Memorandum from Anchor Trust (SPP 35)
SUMMARY:
— Anchor Trust is the largest not-for-profit
provider of housing, care and support services for older people
in England.
— The Supporting People programme appears
to have worked well for groups with higher support costs, but
for those with lower support costs, the programme has delivered
a very different experience.
— Sheltered housing should not be part
of the Supporting People regime because the Supporting People
structure is designed for higher-level interventions. The funding
regime fails to recognise the nature of sheltered housing as a
means of delivering low-level support to older people.
— Following the removal of the Supporting
People ringfence, less innovative councils, facing budgetary constraints,
could fail to provide adequate funding for sheltered housing as
an integrated, low-level support service.
— Older people should have choices in how
they wish to live. At Anchor, we believe it is better to have
a joint and inseparable support and housing provider within sheltered
housing settings rather than a separate "floating" support
provider that is not the same as the housing provider; floating
support removes the option of an integrated housing and support
solution for many older people.
— Older people in receipt of Supporting
People funds only receive a small amount per person despite constituting
the main client group for the programme. This funding structure
is undermining sheltered housing for older people and those with
low-level support needs.
— Staff across the sector have experienced
huge increases in workload due to increased paperwork and bureaucracy
associated with the Supporting People funding regime.
— We hope that the end of the ringfenced
budget will reduce the bureaucracy currently associated with allocating
this funding. We also hope that savings made by local authorities
across the country in this area will be channelled into greater
provision for much needed services to older people.
— The link between housing and housing-related
support must remain intact in the socially rented sheltered housing
sector to ensure that the needs of service users come before the
needs of commissioners.
— Supporting People funding should be paid
directly to those eligible for socially rented sheltered housing.
This would enable those individuals to choose whether to live
in a scheme with an integrated scheme manager or to purchase their
housing and floating support separately from a range of providers.
— Underlying any forthcoming proposals
must be the assurance that older people are at the heart of the
decision-making process and that services are tailored to meet
their needs.
ABOUT ANCHOR
TRUST:
1. Anchor Trust is the largest not-for-profit
provider of housing, care and support services for older people
in England. We deliver services through a number of business streams.
Our sheltered housing, Anchor Retirement Housing, provides more
than 24,000 properties, at 700 schemes across the country.
Guardian Management Services provides housing management services
to leaseholders at 6,700 properties at more than estates.
Our model of extra care housing, Anchor Integrated Care and Housing,
has 915 properties across 25 schemes. Each scheme has
a 24-hour on-site care team. Denham Garden Village, our award-winning
retirement village in Buckinghamshire, also uses the Integrated
Care and Housing model. The first two phases of the development
have been sold, with the third now also for sale. When it is completed
in 2010 there will be 326 homes.
2. Our domiciliary care business, Anchor
Care, works across the country to provide home care to people
who need anything from a short weekly visit to 24-hour personal
care. Anchor Homes provides residential and nursing care to 4,000 older
people in care homes across England. Anchor pioneered the concept
of home improvement agencies, and is now the largest sole provider
of such services in England, via its Anchor Staying Put business.
Staying Put's agencies operate in more than 75 local authority
areas, working with a number of other statutory and voluntary
partners in order to meet locally-identified needs across housing,
health and social care.
3. The Supporting People programme funds
the services of Anchor Retirement Housing (sheltered housing to
rent), Anchor Staying Put (home improvement agency services) and
Anchor Integrated Care and Housing (extra care). Grants from the
programme generate approximately £4.7 million of funding
annually for Anchor Staying Put. Supporting People contracts in
Anchor Retirement Housing are worth a similar figure. For Anchor
Integrated Care and Housing they are worth approximately £0.4 million.
ANCHOR TRUST'S
POSITION ON
THE SUPPORTING
PEOPLE PROGRAMME:
4. We are committed to ensuring older people
are able to choose how they want to live. This is supported by
"Lifetime Homes, Lifetime Neighbourhoods'" (February
2008)[12]
aspiration to provide more housing options for older people. Wherever
possible we want to have direct relationships with the people
we provide services to, as opposed to simply the commissioners
of those services.
