APPENDIX 1 - To report of   14.1.99. Intoductory Report from Dec 98

Government launched the Quality Protects programme to transform the management and delivery of social services to children so that safe, effective and high quality services are delivered to children in need, and particularly to children looked after.

The main elements of the Quality Protects programme are:

! new national Government objectives for children, including some precise targets which local authorities are expected to achieve.
! partnership between local and central government, and an important role for local councillors in delivering the programme
! the requirement that local authorities submit a Quality Protects Management Action Plan (MAP) to the Department of Health by 31 January 1999.
! a new special grant for children's services to be paid from April 1999.

Government published guidance to local authorities in mid November 1998 on the programme, and in particular on the required framework for Quality Protects MAPs.

Whilst Government has prescribed the content of, and format for Quality Protects MAPs, Bristol City has decided to use this opportunity to publicise:

! quantitive and qualitive information about Bristol's children services, particularly in terms of baseline indicators established by the Department of Health.
! its vision and aspirations for children's social services, and particularly for children and young people who are looked after.
! details of how Bristol City Council plans, with other agencies, to improve the quality of all its services to children in need, and how it intends to deliver positive and improved outcomes for all children, and particularly for children and young people who are, or have been looked after. The Bristol MAP complements other statutory plans, including the Children's Services Plan, the Behaviour Support Plan, the Early Years Development Plan and the Health Authority's Health Improvement Plan.
! details of how it will work with other statutory agencies, including the health authority and NHS Trusts and with voluntary and independent sector providers to deliver such improved outcomes.
! information about how, in terms of the six priorities set by Government, it proposes to use the special children's grant which will be available to local authorities.

Following the creation of Bristol as a unitary authority in April 1996, considerable work has been undertaken within Social Services, within the City Council as a whole and with partner agencies, to improve the quality of services to children in need. The recent joint review of Bristol Social Services by the Audit Commission and the Social Services Inspectorate highlighted many positive aspects of children's services in the city as well as endorsing Bristol City Council's assessment of key areas for development. Of particular relevance to children's services is the need to ensure that:

! available resources (including staff) are used in the most effective and efficient way and that there is a consistently high standard of service throughout the city.
! appropriate services are delivered to children, young people and their families on the basis of an assessment of their needs and any risks to which they may be subject.
! City Council staff work together to promote and safeguard the welfare of all children in need, but particularly to ensure that children and young people who are looked after get the best start in life.
! the City Council plans and delivers children's services with the health services, and the independent sector in a 'joined up' way where this will yield benefit to children, young people and their families. The benefits of such an approach are already manifest in Bristol, for example in relation to initiatives to improve the education of children looked after, early years services, the child and family support centre service, and services for disabled children.
! the public, other agencies and City Council members and staff are clear about service standards which must be achieved and about our performance against local and national targets.
! strategic priorities are explicit, challenging and realistic.

The Bristol's Children's Services Plan, which was produced by the City Council and Avon Health Authority, sets out strategic planning priorities for 1997-2000; two subsequent updates have developed these further. Other planning processes which also have relevance to the Bristol MAP are:

! Bristol Education's Behaviour Support Plan
! Bristol Early Years Partnership's Child Care Development Plan date
! Avon Health Authority's Review of Services to School Aged Children
! Avon Health Authority's Health Improvement Plan 1999/2000.
! Social Services Annual Action Plan

The time constraints for completing the Quality Protects MAP have meant that it has not been feasible to consult as widely as Bristol City Council might have wished. There has, however, been some consultation with a group of young people who are, or have been looked after by the local authority. The consultation was organised on the City Council's behalf by the Solutions Project (NCH-Action for Children) and the Bristol After Care group. The process was extremely helpful in identifying some of the key issues for children and young people, and in identifying ways in which children and young people might become more closely and actively involved in shaping and developing children's services in Bristol.

It is Bristol City Council's intention that all stakeholders, including representatives from the independent sector, parent and children's organisations will be fully consulted about the MAP as it evolves and develops over the next three years.

