Examination of Witnesses (Questions 220
- 235)
MONDAY 29 JUNE 2009
MR ANDREW
MEAKIN, MS
VAL BOURNE,
MS JULIE
NIXON AND
COUNCILLOR ANN
MCCOY
Q220 Andrew George: In relation to
the opportunity to complain, what has happened to charters for
independent living? Are you content that that has been rolled
out sufficiently clearly, in your own areas?
Mr Meakin: Reading the CLG strategy,
what charters for independent living were about, setting out what
customers could expect from services, and what we have got is
a leaflet in Stoke-on-Trent that sets out for service users what
they can expect, it is creatively titled, "What you can expect
from Supporting People", and that includes things like you
can expect a support plan, you can expect to be spoken to in a
language you understand, you can expect needs and risk assessments,
you can expect to be spoken to in a respectful way, those kinds
of things, and you can expect help to complain if you need to,
and those kinds of issues that you are talking about.
Q221 Andrew George: Is that something
which is duplicating what you have just described, what Ms Bourne
and Councillor McCoy have just described, in terms of informing
your service users, is that not simply just providing the same
information again?
Councillor McCoy: What, with the
advocacy?
Q222 Andrew George: With the charters,
the charters for independent living.
Councillor McCoy: It is providing
information in an accessible way in whatever form, because strangely
enough, we did a survey to see how people wanted to be communicated,
and we actually thought that e-mail and text would be at the top
of the list, and we found it was not, it was almost down the bottom.
People still wanted either face-to-face or at least telephone
conversations, which surprised us, but obviously that is what
we reacted to because we thought, in this day and age of technology,
people would say, yes, we would like to be communicated, especially
younger people, with e-mail, et cetera, and it is not happening.
Q223 Andrew George: Is there any
term which service users use to describe Supporting People? Because
I imagine that is not probably a term that they themselves would
use. Have they colloquialised it in any way in your own area?
Colloquialised the concept of the service which you are—
Councillor McCoy: Supporting People?
Do you know, I was talking to my colleague here on the way down,
and I was just saying to her that to me, it is quite amazing that
of all the different streams or services, the major service that
people refer to is Supporting People. People know about it, and
that is sort of surprising, because you expect them to sort of
know various things, but that has somehow got some quality and
respect behind it, and I am really pleