| Keeping people that need services at the heart of the Programme
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| 1. | Supporting People has been good at raising the profile of vulnerable groups, but there are still some whose needs are not being properly addressed. As the Supporting People programme develops, further steps need to be taken to ensure that those needs are met. As we have seen, particular care needs to be taken as delivery mechanisms for Supporting People services are developed. Generic and specialist services are both important but local authorities need to be careful not to lose specialist services in the rush to rationalise delivery and 'make the money go further'. In particular, while Supporting People has been excellent in helping people to 'move on' to independence, there is a shortage of low-level, long-term preventative support services, such as supported housing, for people who are less likely to 'move on' and instead need to 'maintain' independence. (Paragraph 18)
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| 2. | We agree with Hact that a clear evidence base demonstrating the effectiveness of different models of intervention in meeting the needs of service users is crucial if the problems described in the above paragraph are to be addressed and providers and commissioners of Supporting People services are to make decisions which keep users at the heart of services. We recommend that CLG take steps to ensure that evidence base is developed and made widely available to Supporting People providers and commissioners. (Paragraph 19)
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| 3. | We recommend that the QAF and the Outcomes Framework should be mandatory for all local authorities unless and until they can demonstrate that they are achieving a high level of involvement, communication and consultation with service users, and a commensurately high level of client satisfaction. (Paragraph 31)
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| 4. | Progress with Charters for Independent Living has been too slow. Consequently, there has been an inadequate focus on clarifying complaints mechanisms and other means of ensuring that individual service users get the services they need. We recommend that CLG prioritise the implementation of Charters for Independent Living, with a particular focus on clarifying complaints handling mechanisms. (Paragraph 32)
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| 5. | Comprehensive Area Assessment cannot alone be relied upon to ensure the continued quality of Supporting People services. The development of Local Strategic Partnerships as decision-making forums for Supporting People services may pose a risk to user involvement in some areas. In order to retain a proper focus on housing-related support and facilitate good service user involvement in the decisions of local strategic partnerships, there is a very strong argument to keep the existing Commissioning Body and associated service user involvement structures established under the Supporting People programme. We return to this point later in this Report. (Paragraph 35)
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| 6. | Personalisation of services is good for increasing service user choice, but sometimes too much choice is overwhelming or even inappropriate. Careful consideration must be given to how to balance personalisation with important commissioned services for people who need emergency support, or who are unable—or unwilling—to choose. Careful consideration is particularly needed of how personalisation will work in accommodation-based facilities. We recommend that the Government extend the Individual Budget pilots to learn more about how personalisation works in practice. (Paragraph 41)
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| Enhancing partnership with the Third Sector
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| 7. | We welcome the progress, albeit slow, which has been made on developing more integrated assessments of service users' needs. The consideration of housing and housing-related support in the context of needs assessment in the Social Care Green Paper is a positive development, and we look forward to seeing further progress in the inclusion of housing and housing-related support in the Common Assessment Framework for Adults. (Paragraph 44)
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| 8. | Our evidence reinforces the importance of the contribution made by the Third Sector to the Supporting People programme. The Third Sector has a major role both in delivering services and in identifying the needs of vulnerable client groups in the first place. The knowledge and expertise of the sector has significantly contributed to the success of the programme so far and it is crucial that it continue to be retained and exploited. (Paragraph 48)
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| 9. | We have already recommended that the Quality Assessment Framework remain mandatory in the context of ensuring continued service user involvement. We further recommend the QAF should be retained to ensure quality considerations are always made when commissioning services and to protect against any potential loss of dedicated Supporting People commissioning and procurement teams. (Paragraph 54)
