Is there a collaborative way to cut services: the example of East Sussex After School and Holiday Clubs?

 It didn’t surprise me when I heard that East Sussex Children’s Services Department intends to shut down the After School and Holiday Clubs service that they run for disabled children. We set the clubs up over 5 years ago as an extended school initiative based at a number of the county’s special schools. Within a relatively short period the service had grown and by the time it was taken over by East Sussex  County Council had become the county’s largest independent provider of short breaks to disabled children and their families ,offering thousands of hours of play to young people for whom play is too often a rare and scarce opportunity. So although it didn’t surprise me, it did sadden me, as much for the opportunity that the children will lose as for what it cost me to set it up.

But putting my own personal commitment to the clubs to one side, does the decision make sense even in a time of austerity or is it reflective of an approach to service management that should have no place in an inclusive society? Or to put it another way do local politician always have to choose between cutting services for different vulnerable groups – whether they are disabled children, or older citizens with dementia, or is there another way of finding the savings and efficiencies that are required in today’s tough economic climate; because not even I do not think that you should fund clubs for disabled children by cutting services to other vulnerable groups.

Nevertheless, the decision to attempt to save money by cutting an entire service is a poor one, especially when considered in the context of the other changes that are being proposed. It is reflective of a Children’s Services Leadership that is at odds with the principles of public sector reform proposed by all of the major parties. In particular the political party that it serves, and what should concern the County Councillors is that it may be open to legal challenge.

The cuts in services most likely to affect children with SEN and Disabilities:

The closure of the Afterschool and Holiday Club Service has to be viewed in the context of the other proposals within the plan that are likely to affect disabled children. So in addition to closing the After-School and Holiday Club service they are proposing to:

‘Convert a short breaks respite unit to residential care home for up to 6 children (currently in agency placement)’;

Reduce the numbers of children and families supported by the Secondary Behaviour Support service;

Reduce NHS/Children’s Services joint commissioning capacity;

Make further cuts to the Inclusion Support Service including a ‘reduced training offer to parents/carers and multidisciplinary professionals acting in role of Key-Worker Early Support’;

Get rid of the Inclusion Bursary Fund –that supports the inclusion of disabled children in childcare settings.

Identifying the strategic and long term impact of these cuts on disabled children is not that difficult and Short Break Provision and Inclusion are a particular concern.

The Impact on Short Break Provision

We can assume that the After School and Holiday Clubs are providing at least 10000 hours of short breaks a year to the families of children attending the county’s special schools and given the budget it may well be significantly more than that.

We can then add the overnight short break provision that will be lost. If it is the Resource C entre I think it is it has the capacity to provide 7 beds 365 days a year, giving a possible total of 2555 days of overnight short break capacity being lost. It is probable that the centre is not being run at full capacity so assuming 90% occupancy we are probably looking at a more likely figure in the region of 2300 overnight breaks being lost. So taken together this set of proposals will decimate the short break provision being made available to families in East Sussex.

The third element of the proposals likely to have an impact on short break provision is the cutting of the Inclusion Support Bursary. This fund supports the inclusion of children with SEN and Disabilities in childcare settings and whilst Short Breaks are not traditionally referred to as childcare the two are closely linked. When childcare is not available or suitable it is to short breaks that families have to turn. As the plan points out a likely consequence of the proposal is that less effective inclusion in childcare is likely to increase demand for more specialist provision.    

The effect of all three of these proposals on the everyday lives of families will be significant. One of the original motivations for setting up the After School and Holiday Clubs was to help parents’ and carers to be able reclaim some of the ordinary back into their everyday lives. It was hoped that for some it might make work possible or that it would give them the opportunity to do things with their other children.

The impact of the cuts to the overnight short breaks provision is likely to be as significant, if not more so.  This type of service is particularly important for the families of young people who have disrupted sleep patterns. Having a disabled child challenges families in many ways but the impact of disrupted sleep patterns is often over-looked by policy makers. But it is easy to gain an insight into just what these cuts will mean to this group of families. All you have to do is to set your alarm to go off every three hours, every night, for a month and then on the last night of the month give yourself an overnight break for a night. If you do this for a month you will have some idea of what some families have to do for years. Then imagine that your one night a month of short break is being taken away from you. 

