Memorandum from the Audit Commission (SPP
80)
SUMMARY
1. The Audit Commission is pleased to submit
evidence to the Communities and Local Government Select Committee
inquiry into the Supporting People Programme.
2. The Commission has sought to comment
on the delivery of the 2007 Supporting People Strategy, the
risk and the mitigation of risk in removing the ringfence of funding
and the opportunities the removal might bring.
3. Since 2003 the Commission has carried
out a programme of inspections of all Supporting People administering
local authorities. Inspections were carried out with partner inspectorates
Commission for Social Care Inspection (CSCI) and HM Inspectorate
of Probation (HMIP). Each team also included a service user. In
October 2005 the Commission published a national study called,
Supporting People reviewing the then state of the programme
and made a number of recommendations for the future, these recommendations
are set out in appendix one.
4. The decision to remove the ringfence
was taken in a different regulatory and economic climate. The
recession brings further pressures and heightens risk. It is likely
that more individuals may become vulnerable and need support because
of the pressures of economic recession. There may be an increase
in depression and other mental health problems, and more individuals
may turn to alcohol or drugs and experience the threat of losing
their home. Academic research has shown that compulsory redundancies
are linked to increases in domestic violence.
5. Our response to the first question is
that the government's national strategy "Independence and
Opportunity: Our Strategy for Supporting People" was in the
main successful in raising the profile of the programme. However,
local authority performance in joint working to commission the
delivery of housing related support to vulnerable people varies
across the country. The commitment to support Third Sector providers
has had a mixed response.
6. This submission also makes a number of
observations in response to the question on how to manage the
risk of removal of the ringfenced grant, and associated grant
conditions, to ensure that the successes of the programme are
not lost, and/or services cut. Included in our response are a
number of examples of positive practice from our inspections,
that evidence where the programme has been delivered well. This
includes the identification of opportunities where funding changes
offer further scope for innovation and improvement in the delivery
of housing-related support services.
INTRODUCTION
7. The Audit Commission is an independent
body responsible for ensuring that public money is spent economically,
efficiently and effectively and delivers high-quality local services
for the public.
8. The Commission, as part of its responsibilities,
has inspected and monitored the performance of Supporting People
Administrative Authorities and a number of other related bodies
and services. These include local authority housing departments,
arms length management organisations and housing associations.
Our published key lines of enquiry (KLOEs) set out the main issues
which we consider when forming our judgements on services provided,
the administration and governance of those services, and the involvement
of service users and commissioned providers. The Supporting People
KLOE can be found on the Audit Commission's website on the attached
link Audit Commission Key Line of Enquiry for Supporting People
9. Inspections are carried out by the Commission
using powers under section 10 of the Local Government Act
1999. Since 2003, the Commission has carried out a programme of
scheduled full inspections of all 150 Administering Local
Authorities (ALA) responsible for the Supporting People grant
and associated programme. The programme of inspections was completed
at the end of March 2009 and inspections were carried out
in conjunction with CSCI and HMIP. Each inspection team included
a service user inspector in order to ensure a major focus on the
impact of the programme and its outcomes for those using these
services. Our inspections have therefore assessed the success
of local programmes in meeting the housing related support needs
of vulnerable people and the performance of local authorities,
and their partners, in the planning and commissioning of services.
10. In October 2005, the Commission published
a national study, Audit Commission Supporting People Report Oct
2005 reviewing the then current state of the Supporting People
programme reviewing lessons from early inspections. The report
assessed the progress made in the first two years of implementation
and delivery and made recommendations to central and local government
for future improvement. The Commission's response to the call
for evidence from this select committee is based on the knowledge
of the programme that has been accrued from research, inspection
and performance support over the six years.
COMMUNITIES AND
LOCAL GOVERNMENT
SELECT COMMITTEE
AREAS FOR
INVESTIGATION
1) To what extent has the Government, so far,
delivered on the commitments it made in Independence and Opportunity:
Our Strategy for Supporting People?
11. We have responded to each of the government's
commitments outlined in their strategy and summarised in the executive
summary as follows:
Capture and share best practice about what an
effective, user-focused model of support looks like.
