5.2.8 Effective Placements and Placement Prioritisation Criteria

RELATED CHAPTERS

AMENDMENTS

This Chapter was amended in June 2009, Section 13, Secure Placements for Children Under 13 Years was amended

Introduction
Assessment
Making a Placement
Delegated Authority
Research
The Children’s Planning Group
Ensuring Safe Placements
Contracts
Monitoring Safety of Placements
Cost Effective Placements
The Team Manager – Checklist
Placement Prioritisation Criteria
Secure Placements for Children Under 13 Years

1. Introduction

Requests for accommodation are often made by families who feel unable to cope any more and the social worker may be put under pressure to immediately Accommodate the child without considering the consequences of such action.

Research shows that if a child has been looked after for more than six weeks there is a greater risk that s/he will be looked after for quite some time (Pattern and Outcomes).

This highlights the need for a thorough assessment before accommodating a child. This assessment may take up to 4 weeks and the SW should consider what supports the family needs in this period.

It is essential that an assessment of the child’s needs is made before accommodation is seen as the most appropriate service.

This checklist outlines the areas that need to be considered before providing accommodation. The Social Worker needs to record the identification of the need, what services were considered to meet this need and why the particular service was offered.

The inclusion of cost and financial indicators reflects the devolution of decision making about expenditure and the need to ensure that the placement provides best value for money in relation to the identified outcomes.

2. Assessment

This section should be read in conjunction with Section 12, Placement Prioritisation Criteria.

When considering whether it is appropriate to accommodate a child, Include in the assessment:

What are the needs of this child?
What is the desired outcome?
What would happen if we did not accommodate?
What information do the family need to make an informed decision about what kind of accommodation they want for their child? What is the parents( or person with parental responsibility) and child’s view of accommodation and/or other services and which is most suitable for this child/family?
Would the family find it useful to have a discussion with the Effective Placements Officer.
Would outreach/day-care provision or other services meet this need?
What package of care would meet the needs of the child? E.g. shared care, family/friends, specific assessment, respite , fostering or residential.
What changes do child/family/SW want to see as indicators of progress? (E.g. less frequency/duration of violent outbursts; improvement in school attendance)?
What evidence is there that this intervention will work?( Include research/ past history of family/ case work experience)
What other work needs to happen? I.e. a care plan. What is the time scale? Short term, medium, long term?
Consult with the Adolescent Forum ( if appropriate) both to alert provider units and to review assessment and provision of service
Copy of assessment given to TM and approved by TM

Once it is established that the provision of accommodation is the best way of meeting this child’s needs -

Ensure that you have

followed the relevant placements procedures, contained in Placements Planning Meetings Procedure
a carefully negotiated Placement Plan that takes account of the wishes of the child and parent is made ( emergency admissions should be avoided if at all possible as these preclude planning)
make a contract which is clear and negotiated before, during and after each review
Consult with TM regarding identified options.

You are then ready to consider what placement would best meet the needs of the child/children.

3. Making a Placement

Making a placement is one of the most important tasks that you can undertake for a child. You should take as much care as possible in choosing a home for your child. These guidelines inform you how to do this and how to ensure that you have the best possible match of placement to child.

Ensure that you have

a carefully negotiated agreement that takes account of the wishes of the child and parent is made ( emergency admissions should be avoided if at all possible as these preclude planning)
each placement made in the P&V sector must have a contract which governs the costs, services and standards of care provided.
make a contract which is clear and negotiated before, during and after each review
Consult with TM regarding identified options.

4. Delegated Authority

In making any placement, you should be aware of who is required to give approval for the costs. Currently the position is:

Team Managers can approve placements up to £1500 per week

Head of Services can approve placements up to £2500 per week

Head of Service approves all placements costing above £2500 per week.

Costs may be divided into care, therapy, education etc. The delegated level should be the regular weekly cost, however this is made up. It is recognised that additional one-off payments for clothing etc. will take costs above these levels on occasions.

5. Research

“What Works” in Placements

Family

Berridge and Cleaver (1987) found that success was helped by factors such as frequent link worker visits to carers, regular contact, along with sensitively managed matching and introductions

Sellick found a correlation of regular social work visits with reduced breakdown rates.

There are no children in a family placement of a similar age to the child being placed (Wedge & Mantle, Berridge & Cleaver).

