Regional care cooperatives (England)

‘Local authorities need help to take back control of this system through establishing new Regional Care Cooperatives (RCCs). They will take on responsibility for the creation and running of all new public sector fostering, residential and secure care in a region, as well as commissioning all not-for-profit and private sector provided care for children as necessary. The scale and specialist capabilities of RCCs will address the current weaknesses in the system and establish organisations able to transform the care system for the future. Local authorities will have direct involvement in the running of RCCs but to work they must be mandated rather than voluntary arrangements. Children will continue to be in the care of local authorities.’

P10 The independent review of children’s social care, Final report, Josh MacAlister May 2022

There is no doubt that the current system for commissioning and finding foster care for children in care in England is inefficient and bureaucratic. There are currently around 20 local authority consortia across England who in some way work together on commissioning external placements. There are characteristics of each of them that are positive, but, in our view, no single consortium has successfully developed as an arrangement fit for purpose yet. There are also around 20 individual local authorities working on their own to commission foster care from independent fostering agencies. This picture is constantly changing.

Local authorities continue to treat their own ‘in-house’ fostering service as the automatic preferred provider of choice, with no prior commissioning or procurement. This goes directly against the principle of finding the most appropriate placement for each child as stated in section 22c of the Children Act 1989. It is not an unlawful practice, but is not in the best interests of children, nor is it the best way of allocating public spending.

It is difficult to envisage any minor changes to current structures that could improve this situation. Sadly, some local authorities seem unwilling to learn from past mistakes and so we support the need for radical thinking. We see some merit in exploring RCCs, but there are also risks in moving towards an untested system at such scale. The closest model to the proposed RCCs are regional adoption agencies (RAAs) which are unproven - DfE’s final evaluation report (2022) paints a mixed picture.

We have not sought to address the issue of children’s homes in this paper as this is for the Children's Homes Association (CHA) to consider, but we see overlaps in the issues for children in both types of placement.

What might RCCs look like?

• The size of the 20 existing consortia varies from 2 to 22 local authorities. The larger consortia mostly operate  in the same footprint as the ADCS regions and this could be an appropriate footprint for RCCs. In some regions there would be a need to bring together smaller consortia. Local authorities working alone should be required to join their RCC - experience suggests that this is the only way to bring all local authorities on board. This could impact on the scale of external commissioning and offer efficiencies in the resources required to undertake commissioning and procurement.
• Local authorities could remain responsible for their own in-house fostering services (so no requirement to change care planning legislation and fostering regulations), and maintain their relationships with their foster carers. As with local authority children’s homes, local authority fostering services should be required to register with Ofsted so they are inspected using the same framework that is applied to IFAs, thus providing a more effective way of comparing quality across all fostering services so that children do not receive services measured against different standards.
• The responsibility for finding a placement for a young person rests with a variety of roles, depending on the structure and commissioning approach of the local authority. Some have placement teams that are managed separately from their in-house foster care service, however in others, the responsibility for finding placements sits with their in-house fostering team. In a few local authorities, the responsibility of finding a placement rests with the child’s social worker. We propose that,, the placement finding function is separated from the local authority fostering service and be located in a commissioning and placements hub for all local authorities. This team could be locally based, but become one of several hubs managed by the RCC.

Commissioning and finding placements

• The hubs would be responsible for commissioning and finding placements for children in their area. In each RCC footprint, there will be a myriad of existing contractual arrangements between local authorities and IFAs so each RCC will need to consider if/how to continue to support these. For example, a RCC may require a local authority to apply to join an existing framework, or a new commissioning exercise may be designed to qualify both the local authority and IFAs that deliver good quality and value for money.
• Local authority social workers would be required to codesign referrals with those who know the child best, including independent provider social workers and/or carers. Social workers would be responsible for providing their RCC commissioning and placement hubs with information about a child’s needs along with timescales and any specific conditions and requirements. The RCC would then seek placement options equally from local authority in-house fostering services, other local authority fostering services and IFAs. NAFP’s forthcoming research on referrals shares messages about enablers and barriers to placement finding. RCCs could benefit from developing their placement finding processes with this learning in mind.
• The RCC would consider the local authority’s internal foster carers alongside those fostering for IFAs and neighbouring local authorities. The overriding principle for matching would be the most appropriate placement for a child, regardless of the provider by whom the foster carer is approved.
• There would be greater focus on child-centred decision-making and ensuring there are arrangements in place for placement decisions to be independently scrutinised. Wherever possible, this scrutiny would take place before the placement is agreed. There would also be greater weighting given to the child’s voice and, where more than one option is available, and where professionals believe any of these could meet the child’s needs, the child should be given an opportunity to express their views about the foster home they feel they will be happiest in.
• Local authority placement budgets would transfer to the RCC. This could result in more children coming into care and protected effectively, as safeguarding would become the primary motivation and not any financial constraints facing the local authority.
• Local authorities would be required to ensure there are appropriate and robust measures in place to ensure the type of placement sought is one that meets a child’s assessed needs. At present, many local authorities apply a sequential sourcing process with those responsible for identifying placements having to (apparently) exhaust lower cost options before permission is given to search for the type of (higher cost) placement really needed. This approach is counterproductive as it prevents children’s needs from being met quickly enough, leading to increased needs and risks at a later stage. In part this has led to an increased demand for higher cost services able to provide the levels of supervision to manage the risks that can result from not meeting needs earlier in a child’s care journey. Removing sequential sourcing would release resources in the system as well as improve stability for children.
• RCCs would be responsible for paying the fee identified in the procurement and contracting processes. There will be times when it would be in a child’s best interests to be placed with a local authority foster carer located in a different authority. The RCCs could enable this and pay the fee agreed with the relevant local authority service. RCCs could agree ‘soft block contracting’ arrangements with both local authority and IFA fostering services, providing a greater level of confidence and assurance, thus reducing risk for these providers and in turn reducing fees.

