Memorandum from the Stoke-on-Trent Supporting
People (SPP 33)
1. SUMMARY
1.1 The Supporting People partnership for
Stoke-on-Trent believes that the programme has delivered significant
benefits for service users and communities since its inception
in April 2003.
— Since its inception Supporting People
has always focused on the needs of service users at the heart
of the programme. Supporting People is an archetypal "personalised"
and flexible service for vulnerable people and households.
— Supporting People is a significant funder
of Third Sector services. In our experience, the Supporting People
programme has helped significantly to strengthen the relationship
between statutory and non-statutory sector partners—particularly
the voluntary sector.
— Sitting at the intersection between social
care, housing, health, and community safety services, Supporting
People is a force for understanding, coalition, and partnership
working. The outcomes framework is further strengthening the evidence
base for this partnership and the importance of the intersection
(particularly in relation to preventative services). However,
we believe that the impact of applying individual budgets or direct
payments to the programme is little understood. Therefore, we
remain cautious in relation to our implementation of this aspect
of the personalisation agenda as we would not wish to destabilise
the valuable contribution of Third Sector partners.
— We believe that efficiency has been increased
and, since the inception of the programme, bureaucracy reduced.
However, we also believe that the anomalies in the distribution
of funding have not been sufficiently addressed in the implementation
of the distribution formula. This has disadvantaged vulnerable
people in the Local Authority areas that were disproportionately
affected such as Stoke-on-Trent. We would like to see the pace
of change within the distribution formula increased for authorities
that are significantly underfunded such that they achieve their
target allocation within three years.
1.2 Given the relative differences between
authority areas in terms of the level of awareness of Supporting
People and integration of housing-related support in to relevant
strategies, we believe that removal of the ring fence would risk
losing the benefits gained to date. Further, it is also our view
that the impact of individualised budgets and direct payments
on the provider market, particularly the Third Sector, is not
yet sufficiently understood for large scale implementation in
Supporting People markets. It is our concern, that removal of
the Supporting People ring fence, combined with a general drive
in social care and health for individual budgets and direct payments,
poses a significant risk to the benefits gained by the Supporting
People programme thus far.
1.2.1 Introduction
1.3 In responding to the request for evidence
we have considered each element of the CLG strategy for Supporting
People: Independence and Opportunity; Our Strategy for Supporting
People. This is divided in to the four key headings with sub-heading
and paragraphs as numbered.
1.4 Where the Supporting People partnership
for Stoke-on-Trent has a view on the national issues this is expressed.
However, we have relied largely on our experience of delivering
the Supporting People programme in Stoke-on-Trent as the basis
of our evidence for the select committee.
2. KEEPING PEOPLE
THAT NEED
SERVICES AT
THE HEART
OF THE
PROGRAMME
2.1 Putting the service user in charge
2.1.1 The Supporting People programme has
been delivering personalised services, with the needs of the user
at the centre, since its inception in April 2003. This is underpinned
by the Quality Assessment Framework (QAF) which provides a robust,
widely understood, and popular basis for quality assurance and
continuous improvement in the programme.
2.1.2 In Stoke-on-Trent, we have worked
with and through service providers to implement the standards
set out in the QAF for consulting and involving service users
at the level where we believe it counts most—their own services.
In the recently revised QAF, this part of the QAF has become a
"core standard" of the framework.
Supporting evidence from Stoke-on-Trent
Supporting People in Stoke-on-Trent worked in
partnership with Brighter Futures Housing Association, Staffordshire
Fire and Rescue Service, and the Local Authority Housing Solutions
Service to develop a service directory for people sleeping rough
in the city. Rough sleepers and former rough sleepers were central
to the design and content of the service directory (which can
be downloaded from (www.stoke.gov.uk/supportingpeople).
Service user involvement through this work also
led to the establishment of a single free-phone telephone number
for rough sleepers. Previously, two different mobile numbers had
been provided and service users highlighted during the consultation
that they found this both confusing and costly.
