IESE_Transform_042

ISSUE 42

An online interactive publication | www.iese.org.uk | www.carecubed.org

Collaborate for care Care England on why a common language and currency is key CareCubed as a catalyst for change How CareCubed can help a struggling market

Also inside: • Our Care Sector predictions for 2025 • How one ICB is using CareCubed • Call for care-focused change in children’s commissioning • Why one Children’s Trust has adopted CareCubed

I N T R O D U C T I O N

CARECUBED

Sherif Attia, Director of iESE CIC

CIC and the CareCubed team. We @TransformSherif expanded our product and professional teams, bringing in new intelligence, skills and diverse experience and we made significant investments in CareCubed itself by redesigning and modernising the platform. This reflects our commitment to continuous improvement and to delivering real value to the public sector. It also strengthens our ability to deliver costeffective, best-in-class solutions.

Our growing CareCubed customer base means more care decisions are now evidence-based and focused on Care, Quality, and Cost.

CareCubed combines independent research, real-world benchmarking, and service-specific data to provide an accurate, transparent view of care costs, empowering commissioners to negotiate effectively and plan strategically.

Looking ahead, the public sector faces further financial pressures, policy shifts, and the biggest structural changes to local government in a generation. iESE CIC is here to support through these challenges and will continue to innovate and provide solutions which drive meaningful change.

The March updates of CareCubed for Adults & Children incorporate the latest economic factors, including rising employer National Insurance Contributions and inflation trends. These shifts have driven a higher-than-usual increase in care costs, making structured cost analysis more essential than ever.

As we move into a new financial year, we are excited to keep building momentum. We will be launching new products and will continue to deliver insights and intelligence to help improve local public services.

• Sherif Attia, Director of iESE CIC, sherif.attia@iese.org.uk

CareCubed is the next generation of digital care pricing which offers a secure online platform to support the open and transparent negotiation of care placements.

It is now being used by almost X of all local authorities in England as both a day-to-day negotiation tool and strategic planning solution to map out future provision and plan for reform.

CareCubed utilises over 20 years of experience in delivering meaningful public sector transformation across the UK.

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Our placement spend and budget, like everywhere, is under huge pressure. It is really positive for me to know colleagues have got this extra tool in their belt to be able to have evidence based negotiations.

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Introduction from iESE’s Sherif Attia and the CareCubed coverage map.

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News and Case Study - How one ICB is using CareCubed plus latest data release news. CareCubed upcoming events.

Page 4-5 Feature and Case Study - Care England on the adult care market and How one Care Trust is using CareCubed.

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Feature - CareCubed and the adult social care market.

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Feature - CareCubed and children’s care challenges.

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Last word - iESE’s Craig White on social care in the new financial year.

EDITORIAL CONTACTS TRANSFORM IS PRODUCED BY: iESE www.iese.org.uk Email: enquiries@iese.org.uk @iESELtd CREDITS: Designed by SMK Design (Aldershot) Editorial by Vicki Arnstein

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70% of Councils In England and over 200 Providers.

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CareCubed has been really helpful in supporting the brokerage role, because it supports the skills and experience in our team.

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Laureta Lake, Brokerage Manager Specialist Services, East Sussex County Council

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Louise De Chiara, Assistant Director Commissioning, Transformation & Governance Northamptonshire Children’s Trust

C O N T E N T S

© Copyright iESE 2025

COVERAGE

CareCubed across the UK

CareCubed expansion continues ast year was one of growth, L impact, and innovation for iESE

BUILDS

Views expressed within are those of the iESE editorial team. iESE Transform is distributed to companies and individuals with an interest in reviewing, remodelling and reinventing public services.

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It was interesting to see how some costs were ‘hidden’ and became more obvious when we put them in CareCubed.

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Maria Makara, Commissioner at NCL ICB

Map shows covergae of CareCubed adult and children's licences at March 2025.

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CareCubed has built partnerships with agencies across the UK including the LGA and Care England to help deliver improvements across the Care Sector.

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N E W S

UPCOMING EVENTS

CareCubed annual update released THE ANNUAL CARECUBED DATA RELEASE, WHERE THE DATA MODELS WHICH SIT BEHIND CARECUBED ARE UPDATED, TOOK PLACE ON MARCH 3RD. THIS BRINGS ELEMENTS SUCH AS NATIONAL INSURANCE CONTRIBUTIONS AND THE NATIONAL MINIMUM WAGE INCREASES DUE TO TAKE PLACE IN APRIL UP TO DATE. Data updates take place at certain times of the year, such as just ahead of the new financial year, but CareCubed is frequently updated throughout the year too through a continual deployment model.