Bristol's Children's Services Plan 1997 - 2000 was published in the Summer of 1997; this identified a number of key strategic objectives for children's services. Since then further work has been undertaken to define more clearly the quality, shape and form which Bristol City Council aims to provide in the medium term. A Children's Services Plan update was produced in Spring 1998; a further update will be produced this Spring (1999).

The Children's Services Plan was jointly developed by Bristol City Council and Avon Health Authority. Structural arrangements for joint planning and commissioning are currently under review (see below section 3 - Services - Commissioning) following recent Government guidance. Currently moreover there are a number of forums for such planning; these ensure that the local authority's goals are both coherent within the City Council and consonant with those of partner agencies. Key inter agency planning and service development forums are:

M Joint Commissioning Group (Children) (involving Social Services, Education, Housing, Leisure and Avon Health Authority)
M Bristol Early Years Development Partnership
M Bristol Area Child Protection Committee

Bristol City Council has strong and vigorous relationships with voluntary sector organisations who individually and collectively make a very significant and effective contribution to children's services in the city. Structures for involving independent sector organisations in planning processes are being reviewed. As importantly it is recognised that children's services planning structures must involved children and young people in more active, creative and effective ways.

The statement below represents a summary of our current position, taking account of Government's objectives and the relative strengths and weaknesses of our current approach to commissioning and delivering high quality children's services. It is informed by the outcome of the Joint Review of Bristol Social Services, Government's priorities and objectives for children's services, the recent Social Services White Paper, and by local analysis, discussion and priorities.

Bristol City Council strives to provide high quality services that will promote and safeguard the welfare of children in Bristol. The major focus of these services are children in need, as defined by the Children Act 1989 and as identified through the children in need matrix which has been developed by Bristol City Council, in partnership with Avon Health Authority.

This section has been organised around the six core inter-related elements set out in our key strategic objectives.

Appendix 2 analyses Bristol's children's services strengths and weaknesses against the Government national objectives for children's services. Bristol's baseline position is set out, along with our objectives and outcomes which should be achieved.

(NB This section will eventually be summarised in the tabular format prescribed by the Department of Health). Document will also be cross referenced throughout to national and local objectives

Baseline - Joint commissioning with the NHS in relation to children's services is relatively undeveloped (with exceptions of joint finance projects). There is, however, recognition of, and commitment by all stakeholders to progress a more coherent, systematic and effective approach to Health/Local Authority joint commissioning. Local planning and commissioning structures are currently under review following recent Government guidance (particularly National Priorities and Partnership in Action).

It is intended that the new structures will drive forward a more focused and effective inter-agency children's services strategy. This will be shaped both by Bristol City Council's priorities and objectives for children services and by the implementation of decisions following Avon Health's recent review of children's services.

In contrast joint commissioning within the City Council, and most particularly between Social Services and Education is more robust and developed. The effectiveness of the partnership between Social Services and Education was specifically commended by the recent Joint Review of Social Services. Joint commissioned services and projects include:

!   early years planning and service provision
!   the child and family support centre service (for primary and secondary school aged children who are 'at risk' of, or have recently become looked after, or who are at risk of, or have been permanently excluded from school).
!   commissioning and contracting for out of authority residential placements.

Action - Work will be progressed in relation to:

!   establishing robust and effective structures for joint local authority and NHS planning and commissioning of children's services; this will include identifying and agreeing shared priorities, and increasing the involvement of actual and potential service users.
!   out of authority placements, (both for disabled children and children with emotional and behavioural difficulties).
!   Quality Protects MAP related objectives and tasks (but particularly in relation to health of looked after children).
!   child and adolescent mental health services. This includes a three year joint finance scheme (start date May 1999) which will pilot and model inter-agency working in relation to children with emotional, behavioural and mental health difficulties, with specific priority being given to children looked after.

Outcomes

! to complete....

Non relevant

Detailed plans will be drawn up during the early part of 1999; these will take account of local City Council and NHS objectives and priorities.

2001-02

As for 2000-2001

Baseline - Collaborative commissioning is relatively undeveloped although, following local government reorganisation in 1996, there has been some collaborative commissioning with other unitary authorities in the former Avon area, (notably Emergency Duty Team service and GALRO service).

