Complex care needs driving ‘astronomical’ care costs, council leaders say

The number of children’s home placements costing £10,000 per week or more increased more than 12x between 2018 and 2023.

A new report from council leaders says that the number of complex care placements – those costing councils more than £0.5 million per year – have increased from 120 to 1500 in the timeframe.

The new research, carried out by the National Children’s Bureau (NCB), warns the challenge of meeting the increasing complexity of children’s needs, along with a lack of appropriate homes for these children and the linked challenges with commissioning those placements, is leading to an escalation in very high-cost placements. 

Those participating in the research pointed to a range of factors leading to increasing complexity of need, from the impact of the pandemic and historic cuts to early help, to rising levels of complex autism, mental health challenges and high instances of self-harm.  

With children coming into care later and at a greater point in crisis than ever before, researchers found opportunities to intervene earlier were being missed, from Sure Start-style family support to special educational needs provision and mental health support.  

They also found that where children do need to come into care, there is a significant challenge ensuring an appropriately trained, trauma-informed workforce, and insufficient clinically led models of care in homes.  

“The research makes clear that there are complex and intersectional factors driving high-cost placements,” Caroline Coady, Deputy Director at NCB, said.

"However, we heard from providers, local authorities and other stakeholders that an important part of the solution is relational commissioning. This includes strong relationships and open communication channels between local authorities and providers, with senior leaders taking an active role in developing these partnerships.

“Children and young people should be able to expect high standards of quality that ensure they are safe and cared for. To achieve this, it is vital we create clear and accessible opportunities for young people to share their views and experiences, with confidence that they will be listened to and acted upon.”

As a result of the report, the Local Government Association is calling on the Government in the Spending Review to ensure all councils receive sufficient funding to invest long-term into family help, child protection, and child in care and care leaver services.

It says it should also develop a cross-government strategy for children, young people and families to ensure all partners are working towards a shared ambition.

Cllr Arooj Shah, Chair of the LGA’s Children and Young People Board, said it could “not be clearer” that we need to do things differently.

“With more children needing help with increasingly complex and challenging needs, what is most important is ensuring they get the best care and support. However in many cases, a lack of choice means provision is not fully meeting children’s needs. 

“The astronomical costs of care placements mean there is less money available for councils to spend on the earlier help children so desperately need.

“As local partners we have key roles to play, and the Government can drive this from the top. By integrating planning and funding across departments and using the forthcoming Spending Review to make sure services have the resources they need, we can make sure children receive the care they deserve.”