Lydia Wootton, Product Owner at iESE, the company which sits behind CareCubed, said: “We have done a lot of work in the last year on the CareCubed offering and there has been a lot of investment in the product. Our customers have been very positive about the changes. We adapt the tool continuously according to what the market needs, and we have an open door if customers want to make suggestions at any point too.”

The March update aimed to give greater granularity and grow the number of scenarios in which CareCubed can be used across the adult and children’s care commissioning markets. Data has been added in for solo homes for children’s services and staffing needs can now be input by

providers using a staff rota which removes the need for CareCubed to make staffing assumptions.

Some additional changes include a fixed background model for adults and older persons services and the ability to define a mix of background staff roles.

Wootton said that in 2025 CareCubed’s dashboard reporting would be updated to enable useful metrics to be more readily available and clearly displayed. The company is also thinking about enabling a direct feed into the labour market so users can pull up local jobs in the local area.

“That will be a great addition, and we will also have data on how long it takes to fill a job in a local area,” she added.

“One of the aims of CareCubed is to take as much of the processing and recording work away from commissioners and providers as possible. If a placement is in range, we want people to be able to be confident about the price agreed. They can know that they have done their fiduciary duty and can spend more time focusing on the needs of the child or adult, ensuring it is the right service for them and that it is delivering long term outcomes.”

• To find out more about CareCubed visit: www.carecubed.org

Where you can meet the CareCubed team on the road in 2025 CareCubed keeps up to date with the sector continuously, including attending and exhibiting at conferences. Contact us at carecubed@iese.org.uk to arrange to meet the team at any of the events below:

ADASS SPRING SEMINAR Bedford, 28th – 30th April.

LGA CONFERENCE Liverpool, 1st – 3rd July.

CARE SHOW Birmingham, 8th – 9th October.

NCASC CONFERENCE Bournemouth, 26th – 28th November.

C AS E S T UDY

How the North Central London ICB is using CareCubed THE NORTH CENTRAL LONDON INTEGRATED CARE BOARD (NCL ICB) WAS FORMED IN 2022 AND IS RESPONSIBLE FOR THE NHS BUDGET IN THE FIVE BOROUGHS OF BARNET, CAMDEN, ENFIELD, HARINGEY, AND ISLINGTON. Initially, the ICB trialled CareCubed for two years to manage high-cost packages and commission new learning disability residential and supported living care packages. It has since signed up for a further three years and now plans to extend the use of CareCubed across all complex care for Adult Continuing Healthcare and Children’s Continuing Healthcare.

ICB’s have a lower volume of cases compared with local authorities but these can be very high cost. During the early stages of the pilot, the NCL ICB was able to achieve a cost avoidance of £418,000 across only a handful of cases. “There are fewer cases than for local authorities, but these can involve a lot of meetings and

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negotiating, a lot of analysing and breaking down the hourly rates and trying to understand what is being included. We have limited resource available, and an ever-increasing demand from providers that need to be supported in a sustainable way. CareCubed helps as we then have an idea of what is reasonable to include and what isn’t. We can then use our limited time and budgets in the most effective way,” said Christina Vona, Senior Commissioner Complex Care at NCL ICB. Maria Makara, Commissioner at NCL ICB has been using the tool for residential placements, she says that CareCubed has added greater transparency to costings: “It was interesting to see how some costs were ‘hidden’ and became more obvious when we put them in CareCubed,” she says, “Sometimes there are reasons for higher costs but knowing that a cost is high gives a good starting point to

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initiate those conversations.”

Georgie Jones-Conaghan, Assistant Director of Complex Individualised Commissioning at NCL ICB, agrees that CareCubed has been useful: “We are a big proponent and advocate of the CareCubed tool. Cases like one we had recently where we negotiated down from £38 an hour to £22 make a difference. It is a really helpful tool, and we are looking forward to seeing how it will work and help us across more cohorts as we increase our usage. We have a responsibility to create a sustainable market whilst ensuring value for money from the public purse, and CareCubed is an important tool to support us with this.”

