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  • Agenda item
  • Agenda item

    Interview with Carolyn McVittie, Managing Director, Stepahead Support

    Minutes:

    (1)       The Chairman thanked Ms McVittie for attending, and those around the table introduced themselves.  Ms McVittie responded to questions from the Select Committee.

     

    Please tell us what you do and what your organisation does, in terms of commissioning.

     

    (2)       I am the Managing Director of Stepahead, which has operated since 1999 to support children, young people and families.  Our work has changed a lot since 1999.  Our funding comes mostly from the County Council, a situation which has brought us some criticism, as we have put ‘all our eggs in one basket’, but there has always been a good relationship with the County Council as a funding partner.  I will highlight some of the key points of my written paper.

     

    (3)       In the past, contracting has started with a discussion around a table, at which meeting partners have identified needs and discussed how these should be met, and we have been given some funding and asked to go away and deliver services.   This does not lead to sustainable contracts, however; we had yearly rolling contracts, which are not ideal. Sometimes we do not know what funding we will have until April.

     

    (4)       Now there is the framework model, in which organisations can apply to go on a selected list to become potential future contractors. We welcome this model as it recognises quality and standards and builds a pool of quality organisations which can deliver services.  However, the process around the framework model is not how we had hoped it would be, and the timescales have slipped.  It also generates an awful lot of paperwork.  We had just undertaken a review of all our contracts, one by one, which for a small organisation was demanding in terms of time and energy. The eligibility criteria to go on the framework changed.  At first, people had to score 80% in the test questions to qualify to go on the framework, but then, after delay, this was reduced and people only needed to score 20% to get on. This led to more organisations - 127 - coming onto it, which devalued the process.  We had made much effort with our preparation work but other providers got in with less effort.  We had a good open relationship with the County Council commissioners and they were honest about not being sure about what services the Council wanted, moving forward. 

     

    (5)       In the framework, we are able to tender for opportunities as they come up, and we expected opportunities to be presented gradually, but sometimes they come three at a time and we have to decide whether to spend time and effort preparing a really good quality tender for one of the three or to divide the time and effort preparing tenders for all three, which means that each one might not be such a good quality tender, (which is difficult to do, professionally, as have high standards) and we might miss getting a contract because of it. As a small organisation we didn’t have a business team which we could dedicate to preparing tenders; I did them all myself.     

     

    (6)       In terms of commissioning, there are some positives; the service specifications are better now, and are quite detailed, but also a negative. The question and answer stage is good.  Market engagement events are good and useful in helping people to understand the process; they are not a ‘tick box’ exercise but are a good way for the County Council to talk to providers and understand which models could work.

     

    (7)       In terms of decommissioning and re-commissioning, there have been some detrimental effects. For example, for a Stepahead mediation service, we had a 27- month period during which staff were put at risk of redundancy as the future of a contract was unsure, then it was renewed for three months, then at the end of the three months we had to start the redundancy process again.  We tendered and went to interview but then no contracts were awarded. Then we had to re-tender, were awarded a contract and then waited when it was challenged, and had a long period of uncertainty. This stop and start is very unsettling and makes it very difficult to plan our staffing and services.  By the time we eventually secured a firm contract, many of our most experienced and skilled staff had found more settled employment elsewhere and we were left having to replace them so we could deliver services under the new contract.  The County Council told us that they hadn’t de-commissioned us because we weren’t good but because they had a process to which they were committed. It was good to know that we hadn’t lost a contract through not being good, but this situation really did not help us in terms of staff morale.  We now have a three-year contract and the possibility of an extension, so we have some security, as long as we continue to perform well.