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| 10. | Constant cycles of competitive tendering are burdensome and expensive and this has a disproportionate impact on Third Sector and smaller providers. The use of short-term contracts to procure services should be avoided where possible by local authorities: we make further recommendations about how this can be achieved below. Meanwhile, however, the problem of the uncertainty of funding, which is at the root of some of the short-termism which has affected some Supporting People commissioning, needs to be addressed both by individual local authorities and by CLG itself. CLG's announcement of three-year funding settlements for local authorities has been a welcome step: the benefits which this has brought not only to the Supporting People programme but across local authority services must not be lost as the financial settlements for local authorities become tighter. Meanwhile local authorities must continue to pass on the certainty of three-year financial settlements to Third Sector providers, in line with the Supporting People strategy. (Paragraph 59)
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| 11. | In letting contracts for Supporting People services, we believe that EU procurement rules are being used by councils as an excuse for their own inertia and risk aversion. It is clear to us that unambiguous guidance is needed to assist local authorities in developing approaches to commissioning and procurement which are legal, proportionate to the size of contracts being let and focused on both cost and quality outcomes. This is something CLG should prioritise. The Commission for the Compact published guidance on grants, contracts and EU procurement rules for Third sector organisations and public sector commissioners in July 2009. We recommend that CLG take advantage of this opportunity to disseminate best practice guidance and encourage greater consistency across all local authority areas in approaches to commissioning and procurement. (Paragraph 68)
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| 12. | Some good procurement practice exists in effective local authorities. That practice needs to be shared much more proactively. With the uncertainty over future funding, we are concerned about the threat to the providers—particularly small and Third Sector providers—in lower performing local authorities where commissioning and procurement practice is already poor. Furthermore, even where there is good practice, the fact that local authorities take different approaches to commissioning and procurement can create a massive administrative and bureaucratic burden for providers working across local authority boundaries. (Paragraph 73)
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| 13. | The new Regional Improvement and Efficiency Partnerships are the obvious vehicle for challenging poor and inefficient procurement practice, as well as for coordinating tendering and commissioning procedures across local authority boundaries. However, at present their role is unclear in many local authority areas. RIEPs need to be much more involved in tackling poor and inefficient procurement practice, and in joining up procurement practice across local authority boundaries. We recommend that tackling the complexities of commissioning and procurement with the Third Sector become a focus for the ongoing work of RIEPs. (Paragraph 74)
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| 14. | Capacity building on commissioning and procurement in the Third Sector should continue, but we recommend that the government focus its major energies on developing and issuing clear guidance to local authorities on commissioning and procurement and in joining up different local authorities' practices with regards to procurement. These measures would significantly reduce the burden on Third Sector providers. (Paragraph 80)
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| 15. | In the evidence we heard, there was general consensus amongst witnesses that the Supporting People decision-making and delivery structures were so effective that they should be considered as providing a blueprint for partnership working within Local Area Agreements and other partnership arrangements. We therefore see the potential loss of these structures not only as a risk, but also a wasted opportunity to showcase and replicate good practice in multi-agency partnership working across the board. We recommend that local authorities retain Supporting People governance and delivery structures (Teams and Commissioning Bodies). We also recommend that the Government further promote these structures more generally as models of good partnership working for local authorities and their partners. The retention of these structures will also assist in addressing the risks to service user involvement which we discussed earlier in this Report. (Paragraph 87)
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| Delivering in the new local government landscape
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| 16. | The increased flexibility and local decision-making which the removal of the ring-fence and the funding of Supporting People services through Area-Based Grant has brought is a positive development. However, the maturity of some local strategic partnerships, and consequently the ability of some LSP partners effectively to commission services jointly, is in doubt. There is a risk of losing some of the excellent practice which has been developed in the commissioning of these services. For these reasons we consider that Supporting People services require some continued protection as LSPs continue to develop. (Paragraph 108)
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| 17. | We recommend that CLG ensure that guidance is drawn up and disseminated for delivering housing-related support in two-tier areas. CLG does not necessarily have to be the author, or main instigator, of this guidance: indeed, in line with the conclusions of our recent Report The Balance of Power, on the relationship between local and central government, we consider that it may be more appropriate for local government itself—whether through the LGA or otherwise—to take the lead in ensuring that this is done. (Paragraph 111)