The paradox is of course that the overnight short break provision is being cut so that East Sussex can provide its own residential provision and to reduce dependence on out of county residential placements.   So rather than providing overnight short breaks to dozens of families it will provide residential care to seven. The provision for the seven young people may well be needed, but the consequences of the cut in overnight short breaks for those families who use the overnight short breaks service are predictable.     

Inclusion

As some families reel with the impact of the cuts to the County’s Short Break provision; other families, whose children might have less obvious but equally challenging difficulties, will then be hit by the Council’s proposals on Behaviour and Inclusion Support.  These proposals are likely to have an impact on our schools ability to include children and young people with SEN and Disabilities in our mainstream schools.  The extent of that impact will be uncertain but its likelihood is reasonable when you consider the following national statistics on the exclusion of children with SEN.  In 2010/11

2010/11	Number of exclusions	Percentage of permanent exclusions	Percentage of school population
Pupils with SEN with statements	430	8	0.20
Pupils with SEN without statements (9)	3,360	66	0.25
Pupils with no SEN	1,300	25	0.02
All pupils (10)	5,080	100	0.07

 

The proposals to cut Inclusion and Behaviour Support to schools are likely to have a detrimental effect on the life chances of this group of young people, who in 2010/11 where 9 times more likely to be excluded from school. 

This withdrawal of support has also got to be seen in the context of the government’s current proposals to restructure the Statutory Assessment Process through ‘Support and Aspiration’ and the Children’s Bill. According to the Council for Disabled Children the implementation of Support Aspiration will make it more difficult for some groups of children and young people to get support. Regardless of whether or not the CDC’s concerns prove to be true, continued cuts to Inclusion Support in the context of the introduction of Support and Aspiration would appear to be a reckless proposal.

Are these proposals in breach of the Equalities Act?

Technically these proposals may be in breach of the Equalities Act, but they are undoubtedly in breach of its principles. East Sussex County Council has adopted a revenue plan for Children’s Services that collectively is likely to have a significant impact on the lives of disabled children. The scale of the changes that are being proposed means that according to the Equalities Act 2010 a proportionate assessment of their impact needs to take place and that assessment should involve the stakeholders likely to be affected by the proposed changes.  As far as I am aware no proportionate assessment of the potential impact was carried out involving the stakeholders who are likely to be affected. The County Councillors were not presented with documentary evidence on the number of short breaks that would be lost and any kind of estimation the impact that this would have on the lives of families. Nor is there any evidence that schools and young people have been involved in discussions on the impact of cuts to Inclusion and Behaviour Support.

East Sussex Children’s Services Department’s public involvement strategy would seem to be to announce slightly more cuts than are actually required, then wait to see which group shouts the loudest and offer a compromise in response to ‘public opinion’. It is an established form of expectation management, but should not be confused with any form of consultation. Whilst David Cameron might wish to get rid of Equalities Impact Assessments and their requirement to consult, at the time that the County Council accepted these proposals they were still a legal requirement. But perhaps the best thing about the Equalities Act is not that it can be used to delay cuts to services (because it can rarely be used to stop them), it is that it requires stakeholders to work together when considering changes to services. Some might think it a bureaucratic waste of time, but it is actually an essential component of an inclusive society and the only way in which services can be protected without damaging those of other vulnerable groups. 

A participatory approach to saving money

If the Children’s Services Department had involved its Children’s Services Stakeholders in its planning, could it have made a difference to the cuts that are being proposed?  The example of the Afterschool and Holiday Clubs illustrates how a collaborative approach to this process might have affected the proposals and mitigated the possible impact of the cuts.  

Operationally the After School and Holiday Clubs are structured in the following way. 

 

The After School and Holiday Clubs were originally set up as an extended school initiative yet have always operated as social care provision within the Community of Families and Schools. The rationale behind this set up, was that it minimises the impact that running the clubs has on the day to day operation of the schools. It means that they are registered as a separate organisation to the school and were they required to do so would be inspected as a separate organisation by Ofsted. This organisation of the clubs does have its disadvantages. It means that it has to have its own management and administrative infrastructure that is distinct from the schools. The core service to families is provided in the schools – by the Club Supervisors and their team of staff. 