2.1.3 However, service users are involved
increasingly in decisions at a strategic level. For example, information
derived from:
2.1.3.1the aggregation of interviews with individual
service users performed as part of contract management arrangements
2.1.3.2project specific consultations with service
users in relation to service improvements, new services, or redesigned
systems
2.1.3.3the aggregations of comments, compliments,
or complaints from service users
2.1.3.4the routine involvement of service users
in governance arrangements; such as, through commissioning bodies,
strategy groups, inclusive forums, provider forums, or service
user specific forums
2.1.4 We believe that this aspect of Supporting
People has been strong from the outset of the programme. It has
improved continuously as the programme has matured which can be
evidenced via QAF scores as well as via the independent assessments
of Audit Commission inspection reports. Further, we believe that
other parts of the social care, health, and wider public sector
could learn from the best practice achieved by many Supporting
People partnerships.
2.2 Challenging barriers to joined up interventions
2.2.1 The tripartite partnership in Supporting
People between the Local Authority, Probation Service, and Health
Service has produced demonstrable results for local people. There
are many clear examples from across the country including extra
care sheltered housing for older people and people with learning
disabilities. However, Supporting People has also brought about
joined up interventions for service users in short-term services
such as homeless people and people with drug or alcohol problems.
Supporting evidence from Stoke-on-Trent
Supporting People in Stoke-on-Trent worked in
partnership with the local Community Safety Partnership, Drug
and Alcohol Action Team, Crime Reduction Initiatives, and Beth
Johnson Housing Association to establish a new accommodation-based
service for people with drug problems.
The partners worked together to develop a service
model, identify a site, and apply for housing corporation funding.
This included extensive work with Elected Members and the local
community.
The City now has a purpose built supported housing
facility for people with drug problems. This is integrated in
to drug treatment pathways through onsite health and treatment
interventions. Service users experience a comprehensive service
through to resettlement and treatment in the community. The service
has been running since September 2007.
2.3 Getting more service users involved and
empowered
2.3.1 While we are unaware of a lead from
central government on the development of "Charters for independent
living", we are aware that many Supporting People partnerships
have developed methods for informing service users of their rights
and responsibilities in respect of housing-related support services.
2.3.2 In Stoke-on-Trent, we produce a leaflet
for service users entitled "Supporting People: What you can
expect". The Supporting People team in the City has committed
through the comments, compliments, and complaints policy to fully
investigate service user complaints. This is where either the
providers' complaints process has been exhausted or where the
service user simply feels more comfortable for us to look in to
the complaint.
2.4 Developing more integrated assessments
2.4.1 A number of Supporting People partnerships
have developed integrated systems of assessment and referral with
social care and health partners. Stoke-on-Trent was recently unsuccessful
in its bid to become a pilot site for the Adult Common Assessment
Framework (ACAF). However, partners in Stoke-on-Trent remained
committed to the principle of integrated assessment and referral
mechanisms. This is a key priority for the Supporting People programme
in the city.
2.4.2 In implementing the single assessment
and referral system, we will be keen to learn from the experiences
of the ACAF pilot areas as well as from places such as Nottingham
City Council and Southwark where we understand a lot of progress
has already been made.
2.5 Meeting the needs of mobile groups and
individuals
2.5.1 In our experience, there is little
regional planning of services for mobile groups. This is perhaps
due to the lack of a regional infrastructure with any resources
to allocate to the commissioning of services.
2.5.2 Similarly, we understand that some
local authorities still operate a local connections policy for
short-term Supporting People services against the explicit guidance
of CLG. We believe that such policies work against the interests
of mobile groups and individuals. At the same time, such policies
also increase the demand for service in areas that do not have
a local connections policy.
2.5.3 There is, however, evidence that sub-regional
working has brought about clear benefits for service users and
local communities.
