Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 -37 Wellington Square, Oxford OX1 2ER, United Kingdom.
Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 -37 Wellington Square, Oxford OX1 2ER, United Kingdom.
Soc Sci Med. 2022 Nov;313:115323. doi: 10.1016/j.socscimed.2022.115323. Epub 2022 Aug 30.
Most residential children's social care services in England, including children's homes, are operated by for-profit companies, but the implications of this development are not well understood. This paper aims to address this gap by undertaking the first longitudinal and comprehensive evaluation of the associations between for-profit outsourcing and quality of service provision among English local authorities and children's homes. To enable investigation of the implications of outsourcing children's residential social care services, we create and analyse a novel and longitudinal dataset covering more than 13,000 children's home inspections by Ofsted (the independent regulator of children's social care in England) over a period of 7 years (2014-2021). We also investigate the association between Ofsted local authority (LA) ratings and the reliance of LAs on for-profit and third sector outsourcing of children in care placements. Our analysis shows that for-profit providers are statistically significantly more likely to be rated of lower quality than both public and third sector services. For-profit children's homes also violate a greater number of requirements and receive more recommendations compared to other ownership types. These findings are robust to model specification and consistent over the full analysed period. At LA level, we find provisional evidence that LA Ofsted ratings are negatively correlated with the percentage of for-profit outsourcing, suggesting that LAs which outsource a greater amount of their children in care placements perform less well than those which do not. These findings are of significant concern given the focus of these services on society's most vulnerable service users. However, caution is needed in terms of regulating the sector going forward, as the role of for-profit provision cannot be replaced without substantial coordination and long-term planning.
英格兰的大多数儿童社会关怀服务机构（包括儿童福利院）都是由营利性公司运营的，但人们对这一发展的影响并不了解。本文旨在通过对英格兰地方当局和儿童福利院的营利性外包与服务质量之间的关系进行首次纵向和全面评估来解决这一差距。为了能够调查儿童住宿社会关怀服务外包的影响，我们创建并分析了一个新颖的、纵向数据集，该数据集涵盖了超过 13000 次 Ofsted（英格兰儿童社会关怀的独立监管机构）对儿童福利院的检查，时间跨度为 7 年（2014-2021 年）。我们还调查了 Ofsted 地方当局（LA）评级与 LA 对营利性和第三方外包儿童护理安置的依赖之间的关联。我们的分析表明，营利性供应商在统计学上更有可能被评为质量较低，而不是公共和第三方服务。营利性儿童福利院还违反了更多的要求，并收到了比其他所有制类型更多的建议。这些发现不受模型规范的影响，并且在整个分析期间保持一致。在 LA 层面，我们发现了初步证据表明，LA 的 Ofsted 评级与营利性外包的百分比呈负相关，这表明将更多的儿童护理安置外包的 LA 表现不如不这样做的 LA。考虑到这些服务的重点是社会上最弱势的服务使用者，这些发现令人严重关切。然而，在未来的监管方面需要谨慎，因为如果没有大量的协调和长期规划，营利性服务的角色是无法取代的。
