Harnessing Social Investment Step Down Fostering SIB Rakesh Mistry, Commissioning Manager, Children’s Commissioning Richard Dixon, Commercial Manager, Core Assets Louise Knowles, Commissioning Officer, Children’s Commissioning July 2017

Welcome and Introductions

Context Largest local authority in Western Europe Population: 1m (250,000 children under 18yrs) Rate of CiC: 66 per 10,000 (National Avg: 60) Declining year on year 38% are 10-15yr olds Placed mainly in residential care (9%) & in foster care (65%)

Context In 2012 CiC population – 1937 (c 1856) Fostering Internal foster care - 675 External foster care - 621 Residential Internal residential – 73 External residential – 86 Currently - 40 Safeguarding & CIC social work teams

Contract mobilised, partnership working in place Birmingham Step Down Fostering Impact Bond STEP 1: A community faces a challenge, and local government makes it a priority STEP 2: Commissioning commences to find a specific intervention to address the challenge STEP 3: Provider raises start-up funding from ‘social investors’ and outcomes funding is raised from the Lottery STEP 4: Contract mobilised, partnership working in place STEP 5: The results are measured, and feedback is used to constantly improve the service STEP 6: Beneficiaries lives improve, and local government saves money to be reinvested elsewhere

A community faces a challenge, and local government makes it a priority Improving Outcomes Young people in residential care have poor outcomes: Significantly higher contact with police, Substance misuse problems, Poor education, attendance and attainment Higher incidents of mental health Lower job prospects and life chances upon leaving care Residential care is expensive for the outcomes it provides. BCC has developed a Step Down Fostering Project to safely transition young people out of residential care into system therapeutic fostering

A community faces a challenge, and local government makes it a priority Why did we do it? Foster care delivers better outcomes than residential care - provides stability Platform for for attachment and relationships to develop space and time for therapeutic interventions to work delivery of long term outcomes e.g. improved behaviour, education attainment, emotional health and well being, reducing harmful behaviours.

What did the data tell us? A community faces a challenge, and local government makes it a priority What did the data tell us? Baseline at the time 1,937 children in care. 10% in residential placements (9% SN) Poor outcomes 13% experienced 3 or more placement disruptions (10% SN) £65m annual spend on CiC - 40% on children in residential care (182 YP) Older cohort of children accommodated 14+ Sec 20 Many enter and leave care rapidly (under 20 weeks) Those in care for over 20 weeks – resulted in a “care career” Accommodated for on average between 113 - 133 weeks £305,000 cost per child

Commissioning Process Commissioning commences to find a specific intervention Commissioning Process 2012 - SIBS Launched – Social Outcomes Fund / Commissioning for Better Outcomes Themes: Reduce CiC, Edge of Care & Reunification Cohort analysis Oct 2012 – Provider engagement Feb 2013 – Procurement commenced – Open Tender Black Box March 2013 – Tender Evaluation July 2013 – Competitive Dialogue (3 Providers) March 2014 – Contract Awarded (Begin mobilisation) August 2014 – Contract commenced November 2014 – First young person placed

Commissioning commences to find a specific intervention Why is it innovative? Deliver cost savings Improve life chances Aims Commissioning Approach (Black Box) Outcome: Placement stability Payment by Results Provider determines intervention Delivery Method 3-way partnership Social Impact Bond Intervention: Systemic Fostering

Nature of the Contract - the basics Commissioning commences to find a specific intervention Nature of the Contract - the basics “Commissioning for outcomes” approach – The Relationship Top Up Funding Commissioner Provider Investor Service Providers

Nature of the Contract - the basics Commissioning commences to find a specific intervention Nature of the Contract - the basics 4 year contract (+2 year option to extend) 138 referrals over 4 years (+69) – historical analysis by BCC Payment by Results – key outcome is placement stability Reward Payment after 52 weeks. Young people successfully transition from residential care into therapeutic fostering Planned moves, careful transition and placement matching Child-centred - use of care-experienced Peer Mentors Core Assets Project Manager co-located with BCC

