Published by The Fostering Network Wales Strengthening Families Support Care Project. This project is funded by the Big Lottery in Wales.

Transcription

1 Unit Costs of Support Care A comparison between the costs of providing support care and associated intensive support services OR full-time foster care and associated intensive support services The report has been produced in conjunction with Lisa Holmes, Assistant Director, Centre for Child and Family Research Department of Social Sciences at Loughborough University Published by The Fostering Network Wales Strengthening Families Support Care Project. This project is funded by the Big Lottery in Wales.

2 The Fostering Network is the UK s leading charity for everyone involved in fostering. With almost 40 years of experience, we are experts in all sorts of foster care. As part of our remit, we undertake projects to drive forward best practice and change. Since 003 we have been working closely with local authority and independent fostering providers to assist them in the development of support care. This has been supported with funding from the Welsh Government, The Four Acre Trust, the Waterloo Foundation and the Big Lottery. We have also worked closely with Cardiff University who are carrying out research into support care outcomes and the Centre for Child and Family Research (CCFR) at Loughborough University who have prepared this report. Support care is short-term preventative foster care aimed at families in crisis with a view to avoiding a child being take into care full time and long term. Support carers look after the child on a part-time basis, while at the same time a package of other support services is offered to the family, giving them space, guidance and help to work through their problems. Despite government focus on early intervention and prevention, support care currently seems to be taking a back seat, a victim of local authority cuts. This new report from CCFR, Unit Costs of Support Care, shows for the first time that this is a false economy it demonstrates that support care, including the accompanying support services for families, has a far lower unit cost than the foster care it replaces and aims to avoid longer term for those children who can be helped to stay at home. Even more importantly than its value for money, support care is effective. The input of the support carer and the help provided alongside can often mean that the child does not need to come into full-time care. It is estimated that just two or three children end up in the care system for any length of time out of every 100 support care referrals. As well as helping struggling families stay together, support care also helps family and friends carers such as grandparents who report that they struggle when children are first placed with them. It is also effective in helping to prevent adoption breakdown, and it can be a breathing space for some families whose children don't hit the criteria for short breaks for disabled children but desperately need help. The more innovative fostering services are already recognising the value of support care; this report helps to show why it is time for others to follow suit. We would like to thank Lisa Holmes, assistant director at CCFR, for preparing the following report highlighting the unit costs of support care, which alongside the social and emotional costs illustrate very clearly the benefits of support care. Freda Lewis Director, the Fostering Network Wales

3 Background Since 000 the Centre for Child and Family Research (CCFR) at Loughborough University has been carrying out a series of research studies and evaluations to explore the relationship between costs and outcomes of services provided to vulnerable children and their families (Costs and Consequences of Placing Children in Care, 008; Understanding Costs and Outcomes in Child Welfare Services: a comprehensive costing approach to managing your resources, 01). The initial research focused on looked-after children and the methodology has since been extended to include children in need, disabled children in receipt of short break services and families supported under Common Assessment Framework arrangements. The key output from this work has been the development of the Cost Calculator for Children s Services (CCfCS), purpose-designed software. The overall objective is to develop the CCfCS to incorporate unit costs for all services that children receive within specific time frames. These will include the unit costs of services provided by a range of agencies so that eventually it will be possible to calculate the costs to the public purse of providing services to children with extensive needs and to explore how these might be better configured to improve outcomes. The overall programme is also designed to clarify how costs are shared between agencies and thus introduce transparency into the joint commissioning of services for children with complex needs. Methodology The programme of research utilises a bottom-up approach (Unit Costs - Not Exactly Child s Play: a guide to estimating unit costs for children s social care, 000) to costing services. Essentially all the costs are built up from an individual child (or family) level, based on all the support and services that an individual receives. The approach identifies the personnel associated with each support activity or service and estimates the time they spend on it. These amounts of time are costed using appropriate hourly rates. The method therefore links amounts of time spent to data concerning salaries, administrative and management overheads and other expenditure. The costs of management and capital overheads are based on those outlined in an annual compendium of health and social care unit costs (Unit costs of health and social care, 01). This methodology allows for the development of a detailed and transparent picture of costs of providing a service, and of the elements that are necessary to support service delivery. This method facilitates comparisons of costs and allows for exploration of variations in costs according to the needs of children, placement type, decision making processes and approaches to service delivery. 3

4 Furthermore, the unit costing methodology is process driven, so includes all the social care activity to support vulnerable children and families as well as the cost of placements/services 1. Unit costs have been estimated for a range of processes; these have been broken down into different service areas, predominantly to reflect research funding for a number of different studies. Each of the processes is costed as a discrete, one off event that may occur on multiple occasions. The exception is the provision of ongoing support. The unit cost for this process is estimated per day and can then simply be multiplied by the number of days that the child receives support, or is in placement. Unit costs of support care Making use of the methodology developed by the team at CCFR and using a range of pre-existing process unit costs (for example referrals, reviews and ongoing support) it has been possible to estimate the unit costs of support care, using individual case studies as illustrative examples. The processes for support care are outlined below. Process 1: Referral to support care Process : Provision of support care (ongoing support) Process 3: Review Process 4: Case closure Support care case studies Two case studies have been selected for unit cost estimation. For each a short case outline is provided, along with a pictorial representation of the key decision points, assessments, processes and services 3 provided. Estimated unit costs for one year are then shown. For comparison purposes the unit costs have also been estimated for the children, had they been placed away from home. 1 The placement fees and allowances used for these unit cost estimations are based on the national minimum allowances for Wales and the fees detailed in Update to the Cost of Foster Care, 010. The pre-existing unit costs have been taken from Costs and Consequences of Placing Children in Care, 008; Understanding Costs and Outcomes in Child Welfare Services: a comprehensive costing approach to managing your resources, 01; Exploration of the Costs and Impact of the Common Assessment Framework, 01. Decisions regarding the most applicable unit costs were based on detailed discussions with the Fostering Network, Wales. 3 The costs of services provided alongside support care have been taken from the C4EO family savings calculator - 4

