The costs of short break
provision for disabled children
Funder
The Department for Children, Schools and Families
Background
Research suggests that, as a group, disabled children, and their
families, are among the most vulnerable. Existing evidence shows that a
break from caring is one of the most frequently requested services from
families caring for disabled children (Beresford 1995; Robinson Jackson
and Townsley, 2001), and many studies point to the positive outcomes
achieved through the provision of short break care.
Due to the high levels of training, specialist equipment and intensive
levels of intervention required for children with complex health needs,
these services are often the most costly of those provided by Children’s
Services departments. However, there is evidence that more research is
needed on the cost-benefits of different types of short break services
Aim
The
aim of this study was to calculate the costs incurred by Children’s
Services Departments of providing short breaks to disabled children and
their families. The study aimed to calculate the costs of individual
services, provided by both local authority and voluntary service
providers. In addition, and in order to calculate the full range of
costs associated with the provision of short breaks, the study aimed to
identify and calculate the costs of the routes by which families are
able to access short break provision,
and any ongoing social care activity undertaken to support the child and
family once in receipt of short break services.
Two
types of access routes were identified and costed for comparison: the
‘traditional’ assessment and referral route, which includes an initial
or core assessment, resource allocation panels, and assessments carried
out as part of the Common Assessment Framework; and a ‘local core offer
model’ whereby a local authority offers the provision of a standardised
package of short break services to a specific population of disabled
children and young people, who meet an identified set of eligibility
criteria.
Methods
Three local authorities were recruited to participate in this study. All
were selected for their approach to offering, or being in the process of
developing a ‘local core offer model’. Two voluntary service providers
were also recruited for participation in the study and provided finance
and service data.
Additional data regarding the social care activity of key processes,
including initial and core assessments, child in need reviews, and
ongoing social care activity, gathered as part of a study to explore the
costs and outcomes of services provided to Children in Need were
utilised in this short breaks study (Holmes, McDermid and Ward,
forthcoming).
Focus groups were held across the three participating authorities and
questionnaires were distributed to the authorities where panel
procedures were in place for short break provision.
Finance data were gathered and the unit costs of short break provision
were calculated using the ‘bottom up’ methodology. (Beecham, 2000; Ward,
Holmes and Soper, 2008).
Key Findings
·
Costing short break provision for disabled children and their families
can be complex. This study has found a wide variety of service types,
alongside a diversity in delivery and funding arrangements.
Consequently, the costs of similar services can vary.
·
The
costs of short break services vary according to: the provider; the type
and number of staff required; the length of the activity; the number of
children attending; the needs of the child or children accessing the
service; the type of service; the locality of the service; the time the
service is delivered, for example, if out of hours or at the weekend.
·
Some
of the services require additional activity before a child could access
them. For instance, in addition to the costs of an overnight short break
placement, costs are attributable to the time spent by social workers to
introduce the child to the placement.
·
The
social care activity undertaken with children receiving short breaks
varies between local authorities, according to different referral and
assessment models and procedures, and different levels of social care
need identified in the families. It was evident from the study that the
costs of individual services or social care processes are best analysed
in relation with one another, whereby different components are built up
to calculate a more comprehensive cost to social care of the provision
of short break services.
·
The
study found that in the vast majority of cases the levels of social care
activity was determined by the needs of family. The referral routes used
in each of the authorities reflected the level of need of each family.
The frequency of visits undertaken with families was in part determined
by the level of need identified.
·
The
research has found that further consideration may need to be given to
the costs of contracting and commissioning services.
Implications for Policy and Practice
This
costing methodology enables local authorities to consider the costs of
services in relation to the additional work required to access and
support children in short breaks. Furthermore, decisions regarding
resource allocation can be taken in light of the needs of children and
desired outcomes.
Outputs
The
costs of Short Break Resource Pack
Holmes, L., McDermid, S. and Sempik, J. (2010)
The
costs of short break provision: Report to the Department for Children,
Schools and Families. London: Department of Children, Schools
and Families.
Research Team
Lisa Holmes
Samantha McDermid
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