Nature of the Contract the detail Commissioning commences to find a specific intervention Nature of the Contract the detail Evidence based intervention: systemic therapeutic fostering Target Group: 10-16 year olds in residential care for 16 weeks or more Young People successfully transition from residential care into therapeutic fostering Planned moves, careful transition and placement matching Child-centred – use of care experienced Peer Mentors 51 referrals (since 2014) 23 currently in the scheme (at various stages) 11 “graduations” Cost comparison £2330 - £4995 (residential placement) versus avg £1,800 (therapeutic fostering) c. £880k savings at Dec 16

Social Investment & Outcomes Funding Provider raises start up funding from social investors Social Investment & Outcomes Funding Bridges raised funding from a group of philanthropists and other ‘social investors’, which can be used to help launch innovative new services Birmingham City Council raised funding from the Lottery and Cabinet Office funds, to help pay for the outcomes delivered by the innovative new service Example ‘social investors’: The £40m Lottery Commissioning Better Outcomes Fund was set up in partnership with the Cabinet Office ‘Centre for SIBs’ Highwood Foundation

Commissioning commences to find a specific intervention The Intervention “Compatible with BCC focus on relationship based practice, systemic SW approach, improved care planning and placement matching Strengths based Family and professional relationships Needs led Joined up approach: bringing all parts of the service together About ensuring effective communication and clear plans Dynamic process Team Around The Child System therapeutic approach Peer Mentors

Commissioning commences to find a specific intervention The Intervention Focused on: Placement stability Providing & modelling appropriate responses to young person’s behaviour Building young person’s resilience School attendance Participation in positive activities Improving emotional well-being

Care experienced mentor Contract mobilised, partnership working in place How it Works Care experienced mentor

Birmingham SIB Payment Method Contract mobilised, partnership working in place Birmingham SIB Payment Method

Service Monitoring & Review 5. The results are measured, and feedback is used to constantly learn and improve the service Service Monitoring & Review

5. The results are measured, and feedback is used to constantly learn and improve the service Outcomes Monitoring

5. The results are measured, and feedback is used to constantly learn and improve the service Project Evaluation Oxford University’s Rees Centre Evaluation On average across the first two years, a 70% stability rate has been achieved across 22 placements Most young people achieved greater stability than they experienced prior to the programme. Evidence of improved school attendance, improved behaviours, reduced self-harming Frequency of engagement in positive activities increases markedly immediately after starting but not always maintained at the initial high level – not a bad thing!! c£40,000 cost savings achieved for each young person that completes Step Down and does not return to residential care (in year one) c£880,000 cost savings for 22 young people on the programme between Oct 2014 - 31st Dec 2016 (in year 1 of their placement) A further £600,000 cost savings for the ten YP who successfully remain in placement following “graduation”(post 52 weeks)

6. Beneficiaries lives improve, and local government saves money to be reinvested elsewhere

6. Beneficiaries lives improve, and local government saves money to be reinvested elsewhere Learning Points Step Down Fostering Placement stability - not easy to achieve Step down to standard framework didn’t happen Child at the centre - driven by their needs and wishes Value of Peer Mentors - relationship building Involvement of SW operational leads from the outset Collaboration - TAC approach at planning stage Culture change & impact on SW practice Foster carers - talent and resilience Psychological impact of “52 week” placement SIB Process: Social Investor – impartiality, accountability and challenge Fidelity of model and metrics Administration: grant and governance

6. Beneficiaries lives improve, and local government saves money to be reinvested elsewhere Looking Ahead Contract extension to 2020 Application to Life Chances Fund - Step Down Fostering for disabled children in residential care WM Regional Innovations Bid - improving outcomes for YP with most complex needs Embrace SIBs - new way of working for LAs; Savings versus Sustainability https://www.gov.uk/government/publications/life-chances-fund http://golab.bsg.ox.ac.uk/

Contacts Rakesh.J.Mistry@birmingham.gov.uk 0121 464 4198 Louise.K.Knowles@birmingham.gov.uk 0121 675 8314 Sunita.Masih@birmingham.gov.uk 0121 675 3322 Richard.dixon@coreassets.com 07813 054784