1. 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

2. Welcome and Introductions

3. 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%)

4. 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

5. 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

6. 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

7. 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.

8. 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 weeks
£305,000 cost per child

9. Commissioning Process
Commissioning commences to find a specific intervention
Commissioning Process
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

10. 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

11. 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

12. 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

13. 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: 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
£ £4995 (residential placement) versus avg £1,800 (therapeutic fostering)
c. £880k savings at Dec 16

14. 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

15. 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

16. 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

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

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

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

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

21. 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 st Dec (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)

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

23. 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

24. 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

25. Contacts Rakesh.J.Mistry@birmingham.gov.uk 0121 464 4198