12. The CLG sponsored Supporting People
inspection programme (2003-09) has provided an opportunity to
asses performance across the country and to address issues of
poor performance. The Commission has identified what we term "positive
practice" uncovered in the inspection programme. These examples,
which total 104, are available for all Supporting People related
agencies and can be found through the following link—Audit
Commission positive practice from inspections from April 2006.
13. We are also aware that other innovative
practice has been recorded and shared through CLG sponsored schemes,
such as the Value Improvement Programme pilots. Training workshops
for providers run by SITRA and sponsored by CLG on the Quality
Assessment Framework have helped share learning.
Clearly set out what service users can expect
and influence locally through the development of charters for
independent living, linked to best practice.
14. We found no evidence in our inspections
of the impact, or any improved outcomes for service users, from
the development of charters for independent living in the period
since these were produced
Ensure that people receiving Supporting People
services are kept properly informed about what is happening, particularly
when changes are being made which could affect future delivery
of those services.
15. Inspection findings have identified
improvements in the availability of information for service users,
both in terms of the range and quality of sources of information,
and in the sensitivity of information in meeting diverse needs.
However, the performance of local authorities and of service providers
in communicating change and carrying out consultation on planned
changes is not consistent. The table below indicates the range
of performance found in the ALA's latest Supporting People inspections
published between December 2003 and April 2009.
CURRENT AUDIT
COMMISSION SUPPORTING
PEOPLE INSPECTION
SCORES FOR
ADMINISTERING LOCAL
AUTHORITIES[20],[21]
(PUBLISHED BETWEEN
DECEMBER 2003 AND
APRIL 2009.)
Ensure that access to services is not unnecessarily
restricted through local connections or administrative boundaries,
particularly for groups of people, such as survivors of domestic
violence or gypsies and travellers, who tend to be mobile.
16. There is evidence from inspections that
the needs of some vulnerable groups are not being identified and
met. Notable examples of this are Gypsies and Travellers, refugees
and vulnerable people with HIV/Aids. A small number of local authorities
are operating local connection policies that prevent some vulnerable
people/groups from accessing short term housing related support
services despite grant conditions and clear guidance from CLG
advising against this.
17. The outcomes from data collected to
record the number of service users in receipt of support is of
continuing concern. Cross boundary acceptances have fallen year
on year. This varies by group and by region. There has been no
reduction in the number of people fleeing domestic violence who
are offered support but there has been a reduction in acceptances
for single homeless people.
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.
18. Adult social care adopted Joint Strategic
Needs Assessments (JSNAs) in 2007. These require local authorities,
with their partners in health, to identify the needs of vulnerable
people to inform the planning and delivery of services. Evidence
from inspections shows that progress to achieve JSNAs has been
slow in many areas. Housing related support issues are not uniformly
addressed where JSNAs have been carried out. In the small number
of local authorities where this has been achieved, there is evidence
that it has successfully raised awareness of the importance of
housing related support in addressing the care and support needs
of vulnerable people and has promoted the joint commissioning
of services to meet needs.
Publish a National Housing Strategy for an Ageing
Society which will review current provision and plan for the future
in the context of an ageing society
19. The national strategy is complete and
local strategies have had an impact in local authorities. Examples
of these were found in the Supporting People inspections of Hampshire
County Council and Bolton Metropolitan Council. Evidence from
inspection shows that the expansion in the delivery of floating[22]
housing related support services to older people is resulting
in improved access to services for some vulnerable older people
in the owner occupied and private rented housing sectors. Additional
support for Home Improvement Agencies has helped to deliver tenure
neutral support services to older people. There is more innovative
use of sheltered housing staff to provide services to older people
in the wider community and standards of support to sheltered housing
residents has improved.
20. There is improved understanding of the
contribution that housing related support can make to the health,
well being and independence of older people amongst health and
social care partners. This improved understanding is not yet evident
in widespread joint planning and commissioning of services for
older people but there are some examples where this is in place,
for example, in the approach taken by Surrey County Council and
Tameside Metropolitan Borough Council.
21. Not all authorities inspected have a
strategic approach of their own to housing for older people. There
are examples of local authorities and service providers who have
not managed changes in sheltered housing support services well,
have not involved service users in the decision making processes
and have caused anxiety to older people. The Commission has recently
produced separate research on the provision of services for older
people. Link to Audit Commission report on an ageing population—Don't
Stop Me Now
Enhance service user choice and control by using
the learning from the Individual Budget pilots and other choice
led personal funding mechanisms.
