Improving Care for Children with Complex Needs: Challenges and Solutions

1. Getting it wrong – the example of children in residential care Peter McGill

2. The current picture • About 3000 children and young people with learning disabilities in residential schools, residential social care placements and health facilities • About 700 of these in 52-week residential schools costing £108 million (£160k per child) • Challenging behaviour a key risk factor (99% prevalence in 52-week school sample) • Most placements out of area, reducing family contact, increasing vulnerability and feeding adult out of area residential care placements

3. What leads to placement? • Complex needs • Almost complete absence of early intervention • Limited availability of evidence-based provision around challenging behaviour • Limited/poor quality professional support to families • Limited access to/exclusion from short break/respite care • Exclusion from educational provision • Family strain and coping difficulties • Limited (often complete absence of) active care management to meet child/family needs • Residential care as an “easy” solution for commissioners

4. What would it take to change things? • Early and continued, family-centred, evidence-based support around challenging behaviour • Facilitated access to local generic and specialist provision (especially short breaks) • Competent and inclusive local services • Proactive approach including prevention and early intervention • “World class” commissioning – who are the people, what are their needs now and into the future, what capacity is required to meet these needs

5. But this requires… • Real commissioning • Coordination across education, health and social care • A strategic approach to the totality of local provision • Sufficient, and sufficiently skilled people • Full inclusion of families as partners in commissioning and provision

6. Contact Information: Peter McGill P.McGill@kent.ac.uk Tizard Centre University of Kent Canterbury Kent CT2 7LZ United Kingdom