If the County Council had adopted a collaborative approach to its need to make savings a number of solutions might have presented themselves. The most obvious of which would have been that each club is taken over by its respective school and that the savings to the local authority are secured not by cutting an entire service but by cutting its management infrastructure.  Including employers contributions this would save something in excess of £80,000 per annum. These savings could be achieved without affecting the service provided to families.

Obviously the feasibility of such an idea would be dependent upon the views of the people concerned. Would the families want the clubs to be run by the schools? Would the schools be able or willing to offer line management to the clubs? Some may, some may not. It is also possible that one school might wish to take over the running of all of the clubs. Then we also need to remember that it is our locally elected politicians who would be funding this service on behalf of the people of East Sussex, most of whom do not have disabled children.  And given that this is a Conservative local authority, it is also possible that the County Councillors might want to make the funding dependent upon the schools with these additional responsibilities having or at least seeking Academy status.

Whilst I have used the example of the After School and Holiday Clubs to illustrate how community engagement could be used to create savings and efficiencies, this process of engaging the community is capable of generating efficiencies and savings across all of our services. What is ironic is that it reflects the inclusive aspirations of the Equalities Act but also interestingly those of David Cameron’s Big Society.

 

 

Support and Aspiration and Social Work: when things don't add up

In her Comment is Free article published on the Guardian website on May24th, Sara Teather argues that the consultation on the SEN Green Paper 'has shown broad backing from across the SEN sector' and she is right, it does appear to have received broad support from across the sector. Personally I have been surprised to see the extent of that support, but to be fair to them despite the reservations about the underyling political motivations that I have expressed elsewhere, Support and Aspiration does have a lot going for it.

The idea of a combined assessment is a good thing and families have been asking for it for as long as I can remember. The earliest references to it in the research literature go as far back as Glendining's Unshared Care (1983). Then there is the idea of a 'Local Offer' of services and information, intended to deal with the information and support challenges that families face following diagnosis and beyond. And thirdly there are personal budgets, which will theoretically provide both choice and control to families with disabled children and overtime provide a more seamless transition into adulthood and adult services.

So for my part I believe Sarah Teather genuinely means it, when she says that 'These reforms are about making sure every child, whatever their needs, gets the right type of help early' and from this perspective it is understandable that the proposals have been viewed favourably by some. However, the problem with Support and Aspiration is not it's content - its the politics and practicalities of its implementation. I have covered some of my resevations about the politics of its implementation in a previous blog but it is probably the practical shortcomings over the proposals that are most worrying.

As Sarah Teather points out it is intended that Support and Aspiration will replace the statutory assessment process set out in the 2001 Code of Practice, and as I have said elsewhere, the statutory assessment process requires that decisions about a child's education are made according to a child's need not according to the budget that is available.  According to the 'Progress and next steps' document this entitlement isn't going to change.

Children who would currently have a statement of SEN and young people over 16 who would have a learning difficulty assessment have an integrated assessment and a single Education, Health and Care Plan which is completed in a shorter time and without families having the stress of going from pillar to post to get the support they need; and,

 Parents have greater control over the services they and their family use with:

every family with an Education, Health and Care plan having the right to a personal budget for their support

On the surface this looks good. It is pretty much everything that many families have ever wanted, although some may have reservations about managing their own budgets. The principal difficulty will lie in the entitlement to a personal budget and other forms of social care service and the implications that this has for social workers.

Currently Personal Budgets are assessed and processed by social workers and should involve the use of the Common Assessment Framework. Indeed as the BASW point out in their consultation response to Support and Aspiration 'the importance of social work involvement with disabled children and their families cannot be stressed enough ' and the involvement of social workers should be seen as good practice. Despite this, at the moment only 1 in 5 families whose children have a Statement of SEN also receive any form of social care service. (This figure is based on DfE data and research carried out by the Thomas Coram Institute at the University of London.). The implications of this for the implementation of Support and Aspiration are significant. Whilst the use of Self Assessment Questionnaires and Resource Allocation Systems may help, the resources required to make Personal Budgets available to every family with an Education, Health and Care Plan are self evidently not going to be made available given the scale of the cuts that are currently being implemented across Children's Services.


Last week the British Association of Social Workers published a report into The State of Social Work in the UK in 2012. In it Fran Fuller the Chair of the BASW, stated that current caseloads are 'quite simply unmanageable and that they pose a serious risk to the people who need services'. In addition to the burden that their workload imposes, social workers complain of being bullied and overall that the current state of social work is "terrifying". How the government imagines that social workers will be able to cope with any increase in their workload borders on the delusional and it is self evident that the development of Support and Aspiration's proposals took no account whatsoever of the views and current status of the profession, in the same way it would appear to have taken little account of the views of front line teachers.

