1. Standard versus Specialist
Standard versus Specialist? What future beckons for specialist residential care for looked after children in a procurement environment dominated by Frameworks?

2. Workshop
A participative exploration of the issues presented using live examples and the attendees own experiences
Presenters
Caroline Jones (Director of MH Services, Keys Group)
Peter O`Neill (Marketing Director, Keys Group)

3. Introduction Premise and Structure of Workshop
Frameworks/Spot purchasing
Market management
Referral information and analysis
What Keys are doing about this
Why take a “Specialist Route” (LIHN)

4. The “Changing Landscape”
Specialist nature of demand and complexity of needs
Spot purchasing
Frameworks – Good and Bad
Commerciality and sustainability
“Partnership” working
Sufficiency and maturity of the supply market
How can LAs drive capacity to ensure they have enough specialist placements locally or even regionally?

5. What we know and what Referrals tell us...
Year on year Increase in referrals (for all services)
Digitalisation of referrals and outsourcing placements
Specialist nature of demand
Focus on particular needs/complexity of needs
Higher incidence of MH, Emergency and Activity/Solo type requests
Also Violence/MFC/SHB - impact on matching options

6. Plans based on demand? Mental Health? Emergency?
What risks are there in developing new or changing existing services based solely on demand?

7. Mental Health
Children and young people in Care are 4 times more likely to have Mental Health difficulties than their peers
More than half of Children in Care have significant Mental Health difficulties
Mental Health provision for Children in Care is poor
Young people leaving care are 5 times more likely to attempt suicide than their peers
Future in Mind – Improving access to specialist support, care for the most vulnerable including Children in care, skilled workforce

8. Service Development - Hub and Spoke
Residential Mental Health rehab model- managing risks, engagement in education and community provision, increasing independence and self management skills.
4 bedded homes, 4 homes in each Hub + Link school Clinical team – CAMHS Practitioners (Nurses, SW’s, Psychologists, OT’s)
One CAMHS Practitioner per Hub
Access to Medical provision – Primary Care, local CAMHS, LAC nurse

9. Service Model Primary diagnosis of mental health needs
Not on Section of MHA but maybe subject to CTO (Community Treatment Order)
Complex needs that cannot be managed within existing services
Each Hub Clinical input – TAC meetings, targeted training, Consultation, 1-1 for YP as clinically indicated, group work, Partnership Liaison.

10. Residential Care staffing Model
Registered Manager – Mental Health background (Clinical or experience)
Deputy Manager – Mental health background (clinical or experience)
Care staff – full training programme to include Mental Health
1-1 staffing ratios, 2 x waking night and sleep in

11. Emergency/Activity type Services
Referrals constantly rising
“Waiting List” permanently
Lack of provision or other options nationally
How should Keys/other providers respond to this demand?
Emergency/Activity type Services

12. Additional Capacity Dewis, Wrexham - to 6 beds
Arthog, Gywnned – to 7 beds
MLV, Burnley – to 6 beds
Gloucester (new service) – 6 beds

13. Questions to consider..
How can LA`s drive capacity so they have enough specialist placements locally or even regionally?
What risks are there in developing new or changing existing services based on demand?
How should Keys or other Providers respond to this increased demand?
How might Frameworks (or other procurement vehicles) ensure enough Specialist placements are available regionally?
How might Commissioners and Providers work more collaboratively to improve sufficiency or specialisation in your region?
Other questions?