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| 18. | We recommend that the development of joint strategic needs assessments be accelerated as a priority in planning for the provision of Supporting People services. Specifically, we recommend that a reference to housing-related support be included in the JSNA guidance. (Paragraph 121)
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| 19. | With greater local freedoms, improved accountability is needed. To ensure that Comprehensive Area Assessment is capable of providing that accountability, therefore, we support the proposal by Westminster City Council and others that there should be a requirement for strategic commissioning and contract monitoring frameworks to be in place in each administering authority so that inspectors know where to look for the information they need for CAA. We also reiterate our recommendation that the Outcomes Framework should continue to be a requirement in all local authorities. The Outcomes Framework will be able to provide a clear focus for CAA inspectors' assessment of the effectiveness of SP services in an area. (Paragraph 136)
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| 20. | There are steps which should be taken by the inspectorates themselves to ensure robust and effective inspection. Crucial among these is ensuring service user input. The previous inspection regime was very effective at enabling such input; the new, lighter touch inspections may find it more difficult. We recommend that the inspectorates develop clear guidance and procedures for inspectors on ensuring user input to inspection results. (Paragraph 137)
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| 21. | It will be important to continue to review the outcome of CAA in the light of experience—not only, of course, in the context of the inspection of Supporting People-related services, but more widely—and to adjust the regime, and the elements such as those we have recommended above, which support it, to ensure that it remains both effective and also as unburdensome as possible. (Paragraph 138)
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| 22. | We agree with the prevailing view amongst our witnesses that there is at present no strong case for putting Supporting People services on a statutory basis. Those services would be extremely difficult to define in legislation, and to attempt to do so would be to risk hampering attempts to join up health, social care and housing in a continuum of services appropriate to the needs of service users. We consider that the recommendations which we make elsewhere in this Report should be sufficient to protect Supporting People services. However, the situation should be monitored and we recommend that the case for placing SP services on a statutory basis be reconsidered at a later date in the light of the evolving social care agenda. (Paragraph 144)
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| Increasing efficiency and reducing bureaucracy
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| 23. | CLG needs to take a stronger ambassadorial role amongst other Government Departments and agencies to promote housing-related support in the context of the health and social care policy areas. Its leadership is crucial in ensuring continued recognition of the value of Supporting People services, and setting a precedent for effective partnership working at local levels. (Paragraph 145)
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| 24. | Apart from the issues with competitive tendering which we discuss above, the administration and bureaucracy associated with managing Supporting People contracts and services seems appropriate—a 'necessary evil', producing useful outcomes. However, the inconsistent use of the QAF—and the use of different versions of the QAF in different areas—is a concern. We have already recommended the retention of the QAF as a requirement. We further recommend that local authorities be required to use the same version of the Framework, to ensure consistency to providers of SP services across local authority boundaries. (Paragraph 151)
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| 25. | We are concerned that decisions about future regulation appear to be made by CLG and DOH in separate silos. With an increasing emphasis on housing-related services being ever more joined up and flexible, providing a continuum of support to service users, from low-level preventative interventions to high end critical care, the risk of support services which straddle the line between social care and housing becoming lost in the complexities and bureaucracy of insufficiently aligned regulatory regimes represents a huge threat to the sustainability of many providers of housing-related support and care services. We recommend that CLG take the lead in addressing this issue of regulation with the Department of Health, with a view to creating a more joined-up approach to the regulation of housing and social care services. (Paragraph 156)
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| Sheltered housing |
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| 26. | We welcome the fact that a Ministerial Group is now considering these issues, and trust that it will take note of the volume and strength of evidence submitted to this inquiry on the topic of sheltered housing. The evidence we received suggests that this Ministerial group needs to focus on:
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- Reviewing whether sheltered housing should stay within the SP regime;
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- Improving needs analysis so that evidence is available of what older people want; and
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- Developing a more coherent strategy for the provision and funding of housing and support services for older people, making clear the role of sheltered housing.