     

    (8)       Previously, the monitoring of contracts was done locally by County Council contract managers who knew the service and with whom we had a good relationship. Performance would be reviewed, and was often output-focused, and Stepahead wrote a report of outcomes (rather than outputs) and talked to local people who understood local needs and issues. This could help with setting up school clinics, etc, but there was no countywide overview. Now, commissioning and contracts are at a countywide level and the process can be more challenging and intimidating for staff.  It doesn’t feel like a partnership now – it now feels more like a Head Teacher and pupil relationship!  Although it is important to build relationships, it is difficult to do this when the turnover of commissioning staff is high (the commissioning manager for the mediation service changed three times in 6 months), but once we are able to build relationships we can work through the other issues with the new system.

     

    (9)       In terms of funding, there is always an assumption that the voluntary sector can do things cheaper, pay lower salaries, have no pensions, etc.  We are lucky that our staff are willing to stay with quite modest salaries but it is not always possible to rely on this long-term. The money we are paid does not always cover what is in the specification for the contract.  When we have been asked to deliver something at a price which we know does not support good quality service provision, and at a risk that the services we would be able to deliver would be below standard, we have withdrawn rather than have our name associated with it. What is specified in a contract, and what is paid, needs to be realistic.  We understand the financial pressure that the County Council is under but commissioning needs to be realistic and fair. 

     

    (10)     We are given contracts to work with those with mostly high and complex needs, as the County Council needs to ensure these families receive attention. Early intervention is often seen as low-need but this isn’t necessarily so.  Previously, young people would be referred to us via their school.  It is wonderful to find someone who wishes to refer themselves, but sadly we cannot accept self-referrals now; they all have to go through the common assessment framework (CAF) process.  I worry that there are people who, because of this, are not able to receive a service which could help them, and who might then develop more severe problems later, as a result.  I am concerned that there is a gap, or that people will only show up when core intervention is needed.     

     

    Thank you.  Some of the points you have raised support things we have heard from previous speakers.

     

    Previously the focus was on outputs and now is on outcomes, which can be difficult to identify in this area. Is it possible to identify the outcomes which should be achieved?  Can you give us an example of good practice as regards the County Council working with you, for example, by looking at something other than just numbers (outputs)?

     

    (11)     Numbers are easy to see but outcomes are more difficult as you have to assess and demonstrate the sustainability of improvements.  We had agreed how these were going to be measured – for example, via follow-up after 3 months, 6 months or 9 months. You would need to have a family’s permission to carry out these follow-up sessions, and they would need to be brief and consist of quick and simple questions.  If follow-up is onerous or oppressive, families will not take part (some do decline) and you won’t be able to undertake the meaningful monitoring you need to do to demonstrate the long-term impact of support.  Different measurement tools need to be used. Previously, I have been told I cannot use the ‘strengths and difficulties’ questionnaire, a recognised social work tool, to monitor outcomes, but now that seems to be back in favour.

     

    I am concerned about early intervention, to avoid greater needs developing later.  People have to be referred through the CAF, and the elimination/filter process starts there. How can you get people needing early intervention to (be able to) come forward sooner? Is this an issue of targeting?

     

    (12)     Yes. Our target age group is currently 0 to 19 years but we get very few babies being referred for mediation. We need to talk to the County Council and other providers (NHS, etc) about how to pool our funding to enable early intervention.  Previously, many young people were engaged and helped at school. We held school ‘clinics’ and drop-in sessions, from which we could signpost them on to appropriate services.  But we can’t do this now – all referrals have to come via the CAF. The way in which we work with our partners, and how we divide our budget, is key.  Some young people we can’t help so we signpost them on via their school (not via GPs – they don’t tend to engage!)  But CAMHS, for example, has a very long waiting list, so there is no easy answer.

     

    You said the County Council is unclear of the service it wants or needs to achieve?

     

    (13)     Children in care and care leavers were previously helped via Catch 22, but this service will not continue to be funded, and will not be re-tendered immediately, as needs are unclear.  It is good that the County Council is honest about not wanting to re-tender for this service, but when it is making this sort of decision it needs to think about what is needed sooner and plan ahead!