Supporting evidence from Stoke-on-Trent
Supporting People in Stoke-on-Trent worked in
partnership with the Staffordshire Supporting People partnership
on two services for mobile groups and individuals; for example:
— joint commissioning of
a floating support service for high risk offenders
— joint commissioning of
a floating support service for people with HIV or AIDS
Supporting People in Stoke-on-Trent has also
developed a new culturally sensitive service for Asian women fleeing
domestic violence. This has been developed in partnership with
Refuge and Beth Johnson Housing Association. Refuge are able to
use the service as part of a network of similar refuges to help
ensure that women feel safe during an extremely difficult time.
2.6 Developing better communication and consultation
with service users
2.6.1 Nationally, the Supporting People
programme—spurred on by the QAF and Audit Commission inspection
programme—has been at the forefront of public sector development
in consultation and communication with service users. There are
many examples of service users being involved in consultations
leading to decisions and innovative ways of communicating.
2.6.2 Many Supporting People partnerships,
including Stoke-on-Trent, involve service users in the evaluation
of service performance as part of the contract management frameworks
and also communicate the outcomes from these evaluations.
2.6.3 In Stoke-on-Trent, we are also in
the process of developing an on-line social network for service
users and other stakeholders to contribute their views and ideas
about the programme which we intend to deliver through a well
known channel such as "Facebook".
2.7 Exploring alternative provision models
and helping service users to make the right choices
2.7.1 In Stoke-on-Trent we have not yet
applied the Individual Budgets approach to delivering Supporting
People services. This is partly due to relative underfunding.
However, we will also be keen to learn from the experience of
early implementing authorities in relation to both long-term and
short-term services. Around two-thirds of the Supporting People
programme in Stoke-on-Trent is commissioned via the Third Sector.
Supporting People is a significant funder of local Third Sector
providers. We are concerned to understand the impact that individual
budgets and direct payments could have on the Third Sector in
the city. Similarly, we will be keen to understand further how
the benefits of the QAF, safeguarding, and adult protection arrangements
can be maintained and improved through micro commissioning arrangements.
2.8 Enhancing the Supporting People Directory
of Services
2.8.1 We understand that this service is
being discontinued. We regret the loss of this service as it is—in
principle—a strong idea and a useful source of information
to a wide range of interested parties as well as service users
and carers.
3. ENHANCING
PARTNERSHIP WITH
THE THIRD
SECTOR
3.1 The role of the Third Sector
3.1.1 The Supporting People programme in
Stoke-on-Trent is largely delivered through Third Sector partners.
We are concerned that their appears to be little understanding
of the potential impact of the "personalisation agenda",
as expressed through individual budgets and direct payments, on
the established markets for services delivered to vulnerable people.
This is particularly the case in relation to small and local Third
Sector providers.
3.2 Our expectations on Providers and having
the right level of reporting, accountability and transparency
3.2.1 In our experience, providers are a
vital route to involving service users in the review, evaluation,
and development of the Supporting People programme. It is our
view that the Supporting People programme has strengthened both
the formal and informal relationships with service providers.
The Audit Commission noted that the Supporting People partnership
in Stoke-on-Trent maintained very good relationships with providers.
3.2.2 As a partnership, we value highly
the role of providers as critical friend in relation to the provision
of services as well as the administration and management of commissioning.
We formally involve providers in the strategy groups that make
recommendations to the Commissioning Body as well as recognising
the independent Provider Forum as a key reference group. Administration
of the programme is 5% of the programme budget. The commissioning
function of the Supporting People team has benefits across local
authority partnerships and adds capacity to the commissioning
functions of other areas such as housing, social care, and community
safety.
3.3 Support and capacity building
3.3.1 In Stoke-on-Trent we have supported
providers to be involved in the national benchmarking group managed
by SITRA and supported by CLG and Housemark. This initiative followed
provider feedback on a local framework designed to evaluate value
for money in services.
3.3.2 Through the contract management arrangements
we also help benchmarking by encouraging the sharing of best practice
and joint working between providers. This has, for example, helped
to establish a relationship for—where necessary—moving
customers between homeless hostels to reduce evictions and, thereby,
rough sleeping.
