Examination of Witnesses (Questions 206
- 219)
MONDAY 29 JUNE 2009
MR ANDREW
MEAKIN, MS
VAL BOURNE,
MS JULIE
NIXON AND
COUNCILLOR ANN
MCCOY
Chair: Since we have twice as many witnesses
this time, you will have to be very disciplined. Please do not
feel obliged to give us an answer every question, and if you just
agree with what has been said before, do not even bother.
Q206 Mr Turner: I wonder if you can
tell us your thoughts on the Supporting People programme, whether
or not you think it is fair, could it be made more fair?
Councillor McCoy: Are you asking
in Stockton?
Q207 Mr Turner: I will ask Stockton
certainly, seeing as you have the worst record.
Councillor McCoy: I am sure you
are aware that we have lost over £5 million, and it is going
to take us 14 years to get it back, so from that point of view,
for us, it is a great loss, because of the need that we have in
Stockton.
Q208 Mr Turner: Do you actually think
the formula itself is fair though?
Councillor McCoy: Yes, I think
that is fair, it is just the actual process of getting it back.
Mr Meakin: I think similarly to
Stockton, Stoke is in much the same position. We have a budget
this year of £6.2 million, and the distribution formula estimates
our allocation needed at £13.5 million, so clearly, over
the life of the programme and over the distribution formula, that
is a massive loss to vulnerable people in the city, in terms of
the opportunity cost. What I would say is that really for us,
recognising the history of the programme, the issue of the distribution
formula is the pace of change, and the movement towards an allocation
that is based on need, which for us cannot come quickly enough
really.
Q209 Mr Turner: The answer that we
had from Hampshire in particular mentioned that they did not think
that the formula properly identified the needs for rurality. Stoke
is not a particularly rural area, but Stockton has some areas
of rurality, has it not, or am I wrong there?
Ms Nixon: It has, and we have
looked as a Supporting People commissioning body, and we have
identified need, and the need we have identified is circa £6
million, and the distribution formula was about £5.5 million,
so our local research that we have done equates to there or thereabouts
the distribution formula.
Q210 Mr Turner: So just to wrap it
up, you think the formula itself is a good formula, but the actual
cash needs to follow that formula a lot more quickly?
Ms Nixon: Yes.
Q211 Mr Turner: Just one more, if
I may. You are both not just down on the Supporting People programme,
your other councils are down on their general formula of distribution
grant. Other councils seem to be up in both of those. Does that
cause you any concern? That is a leading question.
Ms Bourne: Yes, I think it certainly
causes us concern, and again, if we think about Supporting People
going into the area-based grant, if our area-based grant is already
not quite what we would like it to be, then again it puts our
SP programme at risk, so where we have talked before about wanting
to keep the ringfence on the SP grant within the ABG, that is
another one of our arguments really, or it could be a challenge
for it, not to have SP ringfenced, because we know our own area-based
grant is already struggling to meet the needs of the city.
Councillor McCoy: My concern is
that because there are so many pressures and there certainly have
been some major ones this year, with Baby Peter, the Mencap review
of the six unnecessary deaths, learning disability, dementia strategy,
last week the report on the gap in funding for 16-18 year olds;
if Supporting People is not identified, the pressures could be
put on that budget. I mean, we have been fairly lucky in Stockton;
as I am sure you appreciate, over the years we have had some good
settlements, I will not deny that, but when those sort of major
pressures are on you, it may be hard to sustain a budget that
is within another budget, because I noticed your question to the
previous people—if I was to say, yes, I could guarantee
that it will not be touched, you would not believe me, because
of these pressures, but they are so valuable in the smaller targeted
service that they produce and the benefits they give to the people
of the borough who are in need, that I think it is vital that
it is ringfenced.
Mr Turner: You obviously work closely
with your primary care trust, and there is a lot of connection
between the social service and that. Is your primary care trust
also below target in its funding, do you know?
Q212 Chair: Just yes or no will do.
Councillor McCoy: Yes, they do
have a deficit that they are working very hard on.
Chair: Hang on, deficit is different.
Q213 Mr Turner: Does the money that
they receive equate to the target that they should be getting,
or are they below target like yourselves?
Councillor McCoy: No, I think
our PCT are on target.
Ms Bourne: I cannot tell you for
Stoke.
Q214 Mr Turner: I think Stoke is
significantly below.
Councillor McCoy: I think ours
is okay.
Q215 Mr Betts: Obviously there is
a whole variety of people in different circumstances who have
been helped through the Supporting People programme. One group,
however, we have had some evidence are perhaps different and ought
to be funded and treated differently are sheltered housing. Do
you feel that is a service that is not really appropriate to be
included with the other provisions inside Supporting People? I
know authorities who have gone down the route of trying to incorporate
it fully have often got into taking away residential wardens and
putting floating wardens in, and there has been some reaction
from sheltered housing tenants about that. Have you any comments?
Ms Nixon: We actually transferred
the local authority council housing sheltered stock and the association
that took them on went through exactly that process, and it was
very unpopular from the residents' point of view, I think on the
basis that the residents had moved into the accommodation with
that service, and I think although we were questioning whether
it did contribute to them living independently, a lot of it was
about peace of mind, that they had the warden there, in addition
to the call that they might have had twice a day, I think it was
just the security that they had someone who was almost like a
befriender, as well as providing services.