So whilst I can understand why the content of Support and Aspiration has garnered the approval of many in the sector and why Sarah Teather believes it is being done in everybody's best interests, the politics and practicalities of its implementation are fatally flawed. Those who support its implementation need to be aware that if it is not supported by a significant increase in social care funding and is not implemented with the widespread support of front line social workers and teachers, it will fail miserably and do significant damage to all concerned.  

Special educational needs and the undeserving

The fundamentals of how the government is going to manage the implementation of the changes to the Special Educational Needs (SEN) System are now clear, and all present in much of the coverage in today’s media. As expected the government’s media strategy has begun by representing the changes as reform and an improvement to a system 'that is not fit for purpose'. In truth it is not so much the system they are concerned with but the level of funding it consumes and their ability to control that spending. In the current system the Statement of SEN requires resources to be made available according to a child's needs, irrespective of budgets that local authorities may or may not have available. Currently that entitlement is being made available to approximately 3% of all children and in a government where managing budgets comes first the removal of that entitlement is unsurprisingly, a high priority.  

The second thing they have done is to divide the children and their families into two categories: those deserving of additional support and those who are not. This paralells the strategy used in many of their other reforms. The more severely disabled child and their family will be entitled to the support they deserve: a combined assessment and a personal budget. In contrast to this a child with the lowest level of special need will supposedly have their additional needs met through improved teaching methods and better training for teachers.  This group of children are likely to include amongst others; childrenwith high functioning autistic spectrum disorders, children without a diagnosis and particularly those with emotional, behavioural and social difficulties whose difficulties are (often erroneously) attributed to poor parenting skills.

The third element of the strategy implicit in much of the coverage, is to vilify teachers. Along with parents, teachers are seen as the principal abusers of the current system. The treatment of teachers in the Graeme Paton’s Telegraph article is particularly blunt and they are blamed for using the SEN system to manipulate league tables and hide poor teaching and as ever Ofsted is used to support the argument and make what is essentially a political case. What makes this vilification of teachers all the more pointless is that the proposals outlined in the Green Paper Support and Aspiration are almost impossible to achieve without the full support and commitment of a child's school.

So over the coming months, we can expect more examples of deserving disabled children and how effective the combined assessment is at meeting their needs. We can expect examples of the charities that are supporting these proposals, most of which now have significant government contracts. We can expect reports on how inclined teachers and parents are to abuse the current system to get additional funding and how a culture of low expectations deprives these children of their futures. What we won’t get is honesty about the real objective of these changes – the removal of the Statement of Special Educational Needs – as a legal guarantee of a child's statutory entitlement to additional support according to need.

Freedom of Information in Tough Times - a strategy that divides

We are at a critical point in time in the relationship between progressive practitioners and the communities with which they work. This is the first of a series of blogs that will explore the current state of social care, user involvement and participation. This particular blog explores the issue of the cuts and questions the government's approach to assessing the impact that they are having on Local Authorities and relationships with service users. 

Last week the Audit Commission published its report, Tough Times (Audit Commission, 2011). The report looks at the impact that the government spending cuts are having on Local Authority spending, in particular on the way in which they are managing those changes. The tone of the report is a complex mix of re-assurance and dire warning. Warnings that are especially pertinent for those Authorities in deprived areas, that are most dependent on central government funding. However, the central message of Tough Times is that most LA’s are managing the changes effectively and are adopting a range of strategies in order to do so. Some of these are intended to prevent the cuts from impacting directly on users.  These cut prevention strategies would include the use of reserves or the creation of efficiency savings. However, where direct cuts in services have been inevitable they have been carried out in four ways. The first has been to reduce the volume or amount of a service that is available; the second is to increase charges that are made for the provision of services; the third is to reduce the standard of the service that is being provided and the fourth is to change the eligibility criteria for a service so that less people are able to use it.