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| | The Group should also consider the effect of splitting 'accommodation' and 'support' under Supporting People on builders of supported housing, and make recommendations about how to ensure that capital investment in new supported housing is not threatened by the risk of ongoing revenue funding being unavailable. (Paragraph 178)
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| Supporting People Distribution Formula
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| 27. | We accept the argument that without extra government funding for the transition, gradual movement from historical funding patterns towards fully needs-based allocations is inevitable. If a sudden redistribution of funds was made, some areas would be faced with the prospect of having to make sudden cuts to services. Nonetheless we appreciate that without adequate funding, councils will be unable to provide the services vulnerable people need. We therefore consider that there should be accelerated movement towards the needs-based allocations, and we recommend that this take place. (Paragraph 186)
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| 28. | We welcome the commissioning of a study of the Supporting People Distribution Formula itself, and the intention to address any issues found therein. We recommend that the study include consideration of the issues of rurality and of population growth which have been raised with us during this inquiry, and that steps be taken to address those issues should the concerns raised prove valid. (Paragraph 187)
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| Conclusion: the ringfence |
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| 29. | We conclude that pressure on local authority budgets is a potential threat to the future of some existing Supporting People services and to the likelihood of currently unmet need being addressed in future. The question is how best to address that threat, recognising that it applies equally to other local authority services, and that local people should in principle be in the best position to determine how best to allocate resources. (Paragraph 203)
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| 30. | Concerns remain about less well-performing local authorities with regard to their understanding of the value of Supporting People and in their approaches to commissioning and procurement of services. We understand that CLG is targeting support to such authorities but, despite this, we are concerned that additional freedoms in the spending of Supporting People funds could be misused in local authorities where Supporting People is misunderstood or not seen as a mainstream part of service delivery. We support moves to devolve decision making and control over budgets to the local level. However, as we relate above, we are uncertain at this stage how well the new Comprehensive Area Assessment will identify where the needs of vulnerable people are not being met and believe that there is a possibility that the needs of vulnerable people could go un-served and unnoticed in some areas without a continued specific focus on housing-related support. (Paragraph 205)
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| 31. | We see this as a serious risk to the future of housing-related support and believe that the continued existence of such structures is critical in the absence of a ringfence on Supporting People funding. (Paragraph 206)
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| 32. | The uncertainty of future arrangements for the commissioning and procurement of Supporting People services leads us to conclude that any loss of robust mechanisms for assuring quality and assessing outcomes would be a serious threat to the future of housing-related support. The QAF and Outcomes Framework have proven their worth in ensuring quality, promoting effective and consistent local and regional commissioning, and providing an unambiguous evidence base of the value of Supporting People services. (Paragraph 207)
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| 33. | As we discussed earlier in our report, we do not believe that it would be appropriate at this stage to put Supporting People on a statutory footing, nor are we persuaded that there is a need to compel local authorities to adopt mandatory performance indicators for housing-related support. However, we do believe that retaining the Supporting People 'brand' and championing its purpose will be very important in the absence of other protections. (Paragraph 209)
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| 34. | Without doubt, the Supporting People programme has achieved a great deal and it is our view that any avoidable threats to its continued success must be averted. The value of Supporting People has been demonstrated to us not only in robust financial terms, but also through the volume and strength of submissions we received during our inquiry, which show how the programme has transformed many vulnerable people's lives. (Paragraph 210)
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| 35. | With the lifting of the ringfence, we are concerned that many 'protections' of Supporting People are being lost simultaneously in particularly challenging economic circumstances. Nonetheless, we are supportive of the Government's overall policy of reducing ring-fenced funding, and consider that there is much to be gained from the greater flexibility which it offers. We do not, therefore, recommend the reimposition of the ringfence on Supporting People funding. (Paragraph 211)
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| 36. | We conclude that fears about the loss of funding to Supporting People services can best be countered by ensuring that it is clear to all concerned how much money has been allocated to a council for those services; and how much the council has actually spent on them. We therefore recommend continued transparency in the allocation of Supporting People funding in the Area-Based Grant. Local authorities should not be required to spend funds allocated on the basis of assessed need for housing-related support on those services if they consider that it would be better spent elsewhere. They should, however, be required to justify, and account for, any decision to do so. This local accountability, combined with the retention and enhancement of the other protections which we have recommended, should ensure that the Supporting People programme continues to deliver vital services to some of the most vulnerable in our society. (Paragraph 212)
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