Mr Meakin: I think Supporting
People comprises a lot of services, on the face of it, that would
sit well together, if you look at home improvement agencies, floating
support services, accommodation-based services. However, I think
that sheltered housing fits in with the whole principle of building
people's capacity to live independently. I think my colleague
is right that the actual fabric often of sheltered housing meets
people's housing need in terms of freedom from fear of crime and
those kinds of issues, and having a 24-hour on-site presence.
One of the things we have done in Stoke, in response to queries
from customers in sheltered housing, you will be aware that some
customers in sheltered housing qualified for Supporting People
because they were in receipt of housing benefit, and others did
not, and had to pay the Supporting People charges as a condition
of their tenancy out of their own resources. We receive a lot
of complaints from those customers who feel that they are having
to pay for a service that they do not need. Having said that,
that therefore raises the question as to whether we are getting
value for money. It seems that the service is socialising the
costs of support for some across the whole community. In the City
Council sheltered housing stock, we undertook a consultation exercise
as to whether residents would support some of the time of the
wardens being spent supporting other older people in the nearby
community, and largely that was received very positively, and
actually took place, but one of the things that we have learned
from that is that to maximise the use of sheltered housing as
a hub for other services to older people, such as home-based support
for particularly older owner occupiers, for whom there is very
little support available in Stoke, then we need to put in more
resources, and what we have been able to do by working with the
PCT locally is to bring in additional resources for floating support
for older people that would be linked to sheltered housing, and
we are going through the process of commissioning that at the
moment.
Q216 Mr Betts: It has to be built
on top of the resident warden, you have not taken the resident
warden away?
Mr Meakin: No.
Q217 Andrew George: First of all,
my apologies for not being here, I have an overlapping committee
which I just had to deal with. Keeping users at the heart of the
service which you provide, as far as Supporting People are concerned,
I just wanted to get some kind of reassurance regarding whether
the users of Supporting People services are expected to understand
the labyrinth of agencies and authorities that actually have to
enter into contracts to provide those services in the first place.
Certainly a lot of the evidence which we have been given demonstrates
that a lot of users are quite confused by the nature of the services
they are providing, and the way in which they are batted to and
fro. I mean, is that something which you have found that your
users complain about?
Ms Nixon: I would hope that, certainly
from Stockton's point of view, because we do a lot of joint commissioning,
then what we try and do is look at the needs of service users,
and then we bring together the funding streams, providing we have
sufficient resources to be able to fund schemes, so we have done
that certainly with learning disabilities, because there are elements
of that in Supporting People, there are elements about health
and care, so we have tried to bring some of that together for
those very reasons. I think for the service user, they are probably
not particularly bothered about which pot it is, I think it is
more about whether somebody asks them if it is going well for
them; if it is not, do they have an appropriate complaints procedure
to go through. I think the other thing we have done, certainly
the Supporting People commissioning body, periodically, we have
gone and visited our schemes so we can actually talk to service
users, and certainly for me, it has really changed the way I have
thought in terms of some of the commissions, and we had a classic
example of talking to someone who was in one of our substance
misuse schemes, it was a brand new building and I was asking,
is it not wonderful all these things you have here, with this
new accommodation, and I said, what is the best thing that you
have got from this process? What he said was, well, the best thing
for me was being able to get my identity back, and I thought,
that seems a strange thing to say, and I questioned him further,
and he said because he was a substance misuser, had a lot of mental
health problems, he had gone through all kinds of things, sofa
surfing, difficult accommodation, and he had lost every bit of
paper that was about his identity, birth certificate, his driving
licence, everything, and he said when he got fixed roots, he could
start and be that person again. Having those documents, he said,
made him feel that he had roots. So for me, the value of that,
about how that person then felt, and he was talking about training
and employment, that was really useful. Obviously as a commissioning
body, we have the time to fit in those visits.
Q218 Andrew George: Is that the same
in Stoke?
Mr Meakin: I think part of the
purpose of Supporting People services is to help customers to
identify what services they need in order to maintain their independence
in the community, so we include in our service specifications
that part of the role of providers is to help customers identify
which of, as you say, a large range of public sector services
that they need and then provide them with help to access those
services. Again, I would agree with my colleague in that we have
worked with other teams and other functions, such as the drug
and alcohol action team, we worked with them to commission a ten
unit service for people with both housing and drug misuse problems,
and again, that was based on needs assessments that built on conversations
with customers, particularly customers of homeless hostels in
the city, about what kinds of services they would value, and how
they would be able to access them.
Q219 Andrew George: How do you communicate
to users? We are talking about vulnerable users here as well,
and some to whom there may be communication issues. A lot of local
authorities, the agencies, talk in conceptual language which they
may not entirely understand. How do you ensure that they are aware
of their rights, how to complain, what their support plan is?
Can you say anything to the committee and reassure us that the
users are well informed on that front?
Ms Bourne: Certainly in Stoke,
we make sure that all of that is part of our contract, so that
the provider of the service knows that they have to involve the
service user in all of those things, and we certainly make sure
that in contract management terms, when we go in to manage the
contracts, we talk to customers and ask the customers, are you
getting your needs met in these ways, are you receiving the services
that are set out in the contract, in a language that they can
understand. Also one of the things that we will try and do as
well is when we are looking to recommission new services, we will
ask customers to sit on the panel, so we will ask users of services
to sit on the panel who will actually choose the providers, so
we try and involve them as much as we can in that way as well.
Councillor McCoy: I was just going
to say that we in Stockton have a very good advocacy service that
is available for people with learning disabilities, or anybody
who has difficulty understanding, whether that be a carer, user,
so we do provide that advocacy service.
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