22. There was insufficient evidence in inspections
of the recent promotion and use of pilots, individual budgets
or direct payments, as a means of purchasing housing related support
services for the Commission to be able to assess their impact
or effectiveness.
Enhancing partnerships with the third sector.
— We will commit to ensuring that obstacles
preventing good quality providers from across public, private
and Third Sector organisations from competing fairly to deliver
housing support services are minimised
— Work further with national Third Sector
organisations to ensure that front-line agencies receive appropriate
development and support; and
— Further develop capacity building work
to support and encourage smaller voluntary providers.
23. The evidence from inspections is mixed.
There are concerns, drawn from interviews in the third sector
that their contribution is not recognised and we have found evidence
of this in the level of involvement afforded to third sector providers
in commissioning bodies and partnership working. There are some
local procurement practices that make it difficult for small providers
to tender and the insecurity over existing and future contracts
is undermining the viability of some services.
24. In other authorities, such as Liverpool
City Council and Royal Borough of Kensington and Chelsea, the
skills and expertise of the third sector have been harnessed and
are being used effectively to identify and meet the needs of diverse
groups of vulnerable people. Higher performing administering local
authorities are supporting small third sector providers to compete
successfully in tendering processes.
Delivering in the new Local Government landscape
— Look at how the provision of support
to vulnerable people should best be addressed within this new,
risk-based approach to performance management and inspection.
— Support, develop and share positive practice
in the commissioning, procurement and delivery of housing support,
particularly through the appointment of Regional Champions.
— Work with Regional Assemblies, Government
Offices and Communities England (now known as the Homes and Communities
Agency) to strengthen the strategic and practical linkages between
housing and Supporting People.
25. The Commission is working with its partner
inspectorates to deliver Comprehensive Area Assessments (CAA)
and this includes an assessment of the provision of support to
vulnerable people. CAA promotes a risk based approach to performance
management and inspection.
26. The CLG has promoted positive practice
by establishing a network of regional champions in specific areas
of housing related support activity. We found evidence of the
impact of this work in our inspections of improving Administering
Local Authorities (ALAs). Examples include Warwickshire County
Council and Bradford City Council.
27. The CLG has promoted where authorities
are delivering effective Supporting People programmes as a theme
in their Beacon Status Scheme. Oxfordshire, Salford, Suffolk and
Telford and Wrekin have been granted this status.
2) What are the implications of the removal
of the ring-fence and what needs to be done to ensure that the
successes of the programme so far are not lost, or services cut,
following the change?
28. There are risks to the future of housing
related support. These include the potential loss of:
— The current governance and operating
framework, including the commissioning body and the delivery mechanisms.
This could lead to the loss of partnership working if organisations
retreat into previous arrangements. Whilst effective partnerships
are hard to forge, where they have been established they can continue
to lead to innovation. An example of this was found in the Supporting
People inspection of Tameside Metropolitan Borough Council.
— Needs assessments for housing related
support have been continually updated in better ALAs such as the
London Borough of Westminster and Thurrock Unitary Authority along
with Supporting People/housing related support strategies. There
is uncertainty about the continuing arrangements for updating
housing related support needs and it is unclear whether the JSNA
will be a good enough vehicle for this purpose. The JSNA guidance
for Local Authorities does not reference the inclusion of Supporting
People services.
— Focus on contract renewal. Providers
are nervous about the certainty of their contracts going forward
and some have expressed concern that the removal of the ringfence
could be used to the decrease or remove funding for housing related
support.
— Services to marginalised groups may reduce
further. Inspections have found some groups are still unpopular
and invisible in some authorities. These include refugees, those
with HIV/Aids and Gypsy and Traveller communities.
— Data collection and returns, which are
part of the former grant conditions, will become optional. Information
about services to vulnerable people in communities will not be
collected locally or nationally and will impact on the identification
of provision, need and trends.
— The improved understanding by upper tier
authorities of housing related issues. This is still fresh and
underdeveloped in some cases, but it works well in several areas,
for example Warwickshire County Council.
— The established improvement network.
The network has supported joint working and the sharing of good
and innovative practices which have delivered service improvements.
An example of where this is happening is in Greater Manchester.
— Specialist third sector specialist floating
support and accommodation providers from the market, in favour
of more generic support and provision.