Thoburn identifies some factors which more than one study have linked to successful return home. These include:

the child was under two when returned home
The parents having regular contact with the child while s/he was away
The parent attending reviews
The parents being willing to talk to each other and the social worker about problems which they may encounter when the child returns home
No new problems in relation to the child emerging while s/he was away from home or after the return
No younger half or step sibling at home when the child returned
The child had continued to have a role in the family throughout the stay away, e.g. by keeping clothes or toys at home, and her/his bedroom, or at least some personal space.

Other research shows:

Contact with parent or other people important to that child e.g. friends, extended family, sometimes pets (Dartington 1986 & 1989). This improves the child’s sense of identity and can be a fall back if the placement breaks down.

Residential

Sinclair and Gibbs (1998) suggested that the following characteristics in residential are associated with good outcomes:

small homes
head of home is clear about the purpose of the unit
unit is not disturbed by frequent reorganisation
staff in agreement and “harmony” about how the home should be run
low staff turnover
clear worked out philosophy abut how to deal with disruptive behaviour from residents
commitment to dealing with emotional difficulties
strong commitment by head of home to ensuring young people either attend school or work on a regular basis.

Children that come into residential care are more likely to come from disadvantaged backgrounds and have experienced some harm (Kahan 1989 & Jackson 1987), and therefore likely to have more special needs than other children. Expectations of placements need to be realistic about what outcomes can be achieved.

6. The Children’s Planning Group

All requests for placements must be referred at the earliest opportunity to the Children’s Placement Planning Group (CPPG) and preferably before a placement is required. See Children's Placement Planning Group Procedure.

In order to refer the request for a placement for consideration by the group, contact the chair of the group or their Business Support Officer in the first instance. The only information required is the child, their date of birth and any relevant documentation held on ICS that the group should read prior to the meeting. You will be given a time to attend the group. The group will attempt to provide a package whether a placement or other resources to meet the needs of the individual child, avoiding accommodation where possible. Any specific placement request will require details of cost and service provided.

The group will always try and identify a contingency plan for each child in the event of the agreed placement not being viable.

Where the solution offered by the Group is considered to be fragile, it may be necessary to review the decision, in which case a date will be set for a further attendance at the Group. If this is the case, a reminder will be sent to you one week beforehand.

Whilst the decisions of the CPPG are not final, there is an expectation that teams will have clear reasons for not adhering to the decisions made.

7. Ensuring Safe Placements

The social workers role is crucial in selecting if a placement is safe and will meet the needs of the child/young person. You must obtain all the information necessary to make an informed opinion about the nature of the agency and the unit.

The effective matching of a young person to a home occurs when there is an up-to date assessment of both the young person and the home being considered. The placement officer or social worker may have recent feedback on the homes’ performance- if not then the Pan-London contracts team(who provide lists of homes which provide value for money and better standards of care ) should be contacted since they will have access to all recent monitoring visits. The assessment for the young person will determine the type of placement and the Pan-London directory, held by the placement officer, has details of all the various options e.g. long-term male only with education.

Before placement the social worker must obtain:

Copies of inspection reports of the establishment. (The Effective Placement Officer may already have these.)
These include the current and last full inspection reports and the most recent unannounced inspection report. This is essential. You should also telephone the Registration & Inspection Unit to find out whether there have been any care or child protection issues since the last inspection.
Copies of the establishments ‘Statement of Purpose and Function’. (The Effective Placement Officer may already have this.)

Every children’s home is required by law to have such a statement; they are detailed and give a great deal of information about the home.

Details of the qualifications and experience of the staff. These should be at the back of the statement of purpose but if they are missing, ask to see them.
Views of other service users internal to RBK&C/other local authorities? The placement officers or social workers of other authorities are an important source of up-to-date information. However, no two children are alike and what works for one child may not do so for another. Hence, treat each match as unique.
If making a residential placement out of borough see ‘OUT OF AUTHORITY PLACEMENTS’ (DH, Crown Copyright. 2106 IP 500 Jan. 95) for DH guidance for information required when making out of authority residential placements.
Follow the process Assessing a P&V placement
Ask Pan-London for the most recent monitoring reports- these are produced at least twice yearly.
Visit the home. There is no substitute for actually going to the establishment- this is best done with the placements officer but if not available follow the guidelines in “ assessing a P+V home”.