Additionally Bristol is actively involved in the South West ADSS group working on purchasing and contracting non-authority residential placements.

Action - Further work will be undertaken in relation to:

(i) the development of a regional consortium for adoption placements

(ii) the EDT service commissioned from South Gloucestershire Social Services.

Detailed plans will be drawn up during 1999.

2001-2002

Detailed plans will be drawn up during 1999.

Compared to many authorities, Bristol is fortunate in being able to access a relatively diverse and extensive range of resources for children looked after. This resource base includes:

! A relatively large number of places within Bristol's own residential service. Bristol 'inherited' a service from Avon that had been recently 'upgraded' and enhanced (including its staffing structures and buildings). Whilst there have been some reductions in this provision during the past 3 years, there has been some reinvestment in services to children looked after (e.g. remand fostering scheme, after care services and general fostering).
! A range of different types of fostering resources
! Independence development units for young people who are shortly due to leave care.
! Access to a range of independent resources within the region.

Bristol City Council recognises that despite relatively extensive resources, further work is required to ensure that the range and type of available placements reflects more accurately the range of needs of children and young people being looked after, including those relating to age, likely duration of placements, ethnic background etc.

Present capacity and occupancy (as at 30.12.98)

(a) Fostering

Capacity

(i) In house = 343 placements; this represents 315 carers. In addition there are insert number family link placements (respite service for disabled children), representing insert number of carers.

In house fostering provision includes emergency and reception carers (9 places), fostering plus (40), respite (22), specifically approved carers (40), as well as family link service.

(ii) Contracted (from private fostering agencies) = 32

Occupancy

Of 343 placements, 18 were 'vacancies' (i.e. approximately 95%). Bristol purchases from independent sector on spot purchase basis.

(b) Residential

Capacity

(i) In house = 62 places (11 units). This includes:

! 10 places in 2 admission units
! 18 places in 3 settled care units
! 12 places in 2 task centred units
! 4 places in special task unit
! 18 places in 3 independence training units

In addition:

! There are currently 2 residential units for disabled children. One unit (Westbrook Road) provides 9 places; the other provides a respite service to 152 children. Proposals are currently being presented to close Westbrook Road and reinvest in an expanded family link service and a residential resource centre, including respite services.

(ii) Contracted

To be inserted

Occupancy

53 out of 62 places are occupied (i.e. on 30.12.98), i.e. 85% of total residential provision (excluding that for disabled children).

Bristol purchases from independent sector on spot purchase basis.

Planned future capacity and occupancy

To cross reference with relevant objectives

Bristol will be aiming to ensure that 10% of total capacity (i.e. of in house provision) is available at any one time, however, this target will need to clarified further pending the outcome of objective 1 (d) - i.e. analysis of looked after children population. Bristol's strategy to increase placement choice will need to take specific account of:

! Development and implementation of permanency planning policy; consideration will be given to 'twin tracking' approaches (i.e. consideration of potential adoption or long term fostering alongside rehabilitation), particularly for younger children where rehabilitation may not be feasible because of risk of harm.
! Most effective ways of enhancing support services to foster carers in order to encourage stability and high quality care
! Placement needs of children and young people requiring long term foster placements.
! Needs of children and young people looked after who are misusing drugs
! Objective of reducing usage of out of authority placements (i.e. those which are at considerable distance to Bristol).
! Objective of enhancing educational achievement of children and young people looked after. (Expansion of range of placement choice is inextricably linked to the objective of ensuring secure attachments and that of gaining maximum life chance benefits from education, health and social care).

Action

The Children in Need Handbook contains an appendix giving detailed guidance on assessment, and assessments are recorded on a specific form to ensure that relevant information is brought together and evaluated, and can be easily accessed from the case records.

Planning Following any assessment of need, if a service is to be provided for a child in need (outside the Child Protection or Looked After systems), a plan is drawn up in consultation with the child and their family, other carers and relevant agencies. In complex situations, a multi agency planning meeting may be convened.

