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October 2018
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News updates
- The King’s Fund’s report on Integrated Care Systems.
- The Health Foundation’s report on the impact of Integrated Care Teams on hospital use in North East Hampshire and Farnham.
- The Nuffield Trust’s Comprehensive Geriatric Assessment needs assessment tool.
- Brexit and the State of Social Care
- Local authority finances
- ASC workforce and pay
- Lessons from Charities that have closed
- The Government's (non-) policy agenda for ASC
- Is not associated with a lower-than-expected reoffending rate across all offenders who participate, but is associated with a lower-than expected reoffending rate for those at higher risk of reoffending.
- Provides opportunities to build multi-agency partnerships and to start intervening earlier to support offenders to address offending-related needs.
- May be contributing to reduced demand and cost for the criminal justice system by avoiding costs associated with prosecuting the cases for which offenders are now receiving Conditional Cautions.
Looked After Children stress-test 2018
October 2018
This is the second edition of the Looked After Children Stress-Test. It uses uses publicly available data to examine recent trends in the numbers, rates and spend on Looked After Children in England. As well as providing a national picture, the stress-test highlights that there is substantial diversity in the scale and nature of pressures that are experienced by individual local authorities. Our analysis highlights those local authorities that we think, from the data, may be experiencing the most pressures in catering for Looked After Children. For the first time we have also identified local authorities that may be sites of effective practice, i.e. those areas who appear to be consistently avoiding significant pressures in relation to services for Looked After Children.
Cordis Podcast: Episode 1
October 2018
The Cordis Podcast provides a concise and accessible insight into key issues across a broad range of sectors, including children and young people's services, adult social care, criminal justice, and the NHS. Each episode addresses a different topic through interviews with our own research and consultancy team as well as insight from relevant experts within the field.
In Episode 1, Hannah Marshall interviews Cordis Bright researcher William Cafferky on the topic of 'Domestic Violence Perpetrator Programmes' (DVPPs). Drawing from recent research, they cover how DVPPs emerged, some of the differences in how they're delivered, and key principles for best practice.
Listen on Soundcloud here.
Cordis Pulse: October 2018
October 2018
We are involved in conducting a range of evaluations of innovative integrated health and social care programmes, initiatives and services. For example, recently we have evaluated seven NHS England new care model Vanguards. As such, this month we were particularly interested in three reports.
Each of these make valuable contributions to the evidence base and the approach to developing and delivering effective integrated health and social care. Linked to this, we are also pleased to add an evidence review of effective practice in delivering enhanced primary care and support in care homes to our recent series of evidence assessments which can be viewed here.
Inspection judgements under the new Ofsted ILACS framework
October 2018
Context
In 2011, The Munro Review set out numerous recommendations for changes in the way Children’s Services are inspected. These included a proposal for a new inspection framework that put the child at the heart of children’s services. This framework would explore how the rights, experiences, feelings and wishes of children and young people shape and inform practice.
In 2016, Ofsted conducted a consultation about a new framework, in which respondents supported moving away from a universal inspection to one that takes account of past performance. Respondents were also positive about a more child-centred approach, moving away from a focus on accountability that often comes at the expense of the quality of children’s care.
But, eight years on from the Munro Review, how far has this framework succeeded in focusing on the child? Does the old system of accountability, paperwork and prescription permeate into recommendations, or is autonomy and the exercising of professional judgement showcased?
Cordis Bright has summarised the outcomes of inspections carried out since the new Inspection of Local Authority Children’s Services (ILACS) framework was introduced in November 2017. In total, 16 local authority Children’s Services have been inspected: 11 within the standard framework (those who were rated as ‘Requires Improvement’ or ‘Inadequate’ at their previous inspection) and four within the short framework (those who were judged as ‘Good’ or ‘Outstanding’ at their previous inspection). Key findings are highlighted below.
Impact of Leaders
31% of local authorities inspected under the new ILACS framework were judged as ‘Requires Improvement’ or ‘Inadequate’ in this category, and all of these were advised that leaders needed to improve their oversight and challenge. The use of audits to monitor the quality and effectiveness of practice was also found to be lacking in 38% of local authorities, suggesting that monitoring of practice is a key issue. Those who received an ‘Outstanding’ rating in this category were commended for adopting a child-centred approach and having an ambitious leadership team with clear oversight of practice, including responding to areas for development.
Help and Protection
The ‘Quality of Assessments and Plans’ and ‘Response to Missing Children’ were the two over-riding factors that inspectors picked upon as requiring improvement in this category. This applied to many local authorities that were judged as ‘Good’ or ‘Outstanding’ in this category, as well as local authorities that received a ‘Requires Improvement’ or ‘Inadequate’ rating. Those local authorities that received an ‘Outstanding’ rating in this category were commended for how children’s views informed assessments and for their responsiveness to changing circumstances.