     

    When a contract is renewed, is good performance rewarded - for example, a provider who has met all their targets?  However, the County Council has an obligation also to consider other organisations. The framework does not seem to have scope to allow experimentation.  Does the County Council stick with what it knows or does it try new things and take risks?  What is your position, compared to other providers/contractors?

     

    (14)     That’s a very good question! There is a risk of becoming complacent; if outcomes are being delivered, it is easy just to carry on with a current arrangement. A review could be undertaken, rather than a contract being automatically renewed. Companies may have some really good ideas for a good service model in an area in which they may lack experience, and they will lose marks in the assessment process because of their lack of experience.  Assessing potential providers on paper has value, but it’s important also to have a dialogue with them.  They might deliver a good service but it is difficult to put this on paper, so a good relationship between commissioners and contractors is important, and dialogue needs to be ongoing through the whole length of a contract; not start towards the end when it is time to look at renewing.

     

    Is Stepahead a charity?   

     

    (15)     Yes.

     

    As a charity, do you think the County Council treats you any differently from other providers?

     

    (16)     They do seem to expect us to be able to do more with less, but expect the same standards as they set for other providers.  We are part of a consortium which pools its strengths to look at contracting together. This has been a good experience but took some 18 months to agree.

     

    Are there pros and cons of working in a consortium?

    (17)     Yes, there are. It’s not something that can be set up overnight.

     

    If you get a contract for three years and the law changes during that time, how would this affect you, and how would you deal with it?

     

    (18)     This has never happened so we’ve never had to deal with this issue.

     

    The framework has been in place for two years now, so do you consider yourself to be a partner of the County Council now? Do you feel there is a need to review the framework, and how would you influence it or change it?

     

    (19)     I don’t think the framework is worth the paper it’s written on!  It doesn’t meet the service needs and never has.  It was supposed to be made up of high-quality providers who scored 80% or above at the test stage, but it now includes companies who only scored 20%. I appreciate that, at 80%, it would only have had a few providers and there would potentially be gaps in provision.  As regards how I would influence it, I would say there needs to be open discussion about what is needed and how best to support children and families.  The framework needs to be a working document but doesn’t give any guidance within it about how much and what information people need to include on forms.  There needs to be more guidance for people using the document about what information they need to provide.

     

    Do you consider yourself to be a partner now?

     

    (20)     We do now, but we feel contracting and partnership working is led by a process rather than by relationships.  If there could be more consistency around contracting (three commissioning managers had left in quite quick succession) then some good relationships can be built.

     

    Looking at commissioning for complex needs and safeguarding, do you think the County Council sees you as someone it can use as a buffer for capacity?  Do you feel that they mess you about? Outsourcing and safeguarding issues affect people’s lives.  Does this outsourcing model make this risk greater? Would insourcing be better?  Is this a weakness?

     

    (21)     It would depend on the organisation.  It would add an extra layer to safeguarding procedures, information would be third-hand, and it would delay the timeframe. But I don’t think it would put more children or vulnerable people at risk, as long as the commissioning is good and there is good communication with the statutory team.  We have had some issues in the past which we felt were serious but which were not deemed to be serious, once referred to Social Services. Responses used to be poor, but now there is a swift response at any time. There could be some risk if issues and concerns which are raised by an outsourced service are not acted upon.  Safeguarding and monitoring would need to be very thorough. There is always a risk around any method of contracting for people-based services.

     

    It seems to be about continuity, partnerships and relationships.  Why do you think the County Council does not know what it wants to commission?

     

    (22)     I was told a while ago that the County Council had not known how many contracts it held or what it was going to commission. Its central record keeping did not seem good, so there was no overview.  There was a review in 2011. It is only when the County Council came to undertake a review that it realised how many contracts it has, and it found several contracts in which different companies were doing the same work.  The framework would be a useful tool to bring work together information and avoid duplication.

     

    Can you give an example of good or bad experience of your having asked the County Council what it needed to commission to fill a gap?

