Partnerships, not profiteering, are the future for commissioning great Children's Services
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By Chris Luck CB MBE DL
Group CEO, Shaw Trust (Homes2Inspire corporate parent)
This article was originally published on the MJ on August 16th 2024.
The commissioners I speak to are telling me the same things – that they are battle worn by years of dwindling funding and increasing demand, that there is never enough – whether funding, time or staff, and that despite their dedication they feel we are failing children in care.
The ‘Market’ is failing society’s most vulnerable citizens by exploiting a ‘gold-plated’ income stream. A fundamental change is needed in commissioning because doing the same in the hopes of improvement is the very definition of insanity.
The underlying issue is that children need care homes at all. A better outcome is addressing causal factors such as poverty, poor health, poor education, lack of opportunity, and domestic violence. Prevention is better than cure, or in other words treat the cause, not the symptom, to do away with the need. A subject perhaps for another time.
This is not the ‘Market’s’ preference. It thrives on the status quo. Commissioners, dependent on a rentier economy, have unwittingly sleepwalked into market failure, underscored by DfE’s Market Intervention Advisory Group highlighting the problems of profiteering. This is not to say that quality care is not expensive, but we must differentiate cost from value and seek solutions to the Market’s failure to deliver value.
Partnership, rather than profiteering, is the solution. Homes and Horizons, our MJ award-winning, not-for-profit 10-year Strategic Partnership with Somerset Council and the NHS, is such an example with the aim of better outcomes.
Together we’ve co-created a holistic, child-centred model of homes, therapeutic education, and fostering provision, as well as innovation funding. This has been possible through a shared vision, management, and shared risks. The education provision necessitated persuading DfE to change policy. That is no mean feat and took patience and a clarity of shared purpose that the department would eventually have confidence in. Only a partnership can do this, you cannot ‘contract’ it.
Our homes are built around the child, with the child, for the child. We create a strategic pathway with ‘on and off ramps’ for commissioner and child. Adjustments can be made to meet changing local needs and respond to emerging evidence as to what works, thus avoiding the inefficiencies of input-orientated transactional contracts, where there is no incentive to improve and every incentive to maximise margins.
To deliver for our most vulnerable in society, we need top talent. We need kitemark standards of professionalism, and a National Children’s Care Home Academy to induct and then support upskilling and progression in career. Only by investing in our people can we create the aspirational and inspirational professionals the children in care deserve. Professionalisation may be a cost, but it will break the dead-hand of today’s workforce challenges, where staff are too often seen as a cost to the bottom line, rather than the frontline of quality provision, and vote with their feet.
Strategic Partnerships have an open-book cost-plus model, as we have in Somerset. A reasonable return is agreed to reflect the level of shared risk and to enable reinvestment over the period of the partnership. There is no scope for price gauging or increasing margin by reducing quality. Our Homes and Horizons innovation fund gives back money if efficiencies are made, allowing spending on additional programmes. We reinvest ‘productivity’ gains allowing for additional capacity build, innovation, and the development of local stakeholders. There is no rentier economy, no opportunity to inflate pricing through scarcity, no incentive to treat the critical workforce as an expense, and every incentive to create additional outcome value in qualitative and financial terms. Like-minded providers, small or large, can join forces and are not shut out, except for the old practices.
Every place has unique needs, so local provision integration and solution-shaping is more effective than a one-size fits all approach. However, it’s possible to achieve the application of principles at a regional and sub-regional level to deliver efficiency and impact at scale. Therefore, strategic partnerships have two layers; the regional application of principles and then the local co-production of solutions. Done right, it means that solutions are highly exportable, transferable, shareable, and will create further efficiencies for co-working Local Authorities.
I’ve been deliberately pugilistic in describing how to create a better approach to care. It’s essential we do if we are to prevent the generational baton being passed on. Strategic partnerships allow for holistic ‘Child to Career’ thinking to break the cycle of poor educational and career opportunities, victimisation, incarceration, and worklessness, which are statistically the adult expectation of care-experienced children.
Strategic partnerships create real value, where reasonable profit is enough, and scarce resource is reinvested rather than off shored. The measure of a decent society is how we treat our children in care and support them into adulthood. Partnership, not profiteering, is the future.