Five London boroughs, backed by a social impact bond, will offer therapeutic support to at-risk children and their families
In 2017, the number of children in residential care in England rose to 72,670 [pdf] – an increase of more than 2,000 on the previous year. Given that it costs a local authority, on average, £3,000 a week to keep a child in residential care, it’s not surprising that most want to do all they can to keep children with their families.
Five London boroughs are working to tackle the problem by putting intensive, specialist services in place. Sutton, Tower Hamlets, Bexley, Merton and Newham – which have 1,350 children in residential care between them – are taking part in the Positive Families Partnership (PFP), a programme of therapeutic intervention.
Using a social investment bond from Bridges Fund Management, three providers – Family Psychology Mutual, Family Action UK, and the South West London and St George’s mental health NHS trust – will carry out two therapeutic services: multisystemic therapy (MST) and functional family therapy (FFT).
How social impact bonds are funding long-term care projects
Working with families where children are at risk of going into care is challenging. Tom Jefford, business development director at Family Psychology Mutual, says that in these families parenting is often absent, while in some cases parents “have absented themselves through drugs or alcohol or are harsh and punitive or inconsistent”. When the therapists work with these families, they put in place “good behavioural plans that will support the parent as best we can, and do that intensively”.
Both therapies involve working closely with families, coaching them to deal with difficult behaviour. Often the goals are quite simple, such as making sure children come home at a reasonable time or improve school attendance. Parents are encouraged to spend positive time with their children, taking them to the cinema or for walks in the park.
MST is the more intensive of the two: each therapist (usually a social worker or mental health nurse who has had additional training) has a caseload of four families who they’ll see at least three times a week. A 24-hour support line is also available for parents.
FFT is usually delivered by qualified family therapists and is used when the need for intervention is less urgent. Both aim to help parents cope more effectively on their own. “The period of intervention is quite short and we’re trying to get them to a better place,” says Jefford.
Parents and children will be given psychological assessments to track their ability to deal with difficult situations
During the first three years of the programme, social workers will help identify 350 children aged between 10 and 17 at risk of being taken into care. They and their families will receive therapy for three tofive months. The project will continue with a monitoring period of two years after the last referral has been made.
After an intervention is complete, the authorities will make a payment to the partnership for every seven consecutive days the child is out of care over a two-year period – though the Big Lottery Fund is also contributing £1.5m to the outcomes payments.
Other metrics will also be tracked, says Mila Lukic, investment director at Bridges Fund Management, including “increased school attendance, increase in prosocial behaviour and reduction in antisocial and criminal behaviour”. Parents and children will be given psychological assessments to track improvements in resilience and the ability to deal with difficult situations. This means the partnership can make adjustments if the interventions aren’t working.
The scheme began three years ago when not-for-profit organisation Social Finance, backed by money from the Big Lottery Fund, went into partnership with the Greater London Authority. As these services would normally be too expensive for a cash-poor local authority to invest in, the appeal is that they will only pay back the money if the project succeeds in keeping children with their families. As Terry Clark, head of social care commissioning at Sutton, says: “From a council’s perspective, it’s a risk-free way of funding. The councils don’t lose anything.”
The project won’t be without its challenges, he acknowledges; this is, after all, the first time five councils have come together to collaborate in this way. But they have taken encouragement from a similar programme in Essex, which has had success in keeping children with their families.
David Burnett, chair of the PFP, is confident it can deliver good results and believes that Bridges is able to take a longer-term view than local authorities. The wide range of expertise involved in the programme will, he believes, help it react more effectively to unexpected events.
If the project succeeds, other local authorities will be offered the opportunity to join in. The rewards are potentially high, both for the councils, which stand to make substantial savings, and for the children who will be able to stay with their parents. It is, argues Lukic, a “win win” for the providers, the authorities and, “most importantly, for the families who now have access to this”.
This article first appeared on the Guardian’s social care network.