8. Contracts

Check whether the unit has completed a Pan London Residential contract with the Borough. To do this contact the Contracts Section on 0207 361 2205.. Homes that have such a contract are preferable as the arrangements meet a required standard and prices are monitored.

If the unit has completed a Pan-London contract, the SW completes the section of the contract, called Individual Placement Agreement regarding the specific child and clarifies tasks with the unit.
If not, a temporary contract must be issued. Ask the unit if they will sign up to the Pan-London agreement. Consult the Effective Placements Officer. If the unit has not been used before by RBKC, the Effective Placements Officer may complete an evaluation visit and will check if any other authority is adding the unit to the Pan-London contract.
Use the Emergency Interim Placement Agreement for both emergency and planned placements in units not covered by the Pan-London agreement. Copies of the form should be available at each site. Make sure that all parts are filled in. This provides the department with a temporary contract for 3 months during which time an application for Pan-London monitoring will be made.
Seek agreement from the budget holder or Head of Service as necessary for the care plan and expenditure.

Note

It is important that you ensure all the contractual issues are resolved and budgetary approval given before embarking on a process of introducing the young person to the unit. Once the young person has visited it becomes difficult to withdraw from placement but this might be necessary if you cannot come to a satisfactory agreement about the service to be provided and charges. Also if the young person is challenging the unit may be tempted to increase charges once they have met the young person. This is less likely if a contract is already agreed unless you have not been open about the level of difficulty presented by your young person.

9. Monitoring Safety of Placements

There are several mechanisms for sharing information about units, both concerns and where units have been successful. Carebase and Pan-London meetings are held regularly to share information. Registration and Inspection Units hold information about child protection and care concerns that have been notified to them and details of the outcomes of any investigations. You should pass any concerns about a unit to the Commissioning Team, either the Effective Placements Officer, Independent Reviewing Officers and Head of Service Commissioning.

Ensure that the services and assessments set out in the care plan are being adhered to. If care plans are not up-to-date and SMART then it becomes difficult to assess the homes’ performance.
Make sure the unit is “on task” and continuing to meet the needs of your young person. A unit not meeting the young persons needs can be very damaging to the young persons well-being.
Some organisations will move children between units without reference to you. Make it clear that this is acceptable only after proper consultation with the social worker – such moves should generally be seen as “time-out” for the client otherwise it adds to placement instability. Visit any satellite unit prior to agreeing the move. Take as much care to vet the staff and care provided as you did with the main unit. Ask the Registration and Inspection Unit if they are aware of the additional provision.
Children placed some distance away should be a priority for visits. Consider appointing an Independent Visitor for the child. Consider unannounced visits out of school hours.

10. Cost Effective Placements

Please remember that research has found that cost does not determine the quality of placements. Use Messages from Research and the procedures Assessing a P&V Placement to assist you in selecting a placement that will deliver the outcomes you need for your child at a cost that is Best Value.

Pay attention to the following issues:

That the cost quoted is the same as that in the Pan-London directory.
How much does each aspect of the service provided cost e.g. clothing, holidays, therapy, education, travel. (See Pan-London contract for more examples.) You should be aware of what is included in the weekly price and what other items or tasks you may be charged for.
If the unit provides education or buys it in from another provider, check exactly what kind of education is provided and by whom. Is it activity based or delivers the National Curriculum, for example?
If the unit provides therapy check what is provided and at what cost. Some units include therapy in their charges but will reduce these if therapy is not required.
Does the organisation offer a range of care e.g. a high level of supervision, semi-independence etc. Will the rate charged change when your young person moves through the units? Check invoices against the service you have purchased. Question those that do not match.
Each year agencies will want to increase their fees. Those in the Pan-London contract will be tied to increases in line with inflation. Send a letter stating what level of increase the Royal Borough will agree to and question invoices that exceed this. The inflation increase is determined each year based upon the Retail Price Index for November. Where units insist on making increases above inflation, ask the unit to put the reasons for such increases in writing.
Keep the Effective Placement Officer and Head of Service Commissioning informed of difficulties.
Review the placement regularly to ensure that it delivers value for money and is meeting the needs of the child. In certain cases, this will be more frequently than the child’s Looked After Review.
Where additional costs are incurred for specific services e.g. additional staff to care for a challenging child, ensure that the agreement is clear, time-limited and that objectives are identified. Review it frequently. It is easier to add support than to withdraw it. If the unit is competent, your child should make progress.