     

    (23)     I can’t think of an example of having done that.  There is still a lack of clarity but no one specific example. Some contracts do not have a clear service focus.

     

    Surely there are areas in which there should be clarity – for example, around Troubled Families?

     

    (24)     Yes, needs should be clear; that is the aim of the Troubled Families initiative. Troubled Families involves services which are difficult to deliver. We deliver family mediation, Young Healthy Minds, etc, and we do get some inappropriate referrals to the new service.  This is because people need to build up their understanding of what we do. It can take time to get all CAF co-ordinators aware of the remit of a newly-contracted service.

     

    How easy are services such as family mediation, Young Healthy Minds, etc, to get through to, to find help?  An example that I’ve heard of is of a 13 year old who took her younger siblings to the local Police station and asked for them all to be taken into care.

     

    (25)     Cases such as that would be screened via a social worker.  We get some step-down referrals for families who have previously had social work involvement.  Our initial fear about the length of delays did not materialise, and delays now are not due to the CAF process, but people do go on a waiting list for services.  They might have a very quick assessment but then still have to wait a while to access services.

     

    Does this get in the way of delivering services to families who need them?

     

    (26)     No.  We would like there to be a phone-in service for parents, which could run alongside our other services, but we do not have the capacity to set up and run such a service.

     

    Is the lack of clarity around what the County Council wants still evident?

    (27)     Not at the contract specification stage, which is very clear (once the need and desired outcomes have been identified) but too rigid.  I would like to be innovative and adaptable but I can’t do this in the current system. The strength of the voluntary sector is its flexibility and the ability to innovate.

     

    Is the County Council clear about why it is commissioning services?

     

    (28)     It isn’t always clear about why it wants to commission services.  It would help to have some detail about how a contract would link into other provision.

     

    What is it that the County Council does not seem to know – whether it is commissioning something because it is a legal requirement, or because it is best practice, or just a good idea?

     

    (29)     I don’t know – this is not clear.

     

    Can you contact the Central Referral Unit directly if you have safeguarding concerns?

     

    (30)     Yes we can; we are given this responsibility as part of our contracts.

     

    What staff do you have?

     

    (31)     I currently have a total of 40 staff. Some have left recently or switched to working part-time, so I need to recruit to replace them. 

     

    Are you able to access good quality trainees, for example from Canterbury Christ Church University?

     

    (32)     I get social work students from Canterbury Christ Church University and the University of Kent at Canterbury.  Working with an organisation such as ours is part of the training requirement on their degree course.  We have a quality manual which sets out policy and procedure.

     

    Do you find it difficult to recruit and retain staff?

     

    (33)     It’s not too bad, but some staff leave to seek better-paid jobs.  As a voluntary organisation, we lack the funding to provide good quality training but still we are expected to have high quality, well-trained staff.

     

    As you are a partner of the County Council, could you ask it to help you with training for your staff?

     

    (34)     We offered to share with them, at a reduced rate, some mediation training that we were undertaking, but there was no take-up.  We do share a bit of training but it is difficult to find the time to give to planning ahead about setting up joint training exercises.

     

    You say in your written paper that those whom you feel are in danger of being lost are the children, young people and families who need support.

     

    (35)     Everyone working with children and families has safeguarding and support as their main aims, but if the process takes over, the flexibility that is necessary when working with young people can be lost.  Also, the process can hamper the need for people to be able to access services quickly.  If a family is being supported for a period of six or twelve weeks, there is no more opportunity beyond this time to continue to build a relationship.  The process is too rigid, and there are only so many voluntary organisations available to work with clients.

     

    Is there anything else you want to tell the Select Committee?

     

    (36)     Nothing that I can think of.  Taking part in the Select Committee has been very helpful for me as it made me think through what we do and what could be different.  I was very pleased to be asked.

     

    (37)     The Chairman thanked Ms McVittie for attending.

     

     

     

    Supporting documents: