Memorandum from ADASS (Association of
Directors of Adult Social Services) (SPP 108)
SUMMARY
— The use of supporting people funding
to support people's everyday lives has delivered good outcomes
for individuals and avoided the use of more intensive and expensive
services.
— There are still concerns about bureaucracy
and lack of flexibility attached to the funding in some areas,
particularly between county and district councils.
— Removing the ring-fencing should enhance
the flexibility to spend this funding in the most effective way
for local people. The demonstrable value for money of these services
(see first bullet) means that councils will maintain the essential
services needed by the people who have benefitted from supporting
people funding.
— There are concerns that changes to the
allocation formula after removal of the ring fence may permanently
financially disadvantage some councils and potentially these services.
This should be taken into account when designing transition into
the Revenue Support Grant.
INTRODUCTION
1. The Local Government Association (LGA)
promotes better local government. It works with and for member
authorities to realise a shared vision of local government that
enables local people to shape a distinctive and better future
for their locality and its communities. The LGA aims to put councils
at the heart of the drive to improve public services and to work
with government to ensure that the policy, legislative and financial
context in which they operate, supports that objective.
2. The Association of Directors of Adult
Social Services (ADASS) represents Directors of Adult Social Services
in Local Authorities in England. As well as having statutory responsibilities
for the commissioning and provision of social care, ADASS members
often also share a number of responsibilities for the commissioning
and provision of housing, leisure, library, culture, arts and
community services within their Councils and have leadership responsibilities
to promote local access to service, to drive partnership working
to deliver better outcomes for local people.
3. The health and well-being of local people
and communities is a key priority for all councils, and is supported,
promoted and delivered both directly—through the various
areas of council responsibility—and through local partnerships
with NHS and other public authorities, voluntary sector and private
organisations.
4. Local Area Agreements (LAAs) are the
key mechanism for determining and delivering on priorities with
and for local people. They are central to securing better outcomes
for people and communities reflected in the new performance framework
and as such are a priority for all councils and their partners.
Innovative approaches to shaping, commissioning and delivery of
local services is required, and fundamental to this are the following:
— Strategic partnering across local organisations.
— Active engagement of people who use services
and local citizens in thorough assessment of local needs.
— Strategic planning on agreed priorities.
— Alignment and deployment of available
resources.
— Joint or co-ordinated commissioning and
procurement in order to secure effective, responsive and good
value services.
— Effective monitoring and review processes
that involve people who use services to ensure quality and identify
required changes.
5. These components have also been key to
delivery of successes delivered by the Supporting People Programme.
6. The context in which support and care
is and will be delivered now and in the future has changed since
the supporting people programme began in 2003. The recognition
that strong partnerships (rather than separate organisational
responses) are better placed to meet the challenges of demographic
change, increased expectations of choice driven "personalised"
support and care and tightening resources has placed greater emphasis
on "Place shaping" to secure better outcomes for local
people and communities.
7. The focus on securing better outcomes[38]—for
communities as well as for people who use services—and of
local solutions to achieve these has had a number of effects relevant
to the recent and future delivery of the supporting people programme,
including:
— Reconfiguration of organisational arrangements
including separation of children's and adult social care; single
directorates that include adult social services and housing, community
services and other council functions as well as formal partnership
arrangements that include single directorates across council and
NHS services and/or other joint appointments.
— A greater recognition of the importance
of securing good access to universal services in preventative
supports and services across a continuum beyond very targeted
"eligibility"—as for example in adult social care
services.
— That greater attention to the preferences
and choices of people who need support and care is more likely
to deliver better outcomes than buildings based or other service
driven responses.
Have the Aims of the Supporting People Programme
Been Delivered?
8. The Audit Commission's National Report
on Supporting People in 2005[39]
indicated:
— Greater service user involvement in planning
services.
— Improvements in service regulation, quality
and accountability.
— Improvements in Partnership working between
agencies.
— Greater strategic overview, leading to
commissioning of new services where there are gaps in provision.
9. It also noted that improvements had not
been consistently good across all authorities, and that issues
included the long term funding framework and impact of grant reductions
as well as difficulties where local agreements about eligibility
were not in place or were unclear; where there were difficulties
of "Ownership" in local strategic partnerships and where
commissioning bodies were not actively pursuing improvements in
quality and value for money.
10. Similarly, it is recognised that a number
of recent inspections have indicated concerns relating to governance
structure and/or leadership; difficulties with commissioning arrangements
and/or contract monitoring. The LGA and ADASS welcome the fact
that the Audit Commission has been again been commissioned to
review the programme and will be keen to work with partners in
relation to any recommendations that may be made.
11. A Summary of where LGA/ADASS agree that
successes have been achieved is as follows:
— Through Commissioning Bodies, the alignment
of both planning and funding streams across partner organisations
has given greater strategic focus both to the delivery and to
the effectiveness of housing related support and has given greater
focus to the awareness of benefits in linkages between housing
support and adult social care. Previously disparate funding and
commissioning arrangements have been co-ordinated and so have
addressed issues in relation to gaps and overlaps in provision
and so has drawn out a range of service improvements, efficiencies
and improved value for money.
— Greater strategic overview has recognised,
supported and enhanced the importance of third sector—both
in terms of the ability to drive innovation and to achieve improvements
in delivery.