Review All plans for children in need will be regularly reviewed. For children who are on the Child Protection Register or who become Looked After, the review will take place within the formal CP or LAC process. Plans for all other children in need will be reviewed at six monthly minimum intervals. This is to ensure that the work remains focused and purposeful, and that resources are used equitably to meet assessed needs.

CHILDREN IN NEED FRAMEWORK CHART - PAGE - TO BE INSERTED HERE

Child protection assessment and planning systems.

Bristol Area Child Protection Committee have well established procedures for children who are in need of protection. The overarching children in need framework makes links with the child protection procedures at each point, so that paperwork and processes are not duplicated.

Looked after children

Since April 1998 Bristol Social Services has used the Department of Health Looked After Children (LAC) system for all children who have become looked after. By April 1999, all children who have been looked after for more than a year will also have been brought into the system.

CHANGES PLANNED

MEETING TIMESCALES

The Children in Need framework which was implemented in July 1998 is due to be reviewed by July 1999, i.e. within a year of implementation. At that time and in the light of the review, the timescales between each stage of the process will be revised to ensure that they match the timescales that are required to be measured in future.

REDUCE RE-REFERRALS

(Objective 2.vi) Bristol Social Services will restructure its childcare teams to establish a Child Protection Unit, including the setting up of managerial posts to act as independent Chairs of CP conferences. Part of the role of the unit will be to monitor the quality of the work done in child protection cases, including the incidence of repeat referrals prior to registration, the length of time children spend on the Child Protection Register, and the number of (and reasons for) CP re-registrations.

As part of the review of the children in need framework, an analysis of a sample of cases will be carried out to investigate the number and reasons for re-referrals occurring. Appropriate changes will then be built in to the framework and to the training for child care staff on working with children in need.

ENSURE GOOD OUTCOMES

(Objective 1.i.c) Bristol Social Services will restructure its childcare teams to provide a less specialised service, with the aim of fewer changes of social workers and promoting more consistency of decision making for children who become looked after.

OTHER CHANGES PLANNED

(Objective 4) Social Services will work with Avon Health and the local Health Trusts to establish protocols and systems for ensuring that children looked after receive comprehensive health assessments when entering care, their personal child Health Records are used where possible and a personal health plan developed. (NPG). Also to ensure that children looked after receive routine immunisations dental checks and health assessments, and that this information is recorded and aggregated in line with National Priorities Guidance.

Special Grant 1998/99 and 1999/2000. Priority Area - Management Information

(Objective 6.iii.b) Social Services, Education and Health will improve the co-ordination of assessment procedures and service provision. (CSP)

Special Grant ?1998/99 and 1999/2000. Priority Area - Assessment

TRAINING STRATEGIES

The broad training strategy is covered in the Human Resource and Change section of this action plan. In order to meet the specific objective of improving assessment and care planning, the children in need framework has been incorporated into the basic child care and child protection training that all child care social workers are required to undertake. Revisions to the framework following the review mentioned above (e.g. changes to the timescales in the process) will be incorporated into the training, as will issues around reducing repeat referrals, reducing re-registrations (on to the CP register) and ensuring good outcomes for children.

Bristol Social Services awaits the DOH guidance on assessment that is expected in the spring. It is likely that the new will replace our guidance on assessment which forms an appendix of the children in need handbook. Training courses on the Children in Need framework will therefore be amended to incorporate the new guidance.

MONITORING IMPLEMENTATION

EVALUATION PLANNED

To follow.

To be completed

Over the past three years Bristol Social Services prioritised the development of an accessible and effective after care service. These developments have been carried out in conjunction with a number of partners, including Bristol Housing, Learning Partnership West, The Bristol After Care Group, The Princes Trust, local housing associations and NCH Action for Children.

Projections indicate that annually approximately 90 young people ceased to be looked after by Bristol City Council.

Our plans for enhancing the support that all care leavers can expect from Bristol City Council up to the age of 21 years include the following:

! Implementation of the After Care policy agreed by Social Services Committee in December 1998. The policy is based on the 17 key points recommended by the national organisation First Key. The policy includes a new commitment to provide financial support to young people undertaking further and higher education. In implementing this policy, specific attention will need to be paid to the needs of specific groups of young people leaving care, including black young people, young women and disabled young people.