5 Case study: the Shaw family The Shaw family were referred for support care due to social work concerns regarding their living arrangements and deterioration in family relationships. The family consisted of 11 children living with mum and step-dad in a small threebedroom house. In addition to support care the family were engaged with a housing support service, budgeting advice, parenting classes and ongoing social work support. Support care was initially offered to three members of the family, Jack aged 15, Samantha aged 8 and Jordan aged 7. Different support carers were identified for each of the children and they were offered one overnight stay with support carers once a fortnight. The Shaw family support care timeline Key Process : Ongoing support: each of the three lines represent the ongoing support offered to the three children. 5

6 The Shaw family s unit costs: support care Annual social care unit costs Process Process unit cost ( ) Social work cost ( ) Fostering cost ( ) (6.34x1) and (108.70x1) ((147/7)x6)x3 + ((44/7)x6)x x8 and 68.8x Total Annual costs of other support or services provided alongside support care Support or service Frequency/duration Unit cost ( ) Subtotal ( ) Parenting programme One course - group Housing support Once a fortnight Budgeting advice Once a fortnight Total cost of other support or services,11 The Shaw family s unit costs: looked-after children The costs for the Shaw family would have been much higher if the local authority had been required to place them as looked-after children. Using the same methodology developed by CCFR at Loughborough University it is possible to estimate the annual cost incurred by children's services to provide looked-after services to the Shaw family. These costs include the activity to find the first placement for the three siblings, to review the case (using statutory timeframes of 8 days, three monthly and six monthly intervals), update care plans and also support the children in their placements. The costs of these processes are detailed below: Process Cost ( ) 1: Decide children need to be looked-after and find first placement 965 : Care plans: Updated three times following reviews for each of the children ( 38 x 9),14 3: Maintain the placements: Support and placement costs ( 793 per child per week) 13,708 6: Review: Held on three occasions during the year (3 x 614) 1,84 The total estimated unit cost to look after the three Shaw children in local authority foster care for one year is 18,657. This is nine times higher than the estimated social care costs of providing support care for the same duration. 6

7 Case study: Sam Sam, a six-year-old boy was referred for support care as a result of housing and financial concerns. Sam was living with his father and step-mother, along with five other children in a two-bedroom property throughout the week and a further three children stayed at weekends. Space and overcrowding were key concerns as were the financial pressures. Sam was offered support care, for one overnight stay per week at the weekend. Sam's father also agreed to attend support sessions for parenting and budgeting. Sam continued with weekly visits to his support carers for six months, until his family secured larger accommodation. He then continued to receive support care, but on a fortnightly basis for three further months before being reduced to monthly stays. Sam and his family no longer required support care or other support services after 1 months Sam support care timeline Key 7

8 Sam s unit costs: support care Annual social care unit costs Process Process unit cost ( ) Social work cost( ) Fostering cost ( ) (6.34x1) and (108.70x1) ((147/7) x4) and ((44/7) x4) x8 and 68.8x Total Annual costs of other support or services, provided alongside support care Support or service Frequency/duration Unit cost ( ) Subtotal ( ) Parenting programme One course - group Housing support Six sessions Budgeting advice Once a fortnight Total cost of other support or services 1,49 Sam unit costs looked-after child The costs for Sam would also have been much higher if the local authority had been required to place him as looked-after children. Using the same approach as for the Shaw family outlined above, it is possible to estimate the annual cost incurred by children's services to provide looked-after services to Sam. These costs include the activity to find the first placement for Sam, to review the case (using statutory timeframes of 8 days, three monthly and six monthly intervals), update his care plan and also support Sam in his placement. The costs of these processes are detailed below: Process Cost ( ) 1: Decide child needs to be looked-after and find first placement 965 : Care plans: Updated three times following reviews 1,734 3: Maintain the placements: Support and placement costs ( 793 per week) 41,36 6: Review: Held on three occasions during the year (3 x 614) 1,84 Total 45,777 The total estimated unit cost to look after Sam in local authority foster care for one year is 45,777 four times higher than the estimated social care costs of providing support care for the same duration. 8

9 References Ward H, Holmes L and Soper J Costs and Consequences of Placing Children in Care (Jessica Kingsley Publishers, 009) Holmes L and McDermid S Understanding Costs and Outcomes in Child Welfare Services: a Comprehensive Costing Approach to Managing Your Resources (Loughborough University, 01) Holmes L McDermid, S Padley M and Soper J Exploration of the Costs and Impact of the Common Assessment Framework (Department for Education, 01) Holmes L and Soper J Update to the Cost of Foster Care (the Fostering Network, 005) Curtis L Unit Costs of Health and Social Care (Personal Social Services Research Unit, The University of Kent, 01) Beecham J Unit Costs - Not Exactly Child s Play: a guide to estimating unit costs for children s social care (The Department of Health Dartington Social Research Unit and the Personal Social Services Research Unit at the University of Kent, 000) If the financial, social and emotional savings highlighted in this report have caught your attention, please contact us to find out more. The Fostering Network Wales Strengthening Families project, funded by the Big Lottery, can provide materials, training, advice, forums and so on to any fostering provider interested in setting up a support care scheme. Please visit or philippa.williams@fostering.net The Fostering Network is registered in England and Wales as a limited company, no Registered office 87 Blackfriars Road, London SE1 8HA Registered charity no in England and Wales and SC