Can the recently announced study of the children’s social care market by the Competition and Markets Authority (CMA) deliver, writes Rob Finney, the chief operating officer at Tristone Healthcare.
The needs of children and vulnerable young people should always be placed front and centre. Full stop. I often use the analogy that a picture is the ‘service user’ and the people delivering that service are the picture frame holding them in place. We’re in the background; nobody should notice us; what we need to do is concentrate on letting them shine and creating that boundary to hold them and keep them safe.
There’s little doubt that the social care sector is facing incredible challenges that make that job extremely difficult but, no matter what, it should always be our driving motivation. The Competition and Markets Authority (CMA) clearly has a desire to achieve this – CEO Andrea Coscelli set out his stall by saying ‘our clear and overriding priority will be about identifying ways children can get better care’.
I don’t doubt the sentiment, but my question is whether the CMA is the right body to take the mantle of chief investigator in this matter? Yes, with valuations for the likes of The Outcomes First Group reportedly reaching up to a billion, it’s little wonder that there is concern over the acquisition strategy of big players in the market. However, the sector is still massively fragmented, with the vast majority of profits margins at a reasonable level.
The CMA has said that its market study into children’s social care provision will look to establish why a lack of availability and increasing costs could be leading to the needs of children in care not being met. According to government department, the study has been sparked by concerns about private sector provision of children’s social care making high profit margins. A recent Local Government Association report found that some independent providers of children’s residential and fostering placements are achieving profits of more than 20% on their income. The study will apparently examine whether high levels of profit have been made at the expense of investment in recruiting and retaining staff, and providing quality services.
The need for quality is unquestionable, the need for fairness is also important, but the children’s social care sector is a complicated landscape. On the one hand you have providers who are constantly trying to balance the books and manage the significant costs that are associated with running a care provision. On the other hand, you have local authorities that at times struggle to know their own costs, and often fall down on financial and business planning. As someone who’s spent 25 years in the sector, and has managed commissioning/children’s placements for local authorities, I’ve seen how it works. It all adds to the complexity of the issue.
Covid-19 has placed immeasurable pressure on provision – the combination of increased public debt and the rise in the number of vulnerable young people requiring our services has never been higher. But it is not as black and white to say that the problem is driven by the private sector’s desire for profits over provision. Yes, there are providers that do make millions, but you can only do that if you have significant volume and, importantly, you’re good at what you do.
The private sector is not the threat that people think it is. The government has already commissioned Sir Martin Narey to undertake reviews into fostering and residential provisions. In recent years, his findings were that the independent sector provided quality and value for money. However, the key to improving the market is communication – creating a more joined-up conversation between purchasers and providers. The goal needs to be about making the sector more viable in the long term, concentrating on the needs of the people who we deliver services to. What we need is a national framework in place that brings together the two sides and allows Local Authorities to work more productively together.
There’s no doubt that the lack of cohesive working in local authorities, and the huge fragmentation in the provider market, makes it an incredibly complex problem to solve. Only time will tell whether the CMA is best placed to help solve those issues, but the overriding priority – whoever and whatever is charged with tackling the problem – is the needs of young people.
The new children’s commissioner for England, Dame Rachel de Souza, says she will be ‘fearless’ in representing children’s interests. She is launching what is claimed to be England’s biggest survey of children – the “Big Ask” – which will gather children’s views on the impact of the pandemic, and what they think are the barriers to children’s ambitions. This will include children in care and will reportedly provide information for a “once-in-a-generation” review of how children’s lives might be improved.
Clearly, children are being placed front and centre, particularly in response to the global pandemic. We just have to hope that the various findings from multiple agencies and individuals, produce a cohesive approach moving forward. Only time will tell.
Rob Finney is chief operating officer at Tristone Healthcare. He has 25 years’ social work experience, including managing unregulated 16 plus provision, managing children’s homes and fostering services and managing commissioning / children’s placements for local authorities.
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