— Preventative floating support services
due to tight budgets in a way which could be hidden due to the
lack of public knowledge on individuals who are supported through
this programme, in favour of more expensive statutory care services.
— The opportunity to increase floating
support and other services to support those who have become new
service users as a result of the recession.
29. There is a need for Supporting People
administering local authorities to be aware of these risks and
to take action, with their partners, to manage and mitigate these
risks. Local authorities might consider the following action in
order to sustain improved services:
— Prepare an assessment of progress to
date, including the outcomes for service users from the investment
made to date (available through the CLG outcomes data); the value
for money achieved over the past 6 years; the impact of service
user involvement; and a summary of the benefits achieved for all
partners.
— The assessment should include reference
to improvements made in safeguarding of vulnerable adults and
children and savings to other service areas (this data is available
from the CLG cost benefits analysis). This should be shared with
the Local Strategic Partnerships (LSP) for discussion and agreement
on proposals for the future approach to maintaining preventative
services. When inspected, Rochdale Metropolitan Borough Council
were found to have an effective Supporting People cost benefit
analysis sub group as part of their LSP, as did Surrey County
Council.
— Continue to promote the planning, procurement
and joint commissioning of services under Supporting People in
order to sustain the identity for service users, providers and
all commissioners.
— Clarify future local joint commissioning
arrangements for providers and, where necessary, renew or determine
outstanding contracts to give more certainty to providers and
users and to assist providers to decide their own future investment.
— Agree ongoing annual reporting to Local
Strategic Partnerships of the involvement and outcomes for service
users; a cost benefit analysis; up to date needs mapping; and
identification of gaps in service provision for vulnerable groups.
— Prepare and agree plans with neighbouring
local authorities for the maintenance of regional, sub regional
and local groups that support the planning, commissioning, training
and development of staff and delivery of housing related support
services including regional implementation groups (RIGs).
And continue established good practice through
the:
— continuation of the collation and reporting
of information under the Quality Assessment Framework (QAF) and
the CLG outcomes framework. The QAF is an annual self assessment
for service providers which measures levels of performance against
six core objectives; needs and risk assessment; support planning;
security, health and safety; protection from abuse; fair access,
diversity and inclusion; and complaints;
— identification of opportunities to expand
choice for service users through the personalisation of housing
related support planning and delivery including the use of individual
budgets;
— identification of opportunities to ensure
that safeguarding issues are raised in the procurement, commissioning
and contract monitoring of services including representation from
officers with an understanding of preventative housing related
support providers on adult and child protection panels when appropriate;
— regular consultation with service users
and providers in a structured way and agree arrangements for their
full engagement and participation in the future planning, commissioning,
monitoring and delivery of housing related support for vulnerable
people; and
— engagement with relevant professional
bodies, advocacy groups and other agencies that are in a position
to inform and influence their members and partners and assist
in the collection and dissemination of positive practice and in
monitoring outcomes for investors and service users.
30. The plan for the removal of the ringfence
on the Supporting People grant and associated grant conditions
were made before the recession. The economic downturn is likely
to lead to an increase in levels of need among some more vulnerable
groups. The risk of new users, increased usage and pressure on
services and providers in the recession may necessitate additional
support from central government to local authorities in managing
the risks.
31. To manage these risks, central government
should consider:
— the monitoring of supporting people going
forward;
— updating guidance on policy and practice
that is allied to housing related support planning and delivery.
This should specifically cover references to joint strategic needs
assessments (JSNAs); safeguarding of adults and children; tackling
social exclusion and worklessness; crime reduction and the rehabilitation
of offenders;[23]
and
— provide information from the outcomes
framework analysis undertaken by St Andrew University in a format
that enables local authorities to share and benchmark performance.
3) What are the opportunities this change
in the funding mechanism will offer for innovation and improvement
in the delivery of housing-related support services?
32. The removal of the ringfence grant may
provide opportunities for working creatively with partners to
secure improved value for money and facilitate joint commissioning
to create wrap around services for, and with, vulnerable people
that expand the choices available to them. The removal of the
grant conditions may allow more flexible funding of services that
can respond to complex needs at the point of need.
33. Our inspections found the ring-fence
and grant conditions have not held back innovative and progressive
authorities. Authorities who received Excellent scores in CPA
assessments have not been subject to grant conditions and adopted
the wider Supporting People framework, despite having the freedom
not to do so.
