Commissioning foster care services in Falkirk Council: a Public Social Partnership approach

Report summary

This report is about a Public Social Partnership (PSP) pilot in Falkirk, which focused on foster care services. Public Social Partnerships (PSP) are an innovative model of public service delivery, which is based upon the public sector and third sector working together to design and deliver public services.

The report details both the processes involved in the PSP and the learning of those involved. Although the experiences of the participants vary, a variety of common lessons and themes have been identified. We anticipate the report will be of interest to those involved, or interested, in social care commissioning.

The main conclusions that can be drawn from the interviews are:

Providers were overwhelmingly positive about the Public Social Partnership approach and felt that it contributed a significant step forward towards supporting embedding of an outcomes focused approach
Providers involved in the Public Social Partnership felt that the outcomes agreed and used in the funding agreement/contract accurately reflected the personal outcomes they support children to achieve
Providers and Commissioners felt that the Public Social Partnership process encouraged positive relationships to develop

In terms of what helped discussions with commissioners/funders around outcomes the following were identified:

The involvement of local authority service managers alongside commissioners who understand the area of work
The involvement of carers
The willingness (on the part of commissioners and funders) to test out and try different approaches to capturing outcomes and a commitment to working together with providers on this
Agreement between providers and commissioners that outcomes and monitoring mechanisms would be negotiated and agreed, rather than imposed

The Public Social Partnership approach supported people to share experiences with their peers, which had a number of additional benefits outwith the scope of the project. Similarly, the PSP process itself provided a platform for a new, open type of dialogue with commissioners to develop.

When asked to reflect on experiences outwith the PSP process, the following factors were considered to hinder discussions with commissioners/funders around outcomes:

A focus on budgets and hourly rates
A lack of common understanding of outcomes by commissioners/funders and providers
A lack of clarity on how outcomes should be measured and monitored
Overreliance on adversarial commissioning/procurement models

Background

The language of outcomes, and approaches to measuring and evidencing them, are steadily being adopted and developed in care and support services in Scotland. However most services are still commissioned and funded on the basis of units of cost and volume.

As such, in partnership with CCPS (Providers and Personalisation Programme), Iriss believed it was a useful time to raise awareness of commissioning models that are aligned with that of an outcomes focused approach to service delivery. We are keen to support commissioning for outcomes as a mechanism for encouraging the push towards, and appetite for, the adoption of an outcomes focused approach to service delivery.

In 2011, Iriss and CCPS worked together to consider how commissioning models could be rebalanced in favour of effective and positive outcomes for people who use services and their families, and away from consideration solely on cost efficiencies. Over the year, we worked together with Falkirk Council and partners to understand their experiences of implementing the Public Social Partnership model of commissioning services, as well as assisting them to establish an outcomes focused monitoring process.

Introduction to Public Social Partnerships

The commitment to using an outcomes focus to support the 'radical redesign' of public services, and the introduction of outcome agreements to govern and manage local authority performance has led to a growing interest in corresponding tools and processes to plan service delivery in Scotland.

Adopting an intelligent commissioning approach that focuses on desired outcomes and identifies the most appropriate level and scale for the delivery of public services is one way to build a sharper focus on outcomes in interactions between commissioners and providers.

In March 2012, Audit Scotland[1] made clear recommendations that councils should maintain good relationships with providers throughout the commissioning process. This was from evidence that providers can contribute to the development, evaluation and review of commissioning strategies in a number of ways, for example:

by bringing their knowledge, expertise and experience of the needs and aspirations of specific groups or communities, and how best to meet them
by facilitating direct input, comment, ideas and feedback from people who use existing services, or who may need to use them in future, and from families and carers; and
by contributing their expertise and experience of providing particular types of service, as well as their ideas and proposals regarding how services can change, improve and become more personalised, thus enabling an authority to develop local market intelligence.

Public Social Partnerships (PSP) are an innovative model of public service delivery, which are based upon the public sector and third sector working together to design and deliver public services, in an 'investing' model of commissioning. It provides one way for public sector planners and commissioners to engage earlier and more deeply with agencies acting in the interests of the people they serve, putting people at the heart of service design and delivery. The PSP approach should help people to share in every aspect of the process - identifying need, designing actions, sharing in delivery, monitoring and evaluating, as well as re-framing need and re-designing actions.

