Costs and Outcomes in Children's Social Care: Messages from Research(Costs & Effectiveness of Services Children in Need)

About the Book

Care services for children depend on a limited supply of resources; it is vital that these are used to best effect. This book considers the efficiency and cost-effectiveness of these services and their contribution to children's well-being.

The book presents the findings of a set of original research studies. It looks at services provided by the statutory, for-profit and voluntary sectors, examining the way they are delivered and how resources are distributed. It examines the cost of providing particular services, the extent to which they improve outcomes for children and the degree to which they can be considered cost-effective. It explores what changes can and should be made to improve efficiency, paying particular attention to the possible contributions of early intervention and better co-ordination. From the research findings, Jennifer Beecham and Ian Sinclair draw key messages for practice for the use of resources and for future research in this area.

This is an invaluable book for those practitioners, policy makers, managers, who are concerned with social care services for children.

Table of Contents:
Foreword. Acknowledgements. 1. Introducing the Book. 2. How the Studies were Done. 3. Delivering Care Services: The Ideal and the Reality. 4. Costs and the Way they Vary. 5. Interventions Unrelated to the Care System. 6. Interventions Related to the Care System. 7. Conclusion. Appendix A: DfES Implementation and Advisory Group Members. Appendix B: Research Studies and Authors. References. Selected reading on parenting programmes. Subject Index. Author Index.

About the Author :
Dr Jennifer Beecham is Professor of Health and Social Care Economics at PSSRU, University of Kent, and Principal Research Fellow at PSSRU, London School of Economics and Political Science. She has worked on the development of better unit cost methodologies, as well as cost analyses and cost-effectiveness evaluations of services for children and young people, including children with learning disabilities, children with mental health problems, disabled children and those who are supported by social care services.Ian Sinclair is a Research Professor in the Social Work Research and Development Unit at The University of York, where he has been responsible for a large programme of work on children's homes, foster care and movement within the care system. He was acadamic coordinator for the costs and effectiveness initiative which is the subject of this report. His research interests include attachment theory and the evaluation of social work and social work services. His is the author of Fostering Now: Messages from Research and the lead author of Foster Children: Where They Go and How They Get On, Foster Carers: Why They Stay and Why They Leave and Foster Placements: Why They Succeed and Why They Fail, all published by Jessica Kingsley Publishers.

Review :
I have no hesitation in recommending this book and the associated online resources to those with responsibility for commissioning and delivering social care services for children and their families. although this book is aimed primarily at service commissioners, providers, practitioners, researchers and students, in my view it would also provide an excellent introduction to the contemporary world of children's services for all those involved in any way, including teachers, nurses and other professions who will soon become part of integrated service provision (e.g. New hybrid professional roles). It will also be highly relevant to agencies that need help with mapping outcomes and using economic theories for costing services... Jennifer Beecham and Ian Sinclair (...) are renowned in the field of children's services research and exhibit a clear appreciation of the wide needs of the stakeholders in children's services. There is no doubt that this book will become one of the key "messages from research" publications in terms of informing policy and practice and assisting the development of costing models for a wide variety of services. This book is necessary reading for those at the forefront of planning, costing, resourcing and evaluating effective services for children in need. It could be an impetus for small-scale, local action research, of the kind that truly demonstrates partnership in practice. This large size, soft-back book is written and structured in a very clear and accessible manner. Within the chapters, there are helpful `summary boxes' that not only provide summaries at the end of each chapter, but also highlight important aspects. This latest contribution to the excellent Messages from Research Series examines 14 studies of costs and outcomes within the context of Every Child Matters... This book is an excellent contribution to the discussions we need to have about how to spend our money most effectively and should be required reading for those planning or commissioning services for children. The test of the book is whether it delivers that customer demand and this it does brilliantly. It's an easy, readable, succinct, compelling volume... Certainly the relatively brief time invested in reading is amply rewarded by the reader gaining an up-to-date understanding of what's known in relation to costs and outcomes... This is an intelligent and thoughtful canter round important issues which every operational social care service is keen to address. It reminds us what we know from research in this area and why we need to apply due caution to extravagant claims, not that there tend to be too many in this field - at least by practitioners! This is the most recent of the government-commissioned research summaries that have appeared since 1985 and like the others, it offers a lucid and accessible way into a range of studies... The authors draw on 14 studies. Together, they cover services targeted across the age range- home visiting for parents of young children, work with adolescents, foster and residential care, non-infant adoptions, care leavers, mental health services for children in the child protection system, and individual and group psychotherapy for girls who have been sexually abused. This is a timely publication on a subject at the heart of challenges facing commissioners. It has its roots in the concern that rising costs in social care need to be researched in the context of effectiveness of spending, and that this needs to be expressed in terms of outcomes.

The book is clearly presented, with concise explanations of terminology and summaries of key findings. It raises some of the many problems of such research. How can we know that apparently effective services are not simply dealing with less difficult problems? How can we be sure that it is the service which is making a difference and that things would not just have got better anyway?

My overwhelming impression from having read this book is just how important the questions are and just how far we are from being able to answer them with confidence.

The book will be of fundamental interest to those who commission child care services or manage them. It will also be of interest to social workers and foster carers who want to think a bit wider than their immediate experience of dealing with children and ask themselves some bigger questions.

This text represents the findings of a number of research studies carried out over the past six years under the auspices of the government's Cost and Effectiveness of Service for Children in Need initiative, itself part of the extensive Every Child Matters programme. The Plethora of initiatives, programme, policies and reforms introduced over the last 10 years make these findings valuable and timely. The research involves services provided by the statutory, voluntary and private sectors. The studies examine the delivery and distribution of services, their cost - effectiveness and the extent to which they improve outcomes, (a definition of which is provided), for children.

By its nature this book is far more likely to appeal to those charged with the management of children's services, yet there is plenty here for the interested professional or lay care worker to consider. Key questions are addressed such as why do costs and quality very so much? What are the consequences of early and of later interventions in children's lives/ How can a multi-agency `partnership' approach lead to better outcomes?