11. The Team Manager - Checklist

Does the assessment & recommendations match and are they realistic?
Check the summary of the assessment process and identification of need. Is this request in line with the priorities for service provision in the Team/Service Group/Department?
What are the resource options & how do they meet the need? Is the change envisaged realistic? Does more information need to be sought, can the time scale be extended to allow more time to identify the best placement option to achieve the negotiated outcome?
Discuss other options, which may not have been considered in terms of evidence and outcome.
What time scale is envisaged to achieve the outcome? What review processes are built in?
How will the service user be involved in the choice of resource?
What will be the indicators of change and successful outcomes?
What previous investment has been put into this family? What was the outcome?
If the care plan is to be a package of resources are there other costs e.g. transport?
Would this expenditure prevent, if successful, a more costly resource at a later date?
How does this care package compare with other similar family situations, resource provision & outcomes?
What are the time/financial implications for the workload management of the Team & the use of budgets? Long term/ short term expenditure.
Authorisation: Team Mangers can only approve placements costing up to £1500 per week. Head of Services can only approve placements up to £2,500 per week. Any placements with higher costs must be referred to the Head of Family and Children’s Services for approval. Does the expenditure have an impact on the budget profile i.e. an overspend? If so, plans may have to be changed.

1. Placement Criteria - General

To be considered for a placement in a Children’s Home or Foster Home, the social worker should demonstrate the child meets one of the following criteria (for placements in Children’s Homes, there are additional criteria, below):

1.	That a child is assessed as in need and requires accommodation to preserve the child’s welfare and the whole range of available resources has been considered or previously employed to maintain the child in the community and there is no one who has parental responsibility prepared
2.	Or able to provide care and there is no alternative placing possibilities with extended family or friends,
3.	That the child will be at risk of harm if he or she is not accommodated and there are no alternative possibilities with extended family or friends.
4.	That the parents, in order to support them where there are difficulties in providing care, require occasional or regular respite and that community based assistance is insufficient to provide the required level of respite and there are no alternative possibilities with extended family or friends.
5.	That the child may need to be accommodated by virtue of the requirements to accommodate in the criminal justice system through: P.A.C.E. 1984 regulations, Remands to the local authority, Being subject to a supervision order with a residence requirement.

2. Residential Placement Criteria

In order for the child to be considered for a residential placement, the social worker must be able to demonstrate the accommodation criteria as outlined above are satisfied; and that one of the following Residential Criteria are also satisfied.

This will only determine that the child is suitable for a residential placement, not for a specific Children’s Home. Once the child seems suitable for a residential placement it will be necessary to seek a particular home to meet the child’s needs.

That a foster placement will not meet the child’s needs and the child has an assessed need for a specialist therapeutic service and that such services can only be adequately provided in residential settings.
That the child is demonstrably a danger to him/herself or others and the child requires a level of supervision and help that can only be provided in a Children’s Home.
That residential care is the only alternative to a potential remand in custody, as an alternative to a placement in secure accommodation or as part of a range of alternatives to custodial sentence.
That a child or his/her carers has need of short periods of respite and that such respite can best be delivered to meet assessed need in a residential setting.

3. Secure Accommodation Criteria

Section 25 of the Children Act 1989 sets out the ‘welfare’ criteria which must be met before a child Looked After by the local authority may be placed in secure accommodation. There are other, ‘criminal’, criteria which may apply under section 38(6) of the Police and Criminal Evidence Act 1984 and under section 23 of the Children and Young Persons Act 1969 (remanded to local authority accommodation).

The ‘Welfare’ criteria are:

That the child has a history of Absconding (see below) and is likely to abscond from any other description of accommodation and
If the child absconds, s/he is likely to suffer Significant Harm, or that
If the child is kept in any other description of accommodation s/he is likely to injure her/himself or others.

The Designated Manager (Placements in Secure Accommodation) may approve such placements for up to 72 hours in an emergency. Only a Court can grant permission for placements beyond 72 hours.

A placement of a child under the age of 13 years can only be made with the approval of the Secretary of State (see next section)

13. Secure Placements for Children Under 13 Years

Amended June 2009: The whole section is new

If consideration is given to placing a child under 13, the Secretary of State must give approval, see the following guidance issued by the Department of Children, Schools and Families

Guidance for the Placement of Children under the Age of 13 in Secure Accommodation

End