In recent years, there has been an increasing focus on the PSP model in Scotland. In 2006, The Social Economy Scotland Development Partnership (DP) provided funding to three PSP pilots in Scotland and in 2009, the Scottish Government established a further ten pilot PSPs with the aim of funding projects with sufficient geographic and market diversity to enable the PSP model to be fully tested over an eighteen month period.
The Scottish Government's paper, A practical Guide to Forming and Operation Public Social Partnerships (2011)[2] identifies the three stages that PSPs typically take:

1. Design

Third sector and public organisations work together to design the service in a way that maximises social benefit.

2. Piloting

The service is delivered for an agreed period of time. During this pilot stage (which is normally funded through private or charitable investment), partners can adjust how the interventions are delivered, in order to achieve maximum social benefit.

3. Tendering for longer term delivery

Services which successfully meet their agreed outcomes will usually receive mainstream funding from the public sector partners. Typically this involves the public sector partners tendering a contract to deliver the interventions in the longer term. In some cases, longer term delivery could be secured through continuing pilot activity or through grant funding.

Evidence about PSPs

While a number of PSPs have been setup in Scotland to date, the majority of these have not undergone robust review and the small number of evaluations that have been published, have tended to focus on assessing the strengths of the individual projects rather than the PSP model itself.
The results from the Scottish Government pilot highlighted that the most important factor in determining the success of a PSP approach is the level of trust between and commitment of the partners. Organisational and staff changes can cause disruption, but, if there is continued senior level commitment to making the PSP work and a focus on the needs of people, these need not be insurmountable obstacles.

The Scottish Government guidance also highlights a range of different learning and lessons from their pilot PSP programme:

Because the PSP process begins with the needs to be addressed, not the service available, the process can often be the driver for other partnerships within the local area
By giving the third sector an equivalent role in the three stages, services can be designed with the needs of those using services in the community at the forefront of the process
PSPs draw on the expertise from a wide number of groups and individuals
In the Scottish Government's evaluation of the pilot PSP projects they note that a number of the PSPs achieved their intended outcomes, suggesting that PSPs may provide an effective model to achieve social outcomes

The PSP position in Falkirk

The need for a robust commissioning framework for Children's Services was established through an extensive casework audit, commissioned by the council's Children's Commission, (the strategic planning group for children's services which reports to the CPP) which was carried out across services for children and young people in the Falkirk Council area. This audit established that the absence of a broad commissioning strategy meant that there were some gaps in service provision but that also in some areas there was an element of overprovision. This overprovision had developed over a period of time for several reasons. For example, although Falkirk Council had a commitment to local placement for children and young people (Children's Services Plan[1]), an increase in children looked after away from home had led to a significant increase in demand beyond supply which meant the council was often failing to place children locally, and had spot purchased placements with a range of different providers. The result of this was that monitoring of contracts and quality assurance was extremely difficult, and children's needs were not always being well met due to the distance of placements from their local community and networks.

The PSP approach aimed to ensure that staff within the third sector and public sector would have the knowledge and information to participate as full members in the commissioning process. This meant that information regarding the number and characteristics of the children and placements was issued to help planning and development. The local authority was keen to develop a new and innovative approach to commissioning services and was open to developing this in partnership.

Key facts

Service area: Foster care services
Commissioning Authority: Falkirk Council
Partners: Carevisions, National Fostering Agency Scotland, FCA Scotland, Fosterplus, Fostering Relations, JMT Fostering, Barnardos
Goals:

Better outcomes for children and young people
Better outcomes and experience for foster carers
Financial savings
Better use of resources - matching needs to service provision
Better and more meaningful contract management

Current status: the contract is at mobilisation phase i.e. 5 placements have been made to date under the new contract Falkirk Council also directly provides foster care services- placements are outsourced to the voluntary and independent sector where in-house services do not have the capacity to meet the need.

Public Social Partnerships: the experiences of those involved

Interviews were conducted between March 2012 and May 2012 with the commissioners and providers involved in the PSP pilot, and that were successful in the resulting tender. These interviews focused on understanding the process of the PSP approach and each person's perceptions about what worked well and what could be improved. In addition to this, a review of the paperwork from each of the PSP meetings was undertaken.

Factors that supported a positive process

Creating the right environment

Creating spaces for dialogue between people from a variety of different organisations and backgrounds is not an easy task. It requires time, resources and commitment. It also calls for participants to be flexible about their power relationships, as well as to be open to experiencing alternative ways of relating to each other. This diversity can breed innovation, energy, consensus and understanding of a broader context, but it can also bring conflict, inaction and frustration.

All interviewees commented on the positive effect of the PSP process on provider - commissioner relationships in Falkirk. These successful relationships were thought to be promoted by the creation of an environment where every partner involved in the project felt like they were adding value and were trusted.