Monitoring the quality and cost of foster care

• RCCs would undertake monitoring of local authority fostering services and IFAs in their area. RCC commissioning and placement hubs would gather information at an individual child level by reviewing individual placement agreements (IPA) and receiving feedback from social workers and independent reviewing officers (IRO). These anonymised summaries would feed into RCC monitoring local authority fostering services and IFAs. This would enable the RCC to gain an accurate picture of the quality of services being delivered and understand the value for money. The RCCs would be better placed to identify issues where a lack of partnership working was having a negative impact on the quality and cost of services. This would be fed back to the multi agency partner(s) involved.

Support, reporting and governance

• RCCs would provide regular reports to a National Care Cooperative (NCC) which would collate and analyse information to inform a national overview. Whilst RCCs would remain responsible for commissioning services at local and regional level, the NCC would identify which specialist or rarely requested services are needed to support low numbers of children on a national basis. The NCC would commission these services, and provide the commissioning and placement hubs with information on how to access these specialist services under the terms agreed with NCC.
• By having national oversight, the NCC will be able to identify the RCC commissioning arrangements that work well. The removal of sequential sourcing arrangements will be critical to ensure the NCC is able to identify the services that need to be commissioned or decommissioned. The NCC would be responsible for reporting to DfE.
• To provide local authorities, IFAs, those receiving services and those advocating for children in care with confidence, there would be a commitment to ensure robust, comprehensive and transparent communication. Reports and regular bulletins would be available on an accessible website administered by the NCC. This would provide an oversight of the RCCs progress and where lessons could be learned. This would play an important part in debunking some of the current myths and reduce anxieties that exist.
• The NCC could also be responsible for managing, maintaining and promoting national terms and conditions for children in foster care. This would lead to greater consistency for children along with enabling RCCs to better compare the effectiveness of their commissioning. The national terms could be a supportive tool, but would also help the NCC and DfE to hold RCC’s to account. These national terms would build on current national fostering contract terms and conditions, but would need to be further developed so they could apply to all fostering services, including those provided by local authorities.
• Placement portals are extremely unpopular with IFAs for a myriad of reasons. Despite this, most IFAs agree that an effective information systems solution could improve efficiency and identify potential placement options. From discussions with IFAs, we are convinced this would need to be a national system with providers having equal input into its design and implementation. To date the necessary work with providers has not taken place to develop a portal that is truly fit for purpose. The NCC could take this development work forward at a later date, giving suitable forewarning so existing regional and local placement finding portals could be decommissioned. There may be anxiety that RCC-led placement-finding could lead to some children being placed further from home. However, we believe that a well designed national placement portal, if used in conjunction with non-sequential placement finding, could result in more children being placed closer to their families and communities over time.
• A third, not mutually exclusive option, would be for local authority in-house fostering teams services to move to the RCC. Line management arrangements would need to be carefully considered so there was no conflict of interest, particularly when placement decisions were made. Transparency over the placement process and arrangements for decisions to be independently scrutinised could reduce the risk of inappropriate matching or poor decision making. The option to move local authority in-house teams to RCCs should be carefully risk assessed and should consider the specific risks that come with establishing large provider services. It may be better to maintain them within local authorities whilst RCCs are set up as commissioning bodies. Then a period of time is given to analyse the impact of this, before a decision is made whether to transfer local authority in-house fostering services to RCCs.
• In considering governance arrangements for each RCC and the NCC, we believe that current local authority consortia governed by senior local authority officers do not provide a model that is fit for purpose. We would propose each RCC is governed by an executive board which includes non-executive directors, representatives from a wider advisory group, including sector representative organisations and organisations advocating for children in care. 

Regulation

• Consideration could be given to developing a new inspection framework for commissioning which would enable Ofsted to inspect RCCs. This would focus on how RCCs developed robust, theoretically informed and relational practice. There would be a requirement for RCCs to apply therapeutic standards and specifications that are demanding of all providers, but which also hold RCCs and corporate parents to account for the role they play. A programme of training would need to be established to develop the necessary skills and knowledge to undertake these inspections.
• A further option for consideration would be to review the longer term role of the regulator with regards to their inspection of fostering services. A new inspection framework could judge if RCCs to have robust and effective systems in place for vetting and monitoring the services they work with. This could replace some of the work Ofsted currently undertakes, producing efficiency by removing duplication that comes with regulation and commissioning. We recognise that suggesting an amended role for Ofsted in this way may create concern, but do think there is merit in assessing the likely impact of this approach.