! Accommodation needs - Bristol Social Services, with Bristol Housing, currently has 3 semi independence units (15 places). This service includes accommodation and support workers. Additionally, the City Council purchases accommodation services from the independent sector (e.g. NCH Action for Children and housing associations).

We will:

(a) map further (with Bristol Housing and other providers) the accommodation needs of young people leaving 'care' to ensure that provision matches need. Notwithstanding a fairly high level of accommodation for young people, there is a need to address the needs of young people with particularly challenging needs (and most specifically those who are misusing drugs or alcohol).

(b) Reviewing existing service specifications for this service to ensure greater consistency in approach.

! Education and training

Some positive initiatives are underway but we recognise that this is perhaps the area where most development will be required over the next three years.

Pending the availability of funding from the Department of Health special grant, we will:

(a) Consolidate joint work with Learning Partnership West to undertake an evaluation of the training and employment needs of young people leaving care.

(b) Commission an external organisation to set up a training and employment project.

(c) Establish an employment and apprenticeship scheme within the City Council for young people who have been looked after.

(d) Ensure that adult literacy services can be accessed on a needs-led basis.

(e) Promote and encourage young people to enter further and higher education and provide financial support to assist them to do so.

(f) With housing partners, explore the feasibility of linking accommodation services with a training/employment project (with potential funding from the European Social Fund).

! Support and mentoring

A number of general support and mentoring services have been developed over the past few years; it is intended to build upon these.

We will:

(a) Mentoring scheme Consolidate further the Bristol Wings Project scheme which has been established in partnership with the Princes Trust and the National Children's Bureau. Bristol is one of the first local authorities to become involved in the scheme. It is anticipated that 27 mentors will be ready in February 1999 to begin providing a service. Our target is to have recruited and trained 60 mentors by May 2000.

(b) Maintain and consolidate the work of the after care team (currently composed of 3 FTE workers).

(c) Continue to support and work in close partnership with Bristol's After Care group. The group is run by and on behalf of young people who were formerly looked after. The Group plans to open a 'drop in' in the Spring. Bristol City Council would wish to use some of its special grant to support this development.

(d) Defining and confirming access to, and responsibilities for after care services. This will need to be undertaken both within Social Services and with partner agencies, but particularly NCH - Action for Children and their Solutions Project for young people.

(e) Developing the practical support which young people can access. The proposed new community support worker post is designed to help young people access to practical services (for example, minor carpentry or electrical tasks) which their peers might normally be able to access from family networks.

(f) Diversifying and developing the information (e.g. via information directory) available to young people, including about welfare and housing benefits, employment and training, health advice etc. It is proposed to establish a free telephone advice line for young people who used to be looked after.

(g) Setting in place revised arrangements for enabling and encouraging young people to keep in touch with the local authority and/or allied agencies.

Implications of our plans for management information, staffing, training and organisation

To be completed

Special grant

COMMUNICATIONS (National objective 8)

TO BE COMPLETED

The training strategy

Bristol Social Services current position in respect of training is as follows:

In 1997/98 the average % spend above SSA of Metropolitan authorities was 20% (40% in Bristol). In addressing this spending gap between Bristol and other Authorities Councillors in Bristol will be considering 3% budget reductions for children's services in 99/00 (this compares to a 2% budget reduction for Adult services over the same period).

The findings of a recently published report by the Joint SSI and Audit Commission review Team, identified a number of issues which the Authority will be planning to address in the near future. These include:

! Devolvement of children=s services budgets to Team Manager level and the introduction of more creative use of resources in order to establish alternatives for children looked after outside of residential care provision.

! More accurate Unit costings of in - house services and benchmarking of these services with comparator Authorities and independent sector providers. Work has already started in 1998/99 to allocate overheads to direct service provision and the creation of a relational database which will match activity with cost of provision at cost centre level and provide better Management Information.

! Realignment of operational management and associated budgetary control into specialist service areas.

! Closer working with other agencies in order to provide more effective and efficient care plans for children looked after, eg early years work with Bristol Education department.