Whilst Tough Times recognises that consultation is an integral part of successful service planning, the way in which the impact of these strategies affects service users is glossed over, and is evidently secondary to the principal concern of managing budgets. This is indicative of a number of things. The first is the changed remit of the Audit Commission. The decision of Eric Pickles to abolish the Commission and to curtail any research focused activity has meant that the only language and perspective to count is the language of financial audit and Best Value. In this context the voice of service users is quite simply absent from a document that aspires to ‘audit’ the impact of central government cuts and it is at this point that the perspective of the service user needs to be introduced into the discussion.

When the amount of a service is reduced the effect of that action may well be to balance a budget, but it also has a concrete effect upon the everyday life of the user who receives a reduced level of service. This might be a young person who is attending an out of school activity that allowed them to contribute positively to their community, or it might be the parent of a disabled child who receives less support in the home. Equally, changing the eligibility criteria might seem to be a reasonable thing to do in the tough times in which we live, yet it is a budgetary strategy that will change the lives of the people who are affected by it. By moving the eligibility criteria, Local Authorities are required to make decisions about entitlement to support. These decisions are guided by the way in which the government represents and conceptualises the service user. Currently the fashion of governments of most persuasions is to represent service users as consumers.

What is particularly concerning is that through the employment of a range of representational strategies consumers of government services are then be categorised into the deserving and the undeserving. In this way the exclusion of particular groups of service users can be justified on the grounds that the ‘scarce resource’ has to be saved for those who deserve it most. For example the Early Support projects for families with severely disabled children can be identified as a deserving community although the eligibility for accessing the service will be restricted to those whose children are most severely disabled.

Another consequence in the shift in eligibility criteria will be to increase the gap between the number of families who do not meet the initial criteria for access to services and those who are unable to benefit from access to universal provision. Again to use the example of disabled children we have the difference between getting short breaks through a social care service or childcare through a mainstream childcare provider. It may well be that initially a family with a high functioning child with an Autistic spectrum impairment will be ineligible for social care services because their child is ‘insufficiently’ disabled, yet over time an inability to be able to obtain universal childcare and other community activities such as afterschool clubs, will have a long term negative effect on the family’s everyday functioning and long term resilience.  

None of this is apparent in the evidence base provided by the Audit Commission report, which only speaks the language of government. Yet in the long term the lack of the voice of service users, will have consequences. In the end the growing community of people who exist in the gap between universal provision and care services will have to return to their local authority as a consequence of their isolation. Whether it is poverty, ethnicity or disability that marginalises that community, the decision to move the eligibility criteria will simply delay the inevitable.

So how do we move from a situation where the impact of the cuts is measured and described in the language of accountancy, when its real consequences are human and embedded in the context of people’s everyday lives? The government’s approach is that service user’s can be empowered to operate as consumers and in doing so make choices which reward and strengthen successful providers and make them more responsive to the needs of families There are a number of problems with this market based argument, the first is that it presumes choice in a context in which it may or may not be available. In addition to this it fails to deal with those who are excluded from service provision on the grounds that they fail to meet the eligibility criteria. As in the rest of society, competition and choice works for those who have money or who qualify for services, but less so for those who have neither. 

It is also in this context that freedom of information and transparency are increasingly being seen by the government as a means of facilitating the operation of the service marketplace. Whilst the government is getting rid of the Audit Commission and replacing it with a requirement for local authorities to commission the audit of their own services; the public are to be the driving force through which the information about the functioning and performance of the marketplace is generated. The Freedom of Information Act is seen as the principle means through which this will be achieved. This may seem theoretically plausible to neo liberals, but even if it works the Nett effect will be to challenge and undermine the relationship between service providers and service users, replacing one that is ideally based upon collaboration with one that is based upon never ending demands for performance outcomes and information.

The danger for all of us who want to make things better for people who are at risk of social exclusion is that rather than focusing our energy upon meeting needs, we end up fighting, gate-keeping and campaigning over the scraps of service provision that are left. Meanwhile David Cameron, Ian Duncan Smith, Andrew Lansbury and Eric Pickles simply look on and smile, all the time extolling the efficiency of a market place that is built on struggle and conflict and part paid for by the generosity of the different ways in which we care.  

The answer to this challenge for the progressively minded is not simply to do as we are bidden and dance the dance of the puppet masters, but must lie in a transformation of the relationship between the people who are service providers and those who are service users, so that ultimately in these Tough Times it is not our difference that identifies us - but the mutuality of our care.