5. This memorandum is focussed on sheltered
housing, which is the area for which we have the greatest concern
and where we believe the most significant issues regarding Supporting
People are to be found. Overall, our position is that while the
Supporting People programme appears to have worked well for higher
risk groups with higher support costs, the programme has delivered
a very different experience for those with lower support costs.
6. We have concerns about the Supporting
People programme and sheltered housing at both the strategic and
practical levels.
7. At a strategic level, we do not believe
that sheltered housing should be part of the Supporting People
regime. Sheltered housing is a high impact, low cost support service
which should not be subject to the degree of bureaucracy that
is necessary for higher-cost support services eg those for people
with alcohol or drug dependency issues. We therefore welcomed
the statement in the government's "Lifetime Homes, Lifetime
Neighbourhood" strategy document: "There is strong continuing
demand for good quality sheltered and retirement housing. In many
areas retirement housing is sold before it is built and there
are long waiting lists for good public sector housing."
8. Some local authorities in particular
do not seem fully to value sheltered housing. In our experience,
though many councils do welcome and encourage sheltered housing,
a number view it as outmoded. We fear their assessment is based
on the quality of their own provision rather than a clear understanding
of what the best providers have to offer. Innovative councils
with an understanding of the value of sheltered housing in meeting
the outcome framework for Supporting People will no doubt continue
to fund sheltered housing appropriately following the removal
of the ringfence. But there is a concern that less innovative
councils, especially those facing budgetary constraints, could
fail to provide adequate funding for an integrated service.
9. In our discussion document "Anchor
2020: Meeting the challenges of older people's housing and care",[13]
published in 2008, we showed that some sheltered housing properties,
especially those with large numbers of bed-sits, will not meet
the needs of future generations of older people. The rising demands
of the baby boomers, increasing longevity and the associated increases
in care and support needs mean providers face new challenges in
delivering services that meet the next generation of older people's
needs and aspirations. It is clear however that properties with
good space standards and an integrated scheme manager service
are a vital part of the spectrum of options that must remain open
to older people. Our own research indicates that such an option
is extremely popular among older people.
10. We recognise that the introduction of
floating support via the Supporting People regime may be motivated
by an aspiration to create choice for older people. But we have
concerns that it could undermine government's support for sheltered
housing, as expressed in "Lifetime Homes, Lifetime Neighbourhoods".
We see some merit in providing older people with the option of
floating support, particularly if they choose to remain in their
own home, as part of the spectrum of options available to them.
However, the serious concern is that its introduction by Local
Authorities replaces the option of an integrated housing and support
solution for many older people. We believe that it is vital that
this option is not removed. Our tenants tell us they greatly value
this integrated housing and support service. It is also a more
practical business model for the low-level support service in
sheltered housing to be provided by the provider of the housing
element. It is better therefore to have a joint and inseparable
support and housing funding stream in these settings rather than
allow a floating support provider. Our view is supported by research
from Help the Aged. In its "Nobody's Listening"[14]
report, they found that administrating authorities tended to favour
floating support, while older tenants preferred a warden-type
service, where low-level support is delivered alongside housing
services. Two-thirds of all respondents continued to see value
in the warden service, feeling it "dramatically improves
residents' quality of life".
11. Anchor Trust is committed to providing
high-quality sheltered housing which meets the needs and aspirations
of today's older people and the older people of the future. An
integrated scheme manager service (traditionally known as a warden
service), where low-level support is delivered alongside housing
services, is a crucial part of that offering and is something
we remain committed to.
12. Our concerns about the practical delivery
of the Supporting People programme relate mainly to the funding
arrangements. Older people in receipt of Supporting People funds
receive a relatively small amount per person meaning that the
administering of these funds is relatively expensive. This funding
structure is undermining sheltered housing for older people and
for other groups with low-level (but still essential) support
needs. The current funding approach neglects how sheltered housing
as a low-level support service operates. It fundamentally misunderstands
the economic structure of a setting providing these services,
where it is much more economical for us to provide integrated
low-level support and housing, rather than provide housing and
not necessarily provide support services.
