Profile of Children’s Residential Care in Wales 12th September 2018

Background We were commissioned by the T&F Group for Residential Care under the Ministerial Advisory Group for improving outcomes for LAC Aim to build a profile of children’s residential care in Wales Project was part of a suite of work contributing to improving outcomes for LAC

What we did The research tried to map existing residential care services for children and young people provision in Wales Desk-based research and analysis Care Inspectorate Wales (CIW) information on registered care provision Welsh Government’s LAC data collection Children’s Commissioning Support Resource (CCSR) Statement of purpose Daffodil care services projections Provider workshops/supplementary survey of provision

Research questions What does the current residential placement provision for LAC in Wales look like? What do we know about the detail of the provision e.g. the regional picture, specialist services, etc? What do we know about the current LAC population and how does this map to provision? What do we know about recent trends and what might this mean for the future? What might be done to improve the evidence base?

Current residential provision for LAC 149 children’s homes and 11 residential special schools 665 beds in these children’s homes in 2017 Independent sector capacity has grown over the past 5 years, while local authority provision has decreased Nine care providers own five or more settings, equating to around 65% of the registered homes in Wales 40% of beds in available in registered children’s homes were in short break/respite and disability only care settings

Children’s services provision in Wales - Trends Source: Care Inspectorate Wales

Capacity of children’s homes – 5 year change Source: Care Inspectorate Wales

Current residential provision for LAC Registration information provides a useful starting point, we found differences between registered information and normal practice Makes it difficult to provide a detailed profile Statement of purpose analysis provides an insight into the categories of care and services offered In conjunction with the survey, we were able to provide an indicative picture of the national and local provision Spatial distribution across Wales…

Settings are clustered around the South East Wales near urban/built up areas where the populations are higher Cluster in the North East of Wales, around the Wrexham area and along the English border into Powys Notable absence of residential care provision for children in the central areas of Wales, the mid West and North West of Wales Source: Care Inspectorate Wales

Residential service provision – the detail Types of services offered General therapeutic; Disability; Short break/respite care; Sexually harmful behaviour; Transition to independence; or Emergency/crisis and assessment Local and regional variation across Wales

Looked after children population – what is demand like? Residential placements for LAC accounted for around 6% of all children placed 355 LAC placed in residential care in 2017 – stable for the past 5 years Most LAC were aged 10 to 15 years More males than females in residential placements, with a ratio of 60:40 Most common reason for child starting a placement in residential care was abuse and neglect, accounting for 48% of LAC starting residential placements

Mapping need to demand in children’s homes Registered beds in care homes (excl. respite/disability) exceeds the number of children placed in residential care by Welsh authorities Over 90 beds in residential care homes are occupied by children placed by authorities outside Wales Using available information, mapping needs of LAC to service models offered by current provision is challenging. Additional information on the care needs of the child would make it easier Regionally, Cwm Taf and Cardiff & Vale regions have a greater LAC population than the number of general therapeutic and specialist places available in these regions

Recent trends and the future of the LAC population 10-17 year old population is predicted to increase in future years, peaking in 2025 and falling back around 6% higher than the current population by 2035 If the trend in the population is mirrored in LAC numbers, most of the regions are projected to see children going into residential care over the next 18 years remain stable Cardiff & Vale region are projected to experience an increase

Gaps in understanding Robustness of information available Supplementary residential care provider survey Services offered What is normal practice? Statement of purpose (SoP) documents Impact of cross border placements? English LAC in Welsh based care provision Mapping this is difficult from current data sources Affect on supply and demand

Improving the evidence base Exploring the anomalies in the data Need for a robust regular dataset showing care provision and services offered Co-ordination of information and evidence with national partners

Other research commissioned by Ministerial Advisory Group Feedback from the other 3 projects commissioned in the last phase of research projects Evaluation of new and emerging models of care (Cordis Bright) Extension of When I’m Ready to residential care (Voices in Care & Cognition Associates) Good practice guidance on out of area placements (Brian Paget)

Future research Follow up recommendations: Data Cymru Extension of phase 1 project: Brian Paget / Cordis Bright When I’m Ready placements: market engagement Remand placements: scoping & market feasibility Diversion from Secure Welfare placements: options paper

Questions and discussion Commissioners / placement finders Aside from using CCSR: How do you know what provision is in your area and beyond? What are you current sources of information? How do you keep aware of new provision / closing provision? Do you know what services are offered by providers in your area? As the market changes, how responsive are your sources?

Questions and discussion Providers How do you monitor what services are required by LAC in your area? What sources of information are used to shape your models of care in Wales? Appetite for contribution? (Good response to the survey in our research) What do you want in return?