34. Inspections and advice work have identified
a number of areas where innovation and improvement in delivery
have already taken place and could be enhanced by the removal
of the ringfence and parameters which some authorities have been
reluctant to lose to date. These are:
(a) Norfolk County Council—Joint funding
for people with learning difficulties
(Supporting People Inspection score—Good/two
stars with excellent prospects for improvement. March 2007)
The Norfolk Learning Difficulties Service (pooled
fund managers) were awarded a sum of money (£150,000) to
support people with learning difficulties in accessing private
rented accommodation—grant awarded in 2005-06 from
the Department of Health. The fund was to be used to install and
maintain assistive technology to support the day-to-day activities
of service users and reduce the use of costly care services. Supporting
People awarded £70,000 to provide up to six hours of
housing related support to individuals accessing the service (15 people).
(b) Bolton Metropolitan Borough Council—Older
People Strategic Review
(Supporting People Inspection score—Excellent/three
stars with excellent prospects for improvement. May 2006)
This was conducted with older people, including
sections analysing quality, performance, outcomes and the difference
the programme has achieve to date for older people, together with
future plans. The outcomes have included joint commissioning of
services to promote and maintain independence for older people
with health and social care partners. The authority feels that
the removal of grant conditions will facilitate further pooling
of budgets to achieve shared targets and outcomes.
(c) London Borough of Lambeth—rough sleepers,
responding to the needs of teenage parents and those fleeing domestic
violence
(Supporting People Inspection score—Good/two
stars with excellent prospects for improvement. January 2006)
This is an example of a service jointly commissioned
and funded to tackle social exclusion, in other words outreach
for rough sleepers, assistance with teenage parents, and domestic
violence.
The work was carried out in partnership with
a number of voluntary sector providers, children's services, drug
and alcohol action teams, the Police and in full consultation
with service users.
CONCLUSION
35. Policies and external environmental
changes have developed since our last national report in 2005 and
have introduced new challenges for all areas. These include:
— the move to improve services which better
meet the needs and aspirations of users through expanding choice
and the personalisation of services, including individual budgets;
— safeguarding issues for adults and children
are better understood and given a higher profile but with further
improvement required;
— the regulatory framework is changing,
with the development of Local and Multi Area Agreements, the introduction
of a new national performance indicator set and the advent of
Comprehensive Area Assessment;
— from April 2009 funding for housing
related support is included as a separate line in the local authority
financial settlement. From April 2010 the funding will be
included in the Area Based Grant. The removal of the ring fence
from the grant has led to some uncertainty and lack of confidence
in future service development for providers and service users;
and
— the changed economic climate brings new
challenges to all services.
36. The challenge for the inspectorates,
now that the full inspection programme is complete, is to ensure
that through CAA they effectively identify weaknesses, and ensure
that these are addressed, so that vulnerable people receive the
support they need to remain in their homes.
37. There is important learning about:
— how effective service reviews and quality
improvement can be achieved;
— improved value for money;
— inclusive partnerships;
— efficient commissioning; and
— full service user involvement
that could be considered by other services.
38. The cost benefit of good housing related
support services and their preventative value remains important
in a tighter financial climate. As with all services, the benefits
need to be understood, evidenced and clearly articulated to those
who are responsible for making difficult resource decisions in
difficult times. It goes without saying that maintaining service
funding without a ringfence will be harder going forward.
20 In addition to the summary above out Supporting
People inspections have uncovered 20 other "poor"
(zero star) services which have been re-inspected and have subsequently
improved to "fair" (one star) services or better. Back
21
All of the inspection are available on the Audit Commission website
at link to Audit Commission inspection reports and can a summary
of the scores for each of the ALAs can be made available to the
Select Committee on request. Back
22
Floating support is provided to vulnerable people in their own
homes, as opposed to accommodation based servcies, and the availability
of this approach has been expanded during the six years of the
Supporting People programme in all administering local authority
areas. Floating support is also used to sustain support to vulnerable
people after they have left accommodation based services, for
example, hostels for homeless people, domestic violence refuges
and long stay institutional care. Back
23
These groups mentioned are vulnerable in terms of their housing
and they need support in order to access and maintain a home. Back
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