— Greater strategic focus has also given
greater recognition to the importance of establishing a continuum
of support from universal to very targeted services. This in turn
has highlighted the importance of—and value of investment
in—enablement, prevention and early intervention. For example,
supporting people assessments have enabled early identification
of needs—such as depression or support for mobility via
equipment or adaptations, which in turn have supported independence
and prevented the need for "crisis" responses at a later
stage.
— The value of investment in supporting
people services has been supported by research conducted by Cap
Gemini and reported in "Research Into the Financial Benefits
of the Supporting People Programme" in January 2008.[40]
This attempted to quantify the benefits of investment in supporting
people services through consideration of avoidance of costs elsewhere
in the system (eg through admission to hospital or admission to
hospital) and suggested a benefit of £2.77b p/a. A range
of other "Un-quantified" benefits such were also identified,
such as improved health and quality of life; increased participation
and engagement in local communities and reduced burdens on carers.
Although based on assumptions that will change over time, the
model helpfully identifies indicative/illustrative benefits and
we are supportive of the proposal to develop this for local use.
— Improved systems and processes for user
involvement and engagement have supported the development of more
responsive, choice based and personalised services.
— The development of "Floating support"
services has built on the benefits of support to people in "scheme
based" accommodation, providing flexible, personalised support
irrespective of the type of accommodation in which they live.
Floating services give greater access to support services (as
they are not scheme specific) and so enable larger numbers of
people to be supported as well as delivering a number of other
benefits (see Research into the effectiveness of floating support
services for the Supporting People programme[41]),
not least of which is improved independence and quality of life
for people using the service.
— Greater support for personalisation and
choice has been demonstrated through the recent Individual Budget
Pilots.[42]
Supporting people funding was identified as a key ingredient in
developing individual budgets, with some lead officers reporting
it as being integral to success. Further work is needed to develop
this further.
12. A summary of difficulties experienced
with the programme include:
— Numbers of authorities have found the
required reporting overly burdensome and bureaucratic. This has
particularly been the case in two tier authorities.
— There has been frustration about some
lack of flexibility about what funding can be used for and what
have been deemed "eligible" and "ineligible"
services. Again this appears particularly to have been the case
in two tier authorities.
THE EFFECT
OF REMOVAL
OF THE
RING FENCE
13. As indicated above, with only a few
caveats, in a relatively short period the impact of supporting
people has:
— Demonstrated significant success in aligning
and integrating disparate commissioning arrangements.
— Given greater strategic oversight to
the development of services.
— Supported innovative services and delivery,
in particular through partnerships with third sector organisations
and with people using services.
— Highlighted and supported the development
of preventive and personalised services.
14. Concerns have been expressed about removal
of the ring fence—in particular that funding will be diverted
into other services areas. However, removal of the ring fence
does not mean that co-ordinated support to disadvantaged or vulnerable
people is no longer a priority, or that there is no wish to build
on improvements that have been achieved. Additionally, given the
current financial position, it will be essential to ensure that
savings achieved through investment in prevention/early intervention
are maintained and built upon.
15. "Changing Supporting People funding
in England: Results from a pilot exercise"[43]
reports some reservations about the impact of removing the ring
fence, though overall notes that:
"Respondents did not argue in favour of
retaining the existing funding arrangements, instead they saw
opportunities to enhance services through greater freedom of expenditure"
16. The removal of the ring fence—enabling
local partners to determine and deliver on priorities—removes
constraints that have been in place between "eligible and
ineligible" services, gray areas between housing related
support and social care—and so removes constraints from
innovation, enabling, for example "Handyman" and other
preventive services to be funded, enabling greater flexibility
to the further development of floating support services as well
as potential to develop a new generation of specialist supports
responsive to individual user choice and control.
17. Similarly, greater flexibility gives
better opportunities to build on the work of the Individual Budget
Pilots, further integrating funding streams to the benefit of
people needing support.
OTHER
18. A number of authorities have raised
concerns about changes to the allocation formula for Supporting
People funding during the course of the current spending review
and will wish to further press their concerns—in order to
ensure that they are not permanently disadvantaged—in the
next spending review period. The Areas Based Grant guidance 2008,[44]
published details of amounts of Area Based grant that relate to
former specific grants for a transitional period up to the end
of the current spending review. In order to ensure that authorities
can identify and press concerns relating to the current level
of funding it will be helpful for this transparency to continue
for a further transitional period.
May 2009
38 For example, in "Every Child Matters-Change
for Children" (2004); "Our Health Our Care Our Say"
(June 2006); "Strong and Prosperous Communities" (Oct
2006); Supporting People Strategy (June 2007); Back
39
http://www.audit-commission.gov.uk/Products/NATIONAL-REPORT/8864D8E9-48F5-4a64-9FAB-87B049E05B2E/SupportingPeople13Oct05REP.pdf Back
40
http://www.communities.gov.uk/publications/housing/supportingpeoplefinance Back
41
http://www.communities.gov.uk/documents/housing/pdf/floatingsupportresearch.pdf Back
42
Evaluation of the Individual Budget Pilot Programme
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_089505 Back
43
http://www.communities.gov.uk/documents/housing/pdf/supportingpeoplefunding.pdf Back
44
http://www.communities.gov.uk/documents/localgovernment/pdf/706552.pdf Back
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