authorities in a creative and positive way, they can still provide the services that deliver the best possible outcomes for children and young people.
The aim of the project is to highlight examples of best practice. The project document, which is made up of a number of case studies, (SENADs’ see Below), demonstrates instances of effective partnership between provider’s, commissioners and other agencies. It includes evidence which show how young people can contribute to their own care plans, methods for promoting placement stability for children who have suffered from multiple placement breakdowns, examples of innovative commissioning and flexible block contracting, as well as developing a team parenting approach to foster care and working with multi-agency partners to manage the difficult transition into adulthood.
The report is aimed primarily at those with responsibility for making commissioning and placement decisions. It will however be equally useful to private, voluntary and independent sector children’s services providers as they seek to work ever more closely with local authorities to deliver the best possible outcomes for the children in their areas. It will also be useful to parents looking for the best provision for their loved ones.
To read the report please go to the Children’s
Services Development Group website: www.csdg.org.uk/images/pdfs/Inittogether_September2009.pdf
Outcomes based commissioning – The London Borough of Waltham Forest and the SENAD Group
Waltham Forest Council and the SENAD Group are aware of the long-term benefit of basing commissioning decisions on the potential for positive outcomes for each young person and have found that adopting such an attitude is both cost-efficient and positive for children’s development. In order for commissioners to choose the best provider to aid a young person’s progress, a thorough assessment of need is imperative. SENAD work strategically to identify young people’s behaviour ‘pressure points’, through a functional behaviour assessment helping to improve outcomes and aid progress for each young person’s future development.
Case study: Derek has Attention Deficit Hyperactivity Disorder (ADHD), learning difficulties and presented severely challenging behaviour. Prior to his admission to SENAD’s Aran Hall setting in July 2004, Derek was accommodated alone in a large, isolated farmhouse and cared for by three staff for 24 hours a day. These intensive measures were necessary due to the risk he presented to staff and peers, through absconding and physical aggression, frequently damaging property and furniture.
Waltham Forest were keen to build in outcome measurements within a care and education plan to support Derek in maximising his independence and improving his quality of life. Progress was monitored regularly via school and care home reports and review meetings. Initially, Derek settled well into the school routine but within a few weeks he was testing boundaries and presenting disruptive and aggressive behaviour on a regular basis, which limited his access to the community. A functional behaviour assessment identified that many of his behaviours were motivated by restrictions to his preferred activities e.g. computer games. Derek’s attention span was initially very short but was increased by making access to preferred activities contingent on him completing his class work, aided by pictorial timetables and a work-play procedure. Derek has been supported to maximise his independence and his progress is judged against the Every Child Matters outcomes framework:
• Be Healthy - Derek now gets out of bed without protest, carries out personal care tasks without prompts, listens to instructions and is quick to calm if agitated. He has a balanced diet and enjoys sport.
• Stay Safe – Change in routine unsettles Derek, which his mother found difficult to manage on home visits. However, he has been supported to cope with these disruptions and now goes home regularly. He has also been on a plane with his mother on two occasions and to the school without any difficulties.
• Enjoy and achieve - Derek has passed two modules of the ASDAN ‘Towards Independence’ award, works for long periods and is keen to show off his work to staff and visitors. His handwriting has improved and he will now use ‘please’ and ‘thank you’ without staff prompts.
• Make a positive contribution - Derek is learning about recycling and contributes to the school’s internal programme, with a view to volunteering for similar work in the community. He has made friends, often going to sit next to peers if they are upset and has formed lots of strong relationships with adults.
• Achieve economic wellbeing - Derek is working towards greater independence by developing his social and community living skills through visits to shops, restaurants, swimming and bowling etc. His behaviour in the community is generally good and continues to improve.
Making placement decisions based on predicted delivery of outcomes is an effective way of creating significant financial benefits. Indeed, in the case of a child with complex needs, who can often become aggressive, placements that can manage this kind of behaviour can generate significant savings - approximately £500,000 in Derek’s case - as increased independence and less intensive staff support all allow for financial savings. When placements are made on the basis of outcomes, young people are ultimately helped towards greater levels of independence and can enjoy a higher quality of life. Waltham Forest’s commitment to ensuring the best possible outcomes for young people has provided Derek with a positive experience at Aran Hall and he is planning a transition to a supported living placement close to his mother, where he will live with another adult and have a support worker. This is a step that would have been unthinkable were it not for a commitment to identifying his needs and working towards outcomes that would reflect real progress for Derek.
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