Children in Care and Care Leavers
There was more of a diverse range of practice within this category, but factors that were identified as requiring improvement in at least four local authorities included ‘Quality of Assessments and Plans’ and ‘Permanence Planning’. Twelve local authorities were judged as ‘Good’ or ‘Outstanding’ in this category, the most across all three categories. Those local authorities who received an ‘Outstanding’ rating in this category were commended for the child-centeredness of their work and the quality of relationships between children and trusted adults.
Overall judgements
All four local authorities who received a short inspection framework, i.e. those who had been awarded an overall rating of ‘Good’ or ‘Outstanding’ at their previous inspection, received a similar rating again. North Yorkshire was the only local authority to be awarded an ‘Outstanding’ rating across all three categories.
Wakefield was the only local authority to receive an ‘Inadequate’ rating across all three categories. Three local authorities received an ‘Inadequate’ rating in the ‘Impact for Leaders’ category, suggesting that this is the area across England that requires the most improvement.
Conclusion
The aim of placing the child at the centre of Children’s Services is a common theme that comes out of all the inspection reports; indeed, this was a key area that was identified and praised in every local authority that was judged as ‘Outstanding’ in each and every category. There are some common themes of what needs to be improved across some local authorities, including response to missing children and quality of leadership oversight. These findings suggest that child-centeredness is indeed a priority within the new inspection framework.
Interestingly, it could be argued that a flip-side of this move away from accountability and bureaucracy has resulted in higher expectations being placed on leaders’ management capabilities, as they are given more autonomy and subsequent responsibility (see the Munro Report). This may in turn be reflected in the comments regarding management oversight in the reports. Alternatively, perhaps the so-called funding ‘crisis-point’ that has hit Children’s Services up and down the country, combined with ever-increasing demand, has also had an impact upon leader’s ability to have a comprehensive overview and command of their services. It will be interesting to see if these current commonalities, both the positive and negative, are present in subsequent inspection reports as we enter 2019.
Enhanced primary care support in care homes
October 2018
As an independent evaluator of seven NHS New Models of Care Vanguard projects, we have been sharing evidence-based best practice on a range of issues related to integrated health and social care. This month we shine a spotlight on effective practice in delivering enhanced primary care and support in care homes.
You can view the report below.
Cordis Briefing October 2018
October 2018
October's Cordis Briefing covered:
Extracts from the Briefing can be downloaded below. For further information about attending (via subscription) please contact Lucy Asquith on lucyasquith@cordisbright.co.uk.
Conditional Caution Scheme
October 2018
The Office of the Police and Crime Commissioner for Cambridgeshire and Peterborough commissioned Cordis Bright to conduct an independent process and outcomes evaluation of the Conditional Caution scheme which has been introduced in Cambridgeshire and Peterborough. The scheme aims to use Conditional Cautions as a means to defer prosecution, offer eligible offenders an opportunity to address offending-related needs and thereby reduce reoffending amongst these offenders.
The evaluation included a data study based on Police National Computer data to investigate impact of scheme participation on reoffending rates and patterns for offenders. It also involved a literature review, consultation with key stakeholders involved in designing and implementing the Conditional Caution scheme and with offenders who took part in the scheme, observation of practice and development of case studies focusing on the experience and outcomes for specific offenders.
The final report for the evaluation has now been published and can be downloaded below.
It found evidence that the scheme:
The findings of the report have informed the ongoing development of the scheme and related services and pathways. A number of recommendations from the evaluation are already being implemented locally.
Phoning us
October 2018
We're having some intermittent problems with our phone system. If you're having trouble reaching us then please let us know by emailing the relevant person or info@cordisbright.co.uk and we'll call you straight back. We apologise for any inconvenience - it's a problem with Vodafone's network so unfortunately it's out of our hands.
Cordis Pulse: September 2018
September 2018
A major issue in public service delivery is supporting well-evidenced projects, programmes and services which work and are effective to be replicated at pace and scale. For instance, there is a lot of focus on and incentives for innovation in public service delivery, but arguably less incentive for successfully replicating and scaling models of service delivery that have been evidenced to work.
Therefore, we are really pleased to be supporting the Health Foundation’s exploring social franchising and licencing programme. This programme aims to explore whether social franchising and licencing might support the effective spread and scale of well evidenced interventions in the NHS. As such the programme offers an exciting opportunity to investigate the potential benefits of an innovative approach to scale and spread.
Alongside our partners, the Innovation Unit, we’ve been working closely with the Health Foundation to develop a flexible yet robust approach to evaluating the programme. The Health Foundation’s Sarah Henderson explores the challenges of evaluating an “ever-changing experiment”, and the approaches we’ve developed collaboratively to overcome these challenges in this article.
You can download September's Cordis Pulse below.