13. Further misunderstandings are created
by the bureaucracy required to administer the funding. As the
largest not-for-profit provider we work with around 130 local
authorities in the provision of sheltered housing to rent. However,
differences in funding and administrative practice between local
authorities are vast; as a result it is difficult for providers
to administer efficiently the funding for this programme. Staff
across the sector have experienced huge increases in the workload
due to increased paperwork and bureaucracy associated with the
Supporting People funding regime. This only serves to impact negatively
on residents as it acts as a drain on resources. Our workers are
spending more and more time compiling data, which often replicates
that provided within the Quality Assessment Framework, for administering
authorities. This forces them to spend less time with residents
and on service delivery.
14. As a not-for-profit provider, any unnecessary
spend on administration reduces the resources we have at our disposal
to invest in our services. It would be fair to assume that these
different approaches at a local level among local authorities
mean they too are facing higher administrative costs than could
be achieved if a more consist approach were taken. It is our hope
that the end of the ringfenced budget will reduce the bureaucracy
currently associated with allocating this funding. We would also
hope that savings made by local authorities across the country
in this area will be channelled into greater provision of much
needed services to older people.
ANCHOR TRUST'S
RECOMMENDATIONS:
15. Our view, based on our experience, research
and the experience of our customers, is that the link between
housing and housing-related support must remain intact in sheltered
housing. The needs of service users must come before the needs
of commissioners, and this link goes some way to ensuring that
is the case.
16. While we accept that the removal of
the ringfence and moves towards devolved decision-making are unlikely
to be reversed, we hope that these changes will lead to better
informed councils increasing funding for older people's services.
This must also be supported by greater clarity from government
about its long term strategy for sheltered housing. Establishing
secure and clear funding streams is essential for both older people
and providers to ensure consistent and high quality services.
17. The development of the individual budgets
agenda is an important way in which government can empower service
users. For our sector, in future it could allow those living in
socially-rented sheltered housing the freedom to choose an integrated
housing and support option. We therefore propose that Supporting
People funding be paid directly to those eligible for socially
rented sheltered housing. This would enable those individuals
to choose whether to live in a scheme with an integrated scheme
manager or to purchase their housing and floating support separately
from a range of providers. We are confident that our tenants want
this integrated service - and they should be given the freedom
to choose that option. However, we would make clear that such
a funding solution would not be viable for home improvement services
in the owner-occupied sector. It would introduce further complication
for people dealing with the already complex funding regime for
publicly-funded home improvements and adaptations, which is another
issue.
18. The Department for Communities and Local
Government made the commitment in "Independence and Opportunity"[15]
(June 2007) to "explore the inclusion of housing support
in the emerging Common Assessment Framework for Adults, which
would allow a person's health, social care and housing support
needs to be assessed at the same time". Such a move recognises
the increasing links between housing, health and social care and
is reflected in "Lifetime Homes, Lifetime Neighbourhoods".
This approach supports our view that housing-related support for
those choosing sheltered housing should be funded in line with
the personalisation agenda. Ideally, the forthcoming green paper
on the future funding of social care will provide further reason
to extend this agenda to housing-related support for those choosing
sheltered housing.
19. In conclusion, we would once again emphasise
that underpinning any forthcoming proposals must be the assurance
that older people are at the heart of the decision-making process
and that services are tailored to meet their needs.
May 2009
12 http://www.communities.gov.uk/publications/housing/lifetimehomesneighbourhoods Back
13
http://www.anchor.org.uk/2020/ Back
14
http://policy.helptheaged.org.uk/NR/rdonlyres/652BC405-AA9E-49CB-B7FE-E16A7B0D3A99/0/nobodys_listening.pdf Back
15
http://www.spkweb.org.uk/Subjects/Supporting+People+Strategy+-+CLG/Independence+and+Opportunity+our+Strategy+for+Supporting+People.htm Back
| 