• Read the full case study here: https://carecubed.org/case-study/first-icbcarecubed-user-praises-tool/

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C A R E

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F E A T U R E

‘Collaborate and find common language’ councils and care providers urged Transform Magazine spoke to Richard Ayres, Social Care Advisor at Care England, about the outlook for the adult social care sector in 2025 and beyond. While far from rosy, glimmers of hope exist in some areas if both local authorities and care providers work collaboratively on solving commissioning challenges, especially if they agree on a common language and currency to find solutions. the time of writing, the biggest issue facing At the adult care sector was the planned increase to Employers’ National Insurance Contributions (ENICs) announced in the November 2024 budget. This will increase social care providers cost base in 2025/26 by an estimated £940m, with a further £1.85bn added on the total wage bill in 25/26 due to new National Minimum Wage (NMW) rates from April 2025, according to think tank Nuffield Trust.

One Bristol-based provider explained that the changes would have a devasting effect: “The increase in ENICs and minimum wage will reduce our revenues meaning that we will have to hand back local authority contracts, senior care staff won’t receive pay rises and the quality of our services will be reduced.”

Care England’s Ayres says the ENICs changes will be the final straw for some providers in an industry that has been “on its knees for a decade”. He says the changes threaten to bankrupt more than twenty per cent of adult care providers overnight on paper from April 1 if commissioners are unable to fund inflation, NMW and ENIC changes.

The ENICs increase aside, the challenges faced by the sector in recent years have been and continue to be manifold. Local authority older persons care packages have long been underfunded and subsidised by self-funders.

Additionally, the cost of providing care to an ageing population with increasingly complex health needs has also risen in the past decade compounded by the home first approach to commissioning. The

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industry faces huge workforce challenges too with both its domestic attrition and international applications dropping due to changes in immigration rule changes, which brings an additional financial and resource burden.

“In 2021, Skills for Care found it cost £6,222 in the first twelve months to recruit, train and retain someone in adult social care, with about 40 per cent leaving in year one. This situation has been exacerbated by the March 2024 changes that meant international workers can no longer bring their families with them when working in social care except the NHS. This means we have seen a drop in international applications from 105,000 in 23/24 to just 18,000 in Q1 and Q2 of 24/25, so we are expecting a significant rise in agency costs over this year,” Ayres explains.

The latest Sector Pulse Check Report 2024 by Care England and learning disability charity Hft, carried out ahead of the announced ENICs changes, found that three in ten providers had already been forced to close parts of their organisations or hand back contracts to local authorities. One-third were considering leaving the market altogether, while more than a third (37 per cent) said they had curbed investment into building future capacity for care.

The situation is set to worsen still further with the incoming Employment Rights Bill and Fair Pay Agreement which will place additional strains due to proposed changes around terms and conditions such as zero-hours contracts and statutory sick pay, as well as an enhanced pay rate for the

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sector without a clear commitment by government to fund it.

Of the issues highlighted, one of the most problematic is the underfunding of local authority commissioned care. “There is a £4.8bn funding gap between what local authorities pay for older person’s care and what care costs, which increases annually with sub-inflation annual fee uplifts by commissioners,” Ayres explains. He adds that the adult social care sector has not been helped by a flaw in the Care Act 2014 which has allowed local authorities to set personal budgets at a level they are able to buy care at locally. Where some providers may have underpriced in the past to avoid an empty bed, Ayres says this has set false expectations in some cases of the price for care and legitimises commissioning behaviour.

“These rates do not largely reflect the cost of delivering care and, additionally, the cost of delivering care has not historically considered the need to make a profit to reinvest in services to sustain capacity longer term, or elements such as staff development and training and becoming carbon neutral, for example,” he adds.

To start to tackle the problem, he believes changes need to be made. “The industry has reached a point where care providers need to say no to underfunded care packages and that is going to force local authorities to meet the cost of care which allows reinvestment into the sector to meet the needs of local authorities and an ageing population. Local government will fall under pressure as a result in much the

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same way care providers are under financial pressure to sustain their services.

Unfortunately, it seems that we have either got to see a mass of care providers fail or a mass of local authorities fail before central Government will act,” Ayres says.

Ayres has sympathy for local government which he likens to a game of ‘whack-a-mole’. “It has been laboured with a problem and statutory duties which dictate it needs to address the problem but without the resources from Government to do so in one of its largest spend areas that is going to become quickly unstable and unviable. Working in a local authority is a bit like playing whack-a-mole, you whack one mole down that you think is solving a problem but then five others pop up which were not necessarily predicted. Short-term solutions often lead to longer-term problems, for example austerity saw the end of prevention in many areas which local government now say is what’s needed to solve the problems we face today.”

