Memorandum from Dorset Supporting People
Provider Forum (SPP 25)
1. Key Summary Recommendations
(i) Supporting People isn't broke so don't fix
it
(ii) Maintain the Supporting People brand
(iii) Ensure that Supporting People is maintained
as a named grant within the Area Based Grant
(iv) Encourage Administering Authorities to maintain
the ring fencing of the grant locally
(v) Remove the Distribution Formula as a basis
for future funding
(vi) Evaluate the financial impact of the Programme
at local and national level before making any further decisions
"My mother is 96... she was unable to
live alone due to severe deafness and limited use of her hands...
the daily visits from the Warden have enabled her to live independently
from me and give her confidence knowing that there is help at
hand should she need it, simply by using her pull cord. I know
that someone I can trust is looking after my mother... without
this support my mother would lose her independence which means
everything to her and would have to move to a residential care
home."
JS, daughter of MB, Dorset
2. About the Dorset Provider Forum
2.1 The Dorset Provider Forum is an inclusive
Forum of providers of Supporting People services in Dorset. The
Forum has 92 members who meet at least three times a year to discuss
matters relating to the Supporting People Programme. The Forum
is Chaired by Kevin Hodder, CEO of East Boro Housing Association.
2.2 The Forum met on 23 April 2009 to consider
the evidence it wished to place before the Select Committee. This
report was compiled as a result of the meeting and all members
have been consulted on the report prior to submission.
2.3 The Forum were asked to consider the matters
as described in the Select Committee's terms of reference and
this report follows the those areas of inquiry.
3. What has been the success of the supporting
people programme?
3.1 It has, for the first time, defined housing
related support services, provided a distinction between care
and support and raised the profile of a large range of preventative
services, especially sheltered housing.
"As a resident in sheltered housing, I feel
safe as I know that I can get help at any time. Without this 24
hour cover I would not feel secure living on my own."
3.2 It has introduced an excellent national
Quality Assessment Framework which, for the first time, introduced
consistent standards for housing related support. The standards
apply across all client groups and apply to all Providers whether
voluntary, independent, large or small. The use of the Quality
Assurance Framework (QAF) since 2003 has raised standards across
the country evinced by the improvement in QAF scores from D to
C to B and many to level A. Training had been focused on raising
standards.
3.3 Supporting People successfully brought many
funding streams into one clear funding source.
3.4 The establishment of District Inclusive
Fora brought providers together for the first time to share information
with each other and with commissioners. This was instrumental
in delivering strong partnership working between providers and
commissioners in addressing both strategic and operational issues.
3.5 Two tier authorities, especially District
Councils, gained an increased knowledge and visibility of supported
housing and the contribution that SP services make to their strategic
priorities.
3.6 The programme brought financial accountability
for the services delivered, led to an understanding of the true
costs of delivering housing related support and challenged providers
deliver value for money.
3.7 The whole programme has been a huge success
for service users, increasing the supply of preventative person-centred,
housing-related support services of high quality and performance,
focused on raising standards and delivering value for money.
3.8 Supporting People teams have a clear strategic
view for the first time of what cross-tenure support is required
in their administering authority area, across all client groups
and geographical areas.
3.9 Service users are protected from abuse through
clear standards of professional practice, policies and protocols.
3.10 Providers have been encouraged to be innovative
in responding to specifications for new services.
3.11 Many more people are supported now than
before the programme started and people are now supported across
tenure rather than in just the social rented sector.
3.12 There has been a focus on person-centred
support assessment and planning, service user participation and
consultation. Power has been placed in the hands of service users
who have more knowledge of their rights and can hold providers
to account. Dorset has just piloted a peer review process in which
service users assess the quality of services.
4. Have service users been kept at the heart
of the programme?
4.1 It is questionable whether there has been
enough time for Administering Authorities to really place service
users at the heart of strategic commissioning. All service users
have individual support plans tailored to meeting their individual
needs and services have improved their involvement of users in
the planning and delivery of their services. But the involvement
of service users more widely in the programme has been patchy.
4.2 The Ibsen Report demonstrated that insufficient
time has been allowed for Supporting People funding to be integrated
into Individual Budgets and so no real evidence exists of what
works or how.
4.3 There appears to be no relationship between
national Supporting People policy initiatives and the availability
of housing capital and revenue. Government is not joined up in
this respect. Supporting People contracts are relatively short-term,
usually a maximum of three years whilst housing requires long
term capital investments. Why would any housing developer invest
in housing provision when there is no guarantee of support longer
than three years?
4.4 Best practice is not shared either nationally
or locally due to the competition for contracts.
4.5 Service users are not involved in commissioning
decisions, particularly those decisions to decommission services.
Where this occurs, service users are not consulted. It is usually
the Provider who is facing the loss of the contract that has to
inform the service user of the commissioner's decision. Service
users have no right of appeal or complaint.
4.6 The removal of warden assisted sheltered
housing as a support model has been one of the most controversial
national policy initiatives and one which seemingly has been contrary
to the wishes of the vast majority of older people in sheltered
housing.
5. Has the partnership with the third sector
been enhanced?
5.1 Obstacles have been minimised which have
preventing good quality providers from across public, private
and Third Sector organisations from competing fairly to deliver
housing support services.
5.2 In Dorset, some small providers of services
have withdrawn from the market because of the burden of the Quality
Assurance Framework and the bureaucracy of the Performance Workbooks.
