Jo Challenger, Chief Operating Officer at Outcomes Consulting, draws on her experience of both commissioning and provision to ask whether children’s residential care is measuring success by placement availability rather than long-term outcomes for children.
There is an ongoing debate within children’s residential care about rising placement costs, provider availability and the increasing complexity of children’s needs. Much of the discussion focuses on the pressures faced by local authorities or the financial challenges experienced by providers, often positioning one against the other. Having worked as both a Social Worker responsible for sourcing placements and now as a Chief Operating Officer supporting children’s services providers, I have come to believe that the reality is far more complex.
The challenges facing the sector are not simply the result of poor commissioning or poor provision. They stem from a system in which both commissioners and providers are operating under significant pressure, often with competing priorities but a shared objective: achieving the best possible outcomes for children.
The difficulty lies in the fact that the systems surrounding them do not always support that ambition.
When a Social Worker is searching for a placement, the immediate priority is understandably to find somewhere safe for a child. Caseload pressures, court deadlines, safeguarding concerns, family expectations and organisational accountability all create urgency. Decisions frequently need to be made quickly, sometimes within hours, and often with limited placement availability.
From that perspective, the availability of a placement can understandably become the immediate measure of success.
However, from the provider’s perspective, the question is often very different.
Rather than asking whether a bed is available, providers must consider whether the child can genuinely thrive within an existing group of children, whether staff possess the appropriate skills and experience, and whether the placement is likely to remain stable over time. Every admission has the potential to alter the dynamics within a home, affecting not only the child being placed but also the children already living there.
These two perspectives are not contradictory; they simply reflect different responsibilities within the same system.
One of the most frequently used terms within commissioning is “matching”. In principle, matching should represent a thorough assessment of whether a service can meet a child’s needs while maintaining the stability of the home. In practice, however, achieving meaningful matching is often difficult.
Providers are frequently expected to make significant decisions based on incomplete referral information, historic assessments or limited understanding of recent behaviours. Equally, commissioners are often working with the information available to them at the time, while managing multiple competing demands and attempting to secure placements within an increasingly constrained market.
Neither side benefits from incomplete information, yet both are expected to make high-stakes decisions.
This raises an important question.
Are we genuinely commissioning outcomes, or are we commissioning availability?
These are fundamentally different objectives.
A placement secured quickly should not automatically be regarded as a successful commissioning decision if it subsequently breaks down. Equally, a provider declining a placement should not necessarily be viewed as uncooperative if that decision prevents disruption to several other children already living within the service.
Perhaps one of the greatest misconceptions within the sector is the assumption that the most cost-effective placement is the one with the lowest weekly fee.
Residential care should undoubtedly demonstrate value for public money. However, value cannot be measured solely through weekly placement costs. Placement instability carries significant financial consequences through repeated moves, educational disruption, increased mental health interventions, additional policing, agency staffing, property damage and, perhaps most importantly, the emotional cost to children.
The true cost of an unsuccessful placement is rarely reflected within procurement exercises.
This is not to suggest that providers are without responsibility. The sector has undoubtedly seen rapid growth over recent years, and with that growth has come variation in quality. Some organisations have expanded before developing the workforce, leadership or therapeutic infrastructure necessary to support increasingly complex children. Others have adopted specialist terminology without making equivalent investment in specialist practice.
High-quality residential care cannot simply be described within a Statement of Purpose; it must be experienced daily by children and demonstrated consistently by staff.
Likewise, commissioning practice deserves reflection. Increasingly sophisticated procurement processes, framework agreements and financial scrutiny have strengthened accountability, yet they have also risked shifting the emphasis towards compliance rather than collaboration. The relationship between commissioners and providers can sometimes become transactional, when in reality it functions best as a partnership built upon openness, trust and shared responsibility.
Perhaps the greatest opportunity for improvement lies not in asking whether commissioners or providers are performing effectively, but in asking whether the system itself is encouraging the right behaviours.
If providers are financially penalised for leaving beds empty while waiting for an appropriate match, occupancy inevitably becomes a commercial pressure.
If commissioners are required to secure placements within increasingly limited timescales and budgets, availability inevitably becomes a commissioning priority.
Neither situation is created by individuals acting in bad faith. Both are predictable responses to the incentives that currently exist within the system.
As a sector, we may therefore need to reconsider how success is defined.
Rather than measuring the speed at which placements are sourced, perhaps greater emphasis should be placed upon placement stability, educational progress, emotional wellbeing, permanence and the views of children themselves.
These outcomes take longer to achieve and are more difficult to measure, but they are ultimately the reason children’s residential services exist.
The residential care sector is often characterised as a relationship between commissioners and providers. In reality, both are only part of a much larger picture that includes regulators, education, health services, families and, most importantly, children.
Improving outcomes will require more than changes to procurement processes or inspection frameworks. It will require greater transparency, stronger partnerships and a willingness to move beyond viewing residential care as simply the purchase of a placement.
Perhaps the most important question we should ask is not whether a service has capacity today.
It is whether that service can genuinely change the trajectory of a child’s life.
Because ultimately, that is what both commissioning and provision should exist to achieve.