Further issues are going to arise in future years due to already financially pressed care providers not being able to invest in their properties.

“Properties housing public-funded residents tends to be the older less modernised stock incapable of decarbonisation, with inefficient layouts, which are also less attractive to selffunders and more likely to close due to viability.

This stock is being replaced with new more attractive stock which is appealing to the private pay market but results in less publicpaid capacity availability. The investment case to build new state of the art stock does not stack up for public funded residents only,” Ayres says.

He adds: “We need central Government to give local government ring-fenced funding that is aimed at fixing the social care problem, with an eye on the impact of longer-term

outcomes for future sector sustainability.”

Currently, it appears Central Government is making slow progress on the issue. In January 2025 an independent care commission review into adult social care chaired by The Baroness Casey of Blackstock DBE CB was announced. While Care England have welcomed the review, the organisation has also warned that waiting until 2028 for another sector report to confirm what is already known is an unnecessary length of time and a grave error of judgment.

One possible interim alleviator which is backed

by Care England through its partnership with notfor-profit local government consultancy iESE, is the use of CareCubed, an online care pricing benchmark tool which can help care providers and local authorities come to an agreement on the fair costs of care. “The CareCubed model offers a common currency. Sixty per cent of local authorities are using it. We encourage care providers and local authorities to sign up to CareCubed to get to that common currency and to understand what it really costs to provide services. Unless you give the local authorities the information in a format they can digest, they don’t know what data to look at.”

Additionally, Ayres encourages local authorities to engage with their local care market because he believes that working collaboratively would be more likely to solve their problems. “The solutions sit in the local care provider community so tap into them and if you don’t know how to tap into them work with the local care provider association or speak to Care England and we will help co-ordinate a group of voices. I don’t think any local authority wants to undercut care providers – they want to use their budget to their best of their ability to provide as much care as possible for the lowest possible amount. Using CareCubed will help jointly agree a fee that is appropriate and sustainable.”

C ASE STUDY

How Northamptonshire Children’s Trust is using CareCubed NORTHAMPTONSHIRE CHILDREN’S TRUST (NCT) STARTED USING CARECUBED IN OCTOBER 2023. THE ORGANISATION, WHICH WAS FORMERLY CHILDREN’S SOCIAL CARE WITHIN NORTHAMPTONSHIRE COUNTY COUNCIL IS OWNED BY NORTH AND WEST NORTHAMPTONSHIRE COUNCILS. IT HAS BEEN MANAGED AND RUN INDEPENDENTLY BY A BOARD SINCE 2020.

NCT began using the tool to review existing children’s packages but has since rolled it out across its brokerage team for new residential and independent supported accommodation placements. In addition, CareCubed is also now being used strategically to scope out new provision with providers.

Louise De Chiara, Assistant Director Commissioning, Transformation & Governance Northamptonshire Children’s Trust, heads up the brokerage and commissioning teams. As the person who signs off on each placement, she is held accountable for spend and managing budgets. She says procuring CareCubed has been really positive: “Our placement spend and budget, like everywhere, is under huge pressure. It is really positive for me to know colleagues have got this extra tool in their belt to be able to have evidence-based negotiations and that these are based on what the actual costs should be, opposed to what we have got used to paying. I am reassured knowing that we have that robust benchmark in place which stands up to scrutiny and has delivered immediate results.”

The NCT believe that one of the biggest benefits in using CareCubed has been that it has given commissioners and brokers the basis to openly and transparently discuss costs with providers.

While cost-avoidance has been achieved and there is better understanding of the true cost of care, CareCubed is also being used alongside a new way of assessing children’s needs. Where there is a disparity, for example, the costs are high, but the needs are low, or vice versa, it is helping check that the child is receiving the right level of support.

“It has helped us to scrutinise what the child is getting. We don’t want to be harshly negotiating on the costs that go directly into supporting the child and delivering positive outcomes, it is the other costs that we need to focus on,” De Chiara explains.

So far, across just a small number of placements, NCT has achieved a combination of cost avoidance and savings of £3.2m per annum through using CareCubed. Sometimes it is highlighting outlying packages or providers that are higher or lower than the benchmark cost, and sometimes it is helping identify mistakes, such as duplicate information. “In a couple of cases we have noticed that costs have been duplicated so it allows us to query that. These are just genuine mistakes in the way the costs have been built up, but it gives us an extra level of scrutiny” De Chiara adds.

• To read a full copy of the case study visit: https://carecubed.org/case-study/carecubednorthamptonshire-childrens-trust/

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M A R K E T

Is CareCubed a catalyst for change in the Adult Social Care market?

The Adult Social Care market is still facing a range of challenges but CareCubed – The National Care Costing Tool – is well positioned to help. hile the issues in Children’s Social Care have W been under the spotlight lately, the financial situation in Adult Social Care is still as bad as ever. The ADASS (Directors of Adult Social Services) 2024 Spring Survey found adult social care budgets overspent by £586m in 2023/24, the highest for at least a decade. The majority of Directors of Adult Social Services (90 per cent) said they had no confidence or were only partially confident their budgets would enable them to meet their statutory requirements in 2024/25.

Sherif Attia, Director of iESE CIC, says numerous challenges still exist in Adult Social Care, including demographic ageing, increasing complexity of care, workforce challenges and a diminishing funding pot.

“Adult Social Services is still a difficult market.

Some geographical areas are lacking sufficiency and finding the right placements at a fair price with quality outcomes can be challenging,” he said.

Bernadette Nartey, Implementation and Improvement Manager at iESE for Adult CareCubed, used CareCubed in her previous two roles at different local authorities (see box opposite). She believes the tool can help providers and commissioners not only benchmark the fair cost of care, but also help to build strong working relationships.

In her experience, councils can lack the confidence to negotiate on placements and instead can let the process be ‘provider led’. To help ensure placements are value for money and delivering quality, she believes local authorities need to adopt a change mindset. “It is about asking questions and being more curious. Putting the providers to one side, let’s look internally and ask what we can do better.”

She says the fundamental question is whether the services being paid for are, in fact, being delivered.

“To what extent are local authorities being led by providers rather than setting and maintaining their own standards? It is essential to ask rigorous questions of providers, ensuring they are meeting the meaningful improvement outcomes established for residents,” she explains.

“This also raises a key consideration: How are outcomes being measured? Effective assessment of commissioned services is critical to truly understanding and managing the cost of care. By asking the right questions, holding providers to account, and ensuring that the services delivered align with our residents' needs and expectations, we can take ownership of the cost of care and maximise our impact. CareCubed offers the

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rationale and foundation to start these conversations,” she adds.

Questioning commissioners Both Attia and Nartey highlight the need for more resource in commissioning within local authorities to help them move away from reactive commissioning into proactive commissioning. “The commissioners need time to ask questions and explore alternative options available to our residents,” said Nartey, “They might want to explore assistive technology, shared support and co-production with families.

They also need time to do their due diligence before agreeing placements.”

Doing due diligence can help uncover hidden costs too. Nartey highlights a recent case where a provider said they were paying their support workers £18.50 per hour. “We scrolled the Internet for job adverts, saw they were paying £12 per hour and used this to initiate negotiation conversations. It is okay to ask questions and do your investigative research.

Providers must make reasonable profit but when it is excessive there needs to be questioning and justification. Local authorities have a fiduciary duty to steward public funds accordingly. This is taxpayers’ money – we can’t be overprovisioning for services or overpaying for services.”

Attia says CareCubed is continually looking for ways to improve the whole system. While CareCubed can help with one of the challenges in Adult Social Care – benchmarking and negotiating fair pricing for placements – users are increasingly using the tool in other creative ways and CareCubed can help support and facilitate this work.

“Recently we have helped a couple of councils set up dynamic purchasing systems and facilitate data capture from a large number of care providers, 1,000 in one case and 600 in the other. The aim is to collect large amounts of data digitally to enable officers to carry out an effective and efficient financial analysis, enabling them to quickly ascertain which providers fall within the benchmark range. This empowers staff to spend additional time quality assuring placement suitability,” he explains.

Other recent developments to the Adult CareCubed module include the new express tool, providing the ability to fast-track a case through the system, whilst the specialist care property model is being reviewed to allow local authorities to differentiate between the specification of homes, including purpose-built and adapted residential properties.

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Attia said local authorities and commissioners have not made the most of available data historically and that CareCubed can help with this challenge. “A lot of local authorities do not track the reasons placements can’t be made or why a placement is being made if it is a suboptimal decision. There are costs hidden in the system where people are placed in the wrong services. If you capture this data, you can map the gaps in your market. There is a huge opportunity around making data work harder for local authorities that we want to help with.”

CareCubed can help in the short, medium and longterm as commissioners look to move to a more proactive place. “CareCubed is very helpful even if you are in a reactive position because it can help you quickly understand whether the placement you are going to make is the right one. It also can help authorities move to a more proactive position of creating sufficiency, building relationships and right-sizing packages,” Attia concluded.

New staff member Bernadette Nartey is the new Implementation and Improvement Manager at iESE for Adult CareCubed.

Before joining iESE, Nartey worked as a paralegal, then moved to Croydon Council as a Contract and Placement Officer, and later became Islington Council’s first Lead Negotiator. In this role, she embedded CareCubed into their system, developed the policy, and achieved over £300,000 in savings within six months on just eight cases.

Now at CareCubed, she works nationally, collaborating with multiple local authorities and having a broader impact through negotiation and CareCubed implementation training. “I’m passionate about negotiation. I don’t see it as simply having difficult conversations, although some are. I view it as an opportunity to build relationships and work towards a win-win solution. I hope to support both commissioning and the operational workforce in securing quality placements.

“CareCubed is a fantastic tool that helps commissioners secure right-sized placements at a fair price. Now, instead of negotiating placements for one council, I can build up the negotiation skills of many, empowering teams to negotiate confidently, achieve savings, and make cost avoidances themselves.”

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M A R K E T

Children’s Care Challenges Call for Care-Focused Change The landscape of Children’s Social Care has shifted drastically over the last few years amongst a backdrop of unprecedented financial pressures, societal changes, sufficiency challenges, increasing complexity of support requirements and conversations around profit and profiteering. The sector is facing unparalleled pressures, with very real consequences for children, families and those requiring support.

Challenges Sufficiency Predictions state that the number of cared for children and young people is set to rise to 95,000 by 2025, with more children than ever before being homed in residential and semi-independent care due to nationwide fostering recruitment challenges (heavily impacted by the cost-of-living crisis), and the ability of these settings to meet the needs of children and young people requiring specialist or higherintervention based support.

However, the number of available homes has not kept pace with demand, creating significant pressure on home-finders to secure local homes that best meet the needs of their children and young people.

Finance Since 2021, ten Local Authorities in England have issued section 114 notices, with at least one more council on the brink of doing so at the time of going to press. Research by the Local Government Association (LGA) revealed that as of 2023, 1 in 5 councillors believed their authorities were nearing bankruptcy.

Financial pressures are widespread with many areas of overspend outside of children’s social care alone, however, the pressures in children’s services are significant and worsening, amongst a backdrop of lack of transparency and difficulties in truly understand the costs of delivering care. And whilst it is important to state that there are many providers ensuring they work collaboratively with their Local Authorities (LA’s) and Integrated Care Boards (ICB’s) to drive best value for the public purse, there is still significant work to do to enhance transparency and ensure places are best value, needs led, and outcomes focused in their design.

Silo Working and Home-finding Practice It is important to acknowledge that this has not occurred in a silo, with practice around challenge, scrutiny, right sizing and collaboration also

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contributing factors to the scale of the challenge.

The sector has seen traditional procurement vehicles developed that are not always designed to address the individualised packages of care our children and young people require. Many people across home-finding and delivering services have spoken to a sense of “firefighting” – searching in emergencies or at the last moment, going in “in the dark” with little information, and trying to find the best option for those we support with limited vision.

Silo working has also been identified as a key challenge for commissioners, social workers and home-finders, with many now feeling there is a sense of disconnect between teams, the way we work with children and young people, define and describe needs and then home-find to meet those needs.

Opportunities For Change It is important to acknowledge that with any challenge comes opportunity, and a renewed call to action.

Collaborative solutions are at the centre of working to address some of the challenges currently affecting children’s social care and at iESE we have been working hard to support our partnered Local Authorities (LA’s), Integrated Commissioning Boards (ICB’s) and providers of care to enhance home-finding practice, improve transparency and create stronger working relationships both externally and across internal teams.

CareCubed is a secure online tool that enables evidence based benchmarking, and transparent discussion on the true cost of care, and through its training and development offer, Commissioners, Home-finders and Social Workers have opportunities to get closer to understanding what care truly looks like when discussing, designing and commissioning packages of care heightening focus on the individual needs of the child.

This helps support a move away from relying on key terms to define and represent needs and getting into the detail of the presentation and support required, being more child focused and centred throughout, enabling more work collaboratively to co-design

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solutions that are proportionate, right sized, and delivering positive outcomes. Alongside upskilling teams in areas such as negotiation that augment the software, bringing it to life and delivering real impact for commissioners, home-finders and those we serve.

This approach is not designed to penalise providers, but to create transparency, trust and fair costing, enabling long term sustainability of services and encourage re-investment ensuring provides are rewarded for increasing quality through investing in staff, training and support offers. Delivering a win-win situation for all involved.

New staff member Ashleigh Searle is the new Implementation and Innovation Manager and Lived Experience Consultant at iESE for Children’s CareCubed.

Before joining iESE, Searle worked in and around children’s social care for eight years, across commissioning, on Department for Education innovation programmes and in children’s services improvement.

“I have worked as a commissioner, supported home-finding teams and developed best practice, but my role at iESE is enabling me to have a positive impact and deliver immediate benefits at scale to multiple LA’s and regions as the adoption of CareCubed accelerates following success across the country,” she explained.

“The work happening has truly transformative power. We are seeing in real terms, the financial benefits for commissioning authorities, excitement amongst officers developing their ways of working to improve home-finding practice and, most importantly, delivering better outcomes for our children and young people. Instead of looking for somewhere to place blame, we are looking at how we better work together, develop new solutions, improve matching and work towards reducing the sometimes-significant number of moves children and young people are experiencing during their time in care.”

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W O R D

New financial year brings new opportunities Working with 70 per cent of local authorities and a growing number of care providers gives iESE CIC a unique perspective of the health and social care market.

Craig White, Director of iESE CIC, looks at common commissioning issues and potential solutions for the new financial year. ore than half a year into a new Government M and we’ve heard many encouraging things about health and social care change. November 2024 saw the policy paper, Keeping Children Safe, Helping Families Thrive, set out the Government's strategy to ensure opportunities are afforded, not just for some of our children, but for all of our children. We also welcomed the Children’s Wellbeing and Schools Bill and see this as a big step forward for children’s social care. In January 2025 the Government also announced an independent commission into adult social care. This is welcome news for struggling councils and providers and while it gives some hope for the future, we know Government reform is never a quick process.

We’ve also heard more about preventative care. This is commonsense, but it is also not going to be a quick fix. All of the money for prevention work has effectively been stripped out of local authorities and ICBs as they struggle to fight fires, continue to deliver vital services and stay afloat financially – largely down to spiralling costs in adults and children’s services.

While we hope this time is different and the major wide scale reform required is delivered, solutions are

needed now to ensure sustainability of both commissioning authorities and care providers. But commissioning authorities are currently stood on a burning platform, and every penny has to be directed to the right area.

In most of the geographical areas we work in, older person’s services need more money as they have been underfunded for a number of years. This was highlighted in the Fair Cost of Care Exercise in 2022.

The situation is unsustainable, and care homes are closing due to underfunding. We are also seeing growing demand and complexity in working age adult services which in turn leads to increasing costs to commission and deliver services. Children’s services have featured heavily in the press and while many providers are delivering outstanding services and positive outcomes for children, in some cases the cost of delivering services is nowhere near the price being charged for placements. Placement costs can regularly reach £10,000 to £15,000 per week per child, and a small number of these severely impact other council services and financial viability. To help solve this, there has to be a rebalancing of the funding to make sure it is allocated to the right areas and

controlled in the best possible way.

These challenges are going to be compounded further by legislative changes to Employers’ National Insurance and National Living Wage, meaning the coming months are going to be painful for all.

The online care pricing tool CareCubed was created to deliver a low-cost solution and immediate benefits. It provides a consistent approach that can be used across all different age groups to right-size and right-price packages of care in a transparent way between commissioners and providers. Yes, it can help achieve efficiencies, but it can also help redirect limited budgets into the right pots. It uses robust data and evidence to provide a benchmark cost for services and individual placements based on need – and will reflect the legislative changes but provide a rounded view of all cost lines making up a care package.

Balancing the budget across older people, working age adults and children and young people is going to be critical to keep councils functioning and will reduce the chances of the health and social care system and other council services more widely from collapsing.