3.3.3 Where, on rare occasions, providers
have got in to difficulties (eg through contract default), our
approach has been to provide training and support concentrating
our efforts on where the risk is greatest. In such cases, we have
commissioned expert help to build the skills and confidence of
frontline staff (for example, in managing the risks associated
with drug users in a hostel environment).
3.3.4 However, where necessary—in
the interests of service users—we have also been able to
decommission services that were unable or unwilling to meet minimum
standards of quality or safety. Prior to the implementation of
the Supporting People programme there was no mechanism where this
type of safeguarding would take place for housing-related support
services.
4. DELIVERING
IN THE
NEW LOCAL
GOVERNMENT LANDSCAPE
4.1 Forging new relationships and making the
right links
4.1.1 In Stoke-on-Trent, particularly with
the support of data from the Supporting People outcomes framework,
we are increasingly able to attract resources to housing-related
support services or other ancillary services that facilitate service
user outcomes. For example:
4.1.1.1We have been able to work with NHS Stoke-on-Trent
to attract funding to expand the Home Improvement Agency to better
link with hospital discharge arrangements
4.1.1.2We have been able to attract funding from
NHS Stoke-on-Trent for a floating support service for older people
and to research how sheltered housing could be a hub for services
to the nearby community of older people
4.1.1.3Working in partnership with the Housing
Solutions Service and Economic Development section we have successfully
bid for funding from CLG to develop an Enhanced Housing Options
service that integrates housing, employment, and training advice
for vulnerable people
4.2 Developing stronger, more effective governance
4.2.1 The Audit Commission noted that governance
arrangements in Stoke-on-Trent are effective. However, we have
continued to strengthen these arrangements by working to improve
the involvement of Elected Members and service users.
4.2.2 We believe that governance is a key
strength of the programme generally and that Local Strategic Partnerships
could benefit from the approach to governance developed in Supporting
People. In particular:
4.2.2.1the clearly delegated powers of Commissioning
Body
4.2.2.2the supporting advisory sub-groups with
a work programme and clear portfolio (often called Core Strategy
Groups)
4.2.2.3the roles of the accountable officer,
lead officer, and Chair of the Commissioning Body
4.3 Integrating Supporting People in to Local
Area Agreements and developing new PSAs
4.3.1 We believe that the inclusion of the
Supporting People performance indicators in the set of national
indicators (NI141 and NI142) is beneficial for the programme.
4.3.2 In Stoke-on-Trent, we have been successful
in securing the inclusion of number of vulnerable people achieving
independent living in the top 35 priorities for the City.
This represents recognition of both the strategic importance and
wider value of the Supporting People programme for vulnerable
people.
4.3.3 Supporting People has been aligned
with the Healthier Communities and Older People pillar of the
LSP and provides regular performance reports on both NI141 and
NI142.
4.3.4 Increasingly, through the LSP arrangements,
Commissioning Body members are able to raise awareness of Supporting
People and its links to wider services for vulnerable people.
4.4 Developing a Supporting People outcomes
set
4.4.1 The outcomes framework for the Supporting
People programme is proving to be extremely valuable in relation
to demonstrating the impact of housing related support. We believe
that enough data has now been accumulated to begin to release
this potential and that this approach is a model from which other
public sector services could benefit. For example, we are able
to identify easily that in the first three quarters of 2008-09
the following outcomes were achieved:
4.4.1.1518 people or households maximised their
income
4.4.1.2148 people or households managed their
debts
4.4.1.334 people gained paid employment
4.4.1.4227 people engaged in training or education
4.4.1.5203 people achieved outcomes related to
their physical health
4.4.1.6156 people achieved outcomes related to
their mental health
4.4.1.7111 people achieved outcomes related to
substance misuse
4.4.2 Such information has already been
valuable in promoting the Supporting People programme and we believe
will be strengthened through time and development.