The lead for the PSP process was not a commissioner by background and as such, the PSP process represented a steep learning curve. However, this individual had in-depth knowledge of the service area that was being commissioned (as the service manager of the local authority service) and subsequently there was a shared common ground. The majority of providers thought that having this person as a lead was instrumental in creating an environment that was conducive to trust and sharing.

"I think as providers around the table, we felt included and part of it and as if we are safe, as if we are in it together and progressing it on."

"There was never a feeling of, well we have got to bloody well work with you, so I suppose we're just going to have to grit our teeth and get on with. I'm being honest with you, that is sometimes the way that some local authorities make you feel, that you are really there under sufferance and they don't have a choice and if they had a choice they certainly wouldn't be choosing to have to engage."

Providers frequently highlighted that their involvement in the PSP project had been enjoyable, and that the feeling of the project was markedly different from other tender exercises that they'd participated in.

"I suppose you could sense it right away just that kind of relationship that people had built up and, you know, I just find in terms of the process that's happened in Falkirk, it's like a good practice, best model, that kind of way really. ...[if this] had this been for the national contract what a difference it would have made!"

"So I suppose that's the difference, the feeling is very different. You feel as if you're actually having a conversation with professionals and colleagues and that we can work together to get a solution."

Working together principles

Many argue that in order to foster new ways to think and talk together, it is vital to determine collaboratively adopted ground rules. This is particularly so in instances where the interests of partners, as well as their approaches to problems, may be different.

In Falkirk, a formal commitment was required from all parties (commissioners and providers alike), which was demonstrated through agreeing and signing up to a working together agreement. Commissioners suggest that this agreement, established early on in the project, was instrumental in supporting the group to feel comfortable agreeing what they would and would not share in the group context Indeed, in practice the only elements that were not shared were those variables that could be considered commercially sensitive (pricing structures and number of foster carers in the area).

"There were one or two bits where we had discussions about well we can show you where our radius is, but we can't give you a placement number because that is commercially sensitive information, but those were handled really well. I don't think there was anything that anybody had major issues with or concerns about."

This formal commitment from all parties was an important step in reaching out across their respective responsibilities and interests to co-operate on certain issues. Similarly, keeping the vision for the project in mind at each meeting sustained focus on the end goal and away from each individual's organisational perspective and overall workload.

Communication

Good communication between all involved in the pilot seems to be the cornerstone of its success. The view from providers was that the local authority had been able to give good, high quality information from the outset that enabled them to better understand the Falkirk Context and to respond to this in their response to the tender, and the design of the services.

From the outset of the project, the lead was very clear and transparent about details of their own in-house services. Details of training processes, awards and expectations were shared which fundamentally set the tone for the rest of the providers. Similarly, the local authority was up-front with providers about the economic restraints that the council was under as well as the elements of the tender that were negotiable and non-negotiable. The majority of the providers interviewed mentioned that having this information from the outset supported overall clarity of the work.

"I suppose that would be the other thing I would want to say, is that I don't know whether all the councils and how the operate would be able to be this open and this transparent, because it actually requires an element of admitting when you get things wrong and because of the way the commissioning things have evolved, there is a kind of culture out there where we are commissioning, we are not accountable and I don't think that's what came across here. "

Similarly, in this project, the relationships between staff from many of the provider agencies were already strong which undoubtedly assisted their capacity to work well together.

"I think it does make a difference if you feel that people are wanting to work with you, they are wanting to get good outcomes for their children and that they see you as a partner in that, not as somebody that's got to be put up with, and I think that setting, if you like, of that agenda, of that feeling, I think that's very important that's there from the start."

In discussions with commissioners, however, it was evident that the tender process itself often mitigated against the PSP process. For instance, after the tender was launched publicly, Commissioners were required to cease communication with providers. This was described as feeling 'unnatural' and 'difficult' when there had previously been such an open environment of trust established.

Values and outcomes

A theme that ran through each of the interviews with both the providers and commissioners was that they all wanted the best for the children they were supporting. This underpinning understanding meant that any conflict that could have arisen between providers was limited as all involved trusted that the local authority were making decisions about placements based on the best possible evidence and intentions.

"At the end of the day if somebody over there has got the best placement, well that's what you want, hopefully another time your organisation will have the best placement."

"So it was quite nice to be round a table in a way and be able to be talking on the same wave length and not be in any kind of competition, because we were all really basically wanting the same outcome."