Supporting People have tried to support small Providers to meet
the standards but no new entrants to the market have been encouraged.
6. Has supporting people delivered in the
new local government landscape?
6.1 The burden on medium and large providers
has been reduced through a risk-based approach to the validation
of Quality Assurance Framework risk assessments however, this
still remains onerous for small providers
6.2 There is no evidence for providers of any
links to the regional assembly.
6.3 Providers were unable to say who the Regional
Champions were and therefore have no knowledge of their impact.
6.4 In the South West, the Supporting People
Regional Implementation Group has worked well in bringing a regional
approach to the implementation of the programme and has worked
in partnership with the South West Provider Forum.
6.5 The Supporting People teams have become
experts in understanding the supply, operation and commissioning
of housing related support services. Losing these skills and knowledge
with the demise of the programme will be a huge loss of investment.
6.6 A Supporting People qualification should
have been developed to provide a consistent set of skills, knowledge
and behaviours for all those involved in the commissioning and
monitoring of the programme.
7. Has there been an increase in efficiency
and a reduction in bureaucracy in the supporting people programme?
7.1 All Providers have to sustain the continuing
cost of the bureaucracy of the Performance Workbooks, client record
data returns, Outcome Framework returns and contract monitoring
data reports.
7.2 Although the Quality Assurance Framework
is an excellent tool, there is no consistent approach to the standards
of evidence behind the assessment which leads to a burden for
Providers, especially those who work across more than one administering
authority area. In addition, some administering authorities require
the supplementary standards to be adhered to whilst, in others,
this does not happen. This leads to a inconsistency for providers
and an additional burden in bureaucracy.
7.3 The Supporting People national outcomes
framework is not consistent with the measurements behind other
local strategies.
7.4 Supporting People services now have to meet
a broad set of National Indicators including NI 141 and NI 142.
Each Local Authority has chosen a different basket of indicators
and some have chosen NI 141 or NI 142 or both or none. This lack
of consistency adds additional bureaucracy and cost for providers
as they work to meet multiple sets of indicators across different
administering authority areas.
8. Should the ring fence of supporting people
funding be removed?
8.1 The ring fence has been removed for excellent
authorities like Dorset for a couple of years. The Commissioning
Group has made a commitment to effectively maintain the ring-fence
on the funding. Dorset Providers believe that, even if the ring-fence
is removed nationally, local Administering Authorities should,
through their commissioning bodies, agree to maintain the ring
fence at a local level. In order that commissioning bodies have
visibility of the grant for Supporting People services, we further
believe that the grant should continue to be "named"
within the Area Based Grant.
8.2 If commissioning decisions are to be made
by the local LSP or one or many of its Partnership Boards then
there is a huge risk that the knowledge of the Supporting People
programme will not be transferred to these bodies. Currently,
Supporting People Commissioning Bodies are supported by the local
Supporting People teams to make decisions. It is extremely concerning
for Providers that, in future, commissioning decisions should
be placed in the hands of elected members who have no expertise
and may have no officers with expertise to support them in their
decision making.
8.3 If the funding of Supporting People services
becomes invisible within the Area Based Grant then there is a
risk that it will be subsumed into Adult Social Care and the preventative
agenda will be lost.
8.4 In a recession, more people are at risk
of losing their homes, more young people are forced out of their
families, mental health declines, domestic violence and offending
behaviour increases and more people need help with debt and claiming
benefits. Now is not the time to be continuing with the Distribution
Formula which will see funding in Dorset reduce in real terms.
Supporting People services will be needed to prevent far more
cost downstream as evidenced by the Audit Commission report on
the financial benefits of the Supporting People programme.
9. Will the removal of the ring fence bring
opportunities for more flexible, innovative services?
9.1 Providers in Dorset do not believe that
any funding from other commissioners such as adult social care,
probation or health would be used to contribute towards Supporting
People services.
9.2 Without any visibility of a brand or funding,
current Supporting People services could be asked to contribute
towards a number of locally selected National Indicators. The
funding will be fair game for any statutory body to try to poach.
This could lead to services being skewed to deliver outcomes which
may not be preventative.
9.3 The removal of the ring fence and the inclusion
of Supporting People in the Area Based Grant is not a prerequisite
for services to be innovative. Supporting People services have
been flexible as they are person-centred and there are many examples
of innovative services having been commissioned. In maintaining
the status quo, there is nothing to stop agencies coming together
and jointly commissioning holistic innovative services.
9.4 The new CLG definition of Supporting People
services removes the word "housing" from housing related
support. This could lead to Supporting People funding being used
to fund a wide range of services and the focus on the development
and maintenance of independent living will be lost.
9.5 The Supporting People Programme has Investment
in IT systems, the QAF, Performance Workbooks, Outcome monitoring
and contract monitoring. Change now can only represent a huge
waste of this investment. Stability is needed now with the opportunity
to improve services further and to deal with the recession. A
longer period of evaluation is required further demonstrate the
benefits of this excellent programme, not change.
9.6 There is no benefit in the proposed changes
for service users. Quality standards are improving, the cost of
the programme has come down and more people than ever are being
supported. What is the logic for change?
9.7 The brand "Supporting People"
should remain. This programme has been one of the best initiatives
of this government in defining the contribution of housing related
support as a preventative service, which positively changes lives
and is an investment releases longer term savings. Losing that
brand now would be a travesty.
May 2009
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