4.5 Minimising the burdens and bureaucracy
for local government
4.5.1 It is too early to assess the impact
of the decision to cease the rolling programme of Supporting People
specific inspections by the Audit Commission and integrate inspection
in to the CAA.
4.6 Introducing a stronger statutory basis
for Supporting People?
4.6.1 We do not believe that it would be
beneficial to introduce a stronger statutory basis for Supporting
People. While we welcome the decision not to proceed with establishing
housing-related support as a statutory duty at this stage, we
would reiterate our concerns in relation to the removal of the
Supporting People ring fence and integration of the funding in
to the area based grant.
4.7 Promoting and sharing positive practice
4.7.1 Supporting People in Stoke-on-Trent
has benefited from a wide range of CLG promoted, supported, or
attended events to share positive practice. This has ranged from
the annual Supporting People conference to events held by partnerships
achieving three-star status at inspection.
4.8 Funding and investment
4.8.1 The report in to the Supporting People
programme carried out by Robson Rhodes on behalf of CLG clearly
documented the uneven distribution of Supporting People funding
across the country. Although the CLG has implemented the needs
based distribution formula for the programme, we believe that
the pace of change applied to the formula disadvantages partnerships
such as Stoke-on-Trent.
4.8.2 The distribution formula estimates
that the funding needed for Stoke-on-Trent is £13.5 million.
The Supporting People budget for 2009-10 in Stoke-on-Trent is
£6.2 million. Although the programme has benefited from an
annual rise of 7% or more between 2007-08 and 2011-12, this will
not bring the programme in the city to the target allocation for
some considerable time.
4.8.3 The Supporting People partnership
for Stoke-on-Trent would like the pace of change in the distribution
formula to be accelerated for underfunded authorities that are
outliers in the distribution formula. We would like the programme
to move to the allocation estimated by the distribution formula
over a three year period. An illustration of the uneven distribution
that is more up-to-date than that provided in the Robson Rhodes
report is as follows:
|
| Supporting People Partnership | Population
| Supporting People
Grant 2009-10
| Supporting People
Grant Per Capita
|
|
| Stoke-on-Trent | 240,636
| £6,273,683 | £26.07
|
| Liverpool City Council | 439,473
| £39,068,629 | £88.90
|
| Nottingham City Council | 266,988
| £23,512,499 | £88.06
|
| Birmingham City Council | 977,087
| £51,912,681 | £53.13
|
|
5. INCREASING EFFICIENCY
AND REDUCING
BUREAUCRACY
5.1 The value improvement programme
5.1.1 We are aware of the value improvement programme
and have attended past events sharing the practice that emerged.
With our partners, we have applied some of the lessons from the
programme to services for young people locally—such as the
YMCA.
5.2 Reducing Bureaucracy
5.2.1 Following the original service review programme
the Supporting People partnership in Stoke-on-Trent sought to
ensure that contract management interventions were based on a
clear assessment of risk. In consultation with providers, we developed
a value for money framework that integrates risk, performance,
and quality in to contract management. This was highlighted by
the Audit Commission and featured on the Housemark benchmarking
website. In a recent review, the providers expressed a high degree
of satisfaction with the approach. Since the implementation of
the value for money framework we have further rationalised the
approach by reducing the frequency of contract management review
for services measured as high and medium value for money.
5.3 Using new technology and business process to improve
efficiency
5.3.1 We believe that this is an area in which the Supporting
People partnership and Local Authority in particular can take
a lead. As part of our considerations in relation to and Adult
Common Assessment Framework, we are looking at the IT systems
used by Adult Social Care to perform assessment and care planning.
We intend to work with providers to evaluate the feasibility of
making this system available to partners in an integrated approach
through mobile networking technologies.
5.3.2 However, we recognise that many large providers
have already made substantial investments in IT infrastructure
to support their staff and service users. While we would see this
as largely beneficial, we are concerned that this may enable large
providers to "outcompete" small, local, and Third Sector
providers in competitive tendering processes if this element has
a significant weighting in the considerations of the Supporting
People partnership.
May 2009
| 