The focus on the underpinning principles and values of SHANARRI is also considered to have supported the group to come together with common understanding around outcomes. In their interview, commissioners recounted how a particular session focusing on the SHANARRI indicators provided a turning point for the group. In this session, the group considered the meaning of SHANARRI for fostering services and shared their experiences of integrating SHANARRI within their own organisations, and with other local authorities.

All interviewees highlighted the increasing pressure to demonstrate the impact of the services they provide in terms of service user outcomes. Many were confident that they were delivering positive outcomes, but were less confident that they were able to evidence this in an effective way, or in a way that would be deemed acceptable to the various local authorities that they work with. As a result of this, providers embraced the PSP process as a way to work together and learn from a range of other provides who were struggling with some of the same issues of measuring outcomes.

Providers talked of the added incentive of doing this in partnership with a local authority and working towards a process, which could influence the work going on in other areas. Similarly, a frequently cited strength of the PSP approach is that public sector partners are involved alongside other providers the whole way through the process, which is often beneficial in terms of securing sustainability of a service.

"at the minute every local authority has got their own way of dealing and outcomes, and although it's all round SHANARRI....the fact that we are having an opportunity to look at the outcomes with you, make sure that we are all singing from the same hymn sheet developing what's best, but also I think it's quite a good learning process for ourselves and hopefully the staff as well.

"I think as well because the relationship building that happened not just with Falkirk Council, but with other providers, so there was a shared understanding... It was actually a really good practice discussion to have and there was learning from both sides, from other agencies, but also from Falkirk as well, some of the stuff that had been brought to the table was actually really valuable."

Time

Perennial issues to do with time and resources are ever strong in the social services, particularly in this age of austerity. For many of the participants it is clear that the experience of participating in the pilots has been a rewarding one, but that the time taken to achieve progress has been longer than expected.

"...the only negative I would say about it is in terms of the number of placements and the time commitment, it was very disproportionate, that's the only thing, that's the only complaint I would make."
"I suppose it is quite resource intensive or was quite resource intensive and I certainly missed a couple of meetings just because of other things..."

However, although participants in the pilot were clear that it had taken more time than they'd anticipated in relation to the number of placements that were on offer, many of them pointed out the additional benefits of being involved in the pilot. These included:

Sharing training and resources with other providers
An opportunity to share issues and generate solutions
CPD /time to reflect away from their day job

"...whatever discussions we have with you about outcomes, we would be applying the learning to anybody else [other local authorities and agencies] who we may be working with."
"I think there has been quite a bit of impact for me as a professional worker, but also in terms of my organisation - it has made people think a wee bit more about commissioning."

In terms of lessons learned for other PSP processes, it is clear that providers are likely to have to make a cost benefit analysis of their involvement across local authorities as well as across different areas of service provision. Indeed, commissioners may also have to consider the number of PSP processes undertaken at any given time to reflect on any resource implications.

Impact of the PSP process

Innovation

A host of innovative contracting/procurement/commissioning models were explored and considered throughout the PSP process. Commissioners were clear that their starting point was not based on preceding contracts and that no suggestions would be disregarded. As such, it is surprising that such a traditional solution (a framework agreement) was the chosen option. However, although a standard contract was agreed, it was the process of development that was crucially different and valuable.

Although not demonstrably innovative, the process taken to generate the contract is reported to have felt substantially different from the national contract that is currently under development. In fact, all those interviewed considered that the framework agreement has advantages for both providers and commissioners alike as it means that providers could be flexible and would not have to 'hold' Falkirk carers for Falkirk council when they could be placing other children with them. For commissioners, it means that they are able to ensure quality and value for money, as well as having choice between a range of providers.

Risk-taking

The desire from Falkirk council to recognise and support the full range of contributions from providers was clear from the outset. In interviews, both the providers and commissioners discussed how working together with the knowledge of all partners supported them to take risks, and to do things differently. Specifically, working together enabled the group to weigh up the potential benefits and harms of exercising one choice of action over another. As such, this makes for a much more robust decision-making process than would normally be possible under most other commissioning processes.

The approach itself provides a framework for trying out new services within the context of collective responsibility and shared risk. In a group setting they were able to identify the potential risks involved, and to develop plans and actions that reflect the positive potentials and stated priorities of the overall focus of the work. For both providers and commissioners this was thought of as illuminating as they were able to gain insight into the others perspective.

"So if anything the old system or the other system that other people are using actually stops creativity, because companies will actually only give what's on the bit of paper, whereas I think this is much more about an openness and were buying into a partnership working,"

Recording and monitoring

Falkirk Council, in partnership with the PSP group, has now developed a flexible approach to monitoring and evaluation. The monitoring arrangements have been designed to ensure quality, with regular meetings to discuss overall objectives and progress towards them. The success of this approach is ultimately dependent on the continued dialogue and good stable working relationships that have developed through the PSP process between the authority and provider representatives.

This particular solution was developed from the desire from Falkirk Council to ensure that completing monitoring documents did not become too burdensome, and to ensure that providers could respond flexibly using their own outcome measures or tools. The solution emerged from a strategic approach where the group identified it would be beneficial to understand organisational outcomes, to understand the quality of the organisations themselves. This approach was developed and will be tested in accordance with PSP principles.

General implications of this way of working

Competition from elsewhere

There is no guarantee that service providers who invest their time and skill in the design and piloting stages of the PSP process will successfully win the business at the tendering stage.

In fact, this was the case for the Falkirk project where the highest ranking provider was not involved in the pilot phase of the PSP project, and where not all participants in the pilot were successful in going through onto the framework agreement. That being said, this fact in itself was considered by interviewees to be a positive sign that the tendering process was fair i.e. that involvement in the pilot didn't make it a 'done deal' that they would automatically be in line for the contract.

Small group of providers

Some providers talked about the benefits of using a PSP approach in a small local authority such as Falkirk council, but had concerns about whether or not this approach would work in a larger, more complex area. This concern was centered on the practicalities of having meaningful dialogue with a large number of people with a broad range of perspectives.

Furthermore, providers highlighted that the size and capacity of organisations involved in PSPs are likely to vary. Some organisations may need additional support to be able to participate as fully as other organisations - particularly those smaller, local agencies. Similarly, it is thought that some providers may be more likely to invest and engage in the PSP process for some local authorities rather than others in the process for some local authorities where they are delivering more services, than in others.

Internal support for the lead agent

This lead for this project as aforementioned was inexperienced in commissioning processes. However, this person was well supported internally by other proponents of the PSP approach, a colleague service manager from commissioning, as well as those in contracting and procurement, which enabled the risk management process associated with the project easier for her, and by association, for the rest of the group.

Similarly, a key element of the Falkirk approach was to recruit and develop a cohort of advocates to raise awareness of PSP commissioning across both the public and provider sectors. This chimes with the recent Scottish Government guidance, which suggested that PSP champions are a crucial enabling factor in successful PSP process.

Involvement of people who use services and their carers

In this project, foster carers were involved in scoring the tender submissions. Commissioners highlighted how invaluable this was in assisting their decision-making. Carers were thought to have a useful perspective on the scoring, frequently acting to challenge commissioner assumptions and seeking clarification of provider responses. The lead agent on the project was clear that if the project were to be re-administered, carers and people who use services would be involved at an earlier stage of the process.

Emerging lessons

Public Social Partnerships take time, and it is important to invest time at the beginning of the process to agree shared values and goals.
It is important, from the beginning, to develop a shared understanding of the nature of the service to be developed and tested.
It is also critical to involve a range of stakeholders where possible (in this instance, carers were involved).
A strong lead person is essential to drive the process and plays an important neutral role as facilitator and co-ordinator of all PSP activities.
The size and capacity of organisations involved in PSPs are likely to vary. Some organisations may need additional support to be able to participate as fully as other organisations.
The PSP model provides third sector organisations with the opportunity to be involved in design and delivery of services.

Footnotes

[1] Audit Scotland (2012) Commissioning Social Care

[2] Scottish Government (2011) A practical Guide to Forming and Operating Public Social Partnerships (PDF)

[3] Available from: http://www.falkirk.gov.uk/services/social_work/children_and_family_services/child_protection/childrens_integrated_services_plan_11.pdf In particular, see reference to 'for falkirk's bairns" Update 2016, link no longer available

[4] Innes J E and Booher D E (2003) Collaborative policy making: governance through dialogue, in: Hajer M W and Wagenaar H (Eds) Deliberative Policy Analysis: Governance in the Network Society, pp. 33-59 (Cambridge, Cambridge University Press

[5] In Scotland, Getting it right for every child puts wellbeing at the heart of its approach to child welfare. Wellbeing is defined through 8 Wellbeing Indicators, often known by the acronym, 'SHANARRI' (safe; healthy; achieving; nurtured; active; respected; responsible; included) that capture the full range of factors that affect children's and young people's lives

Header image was originally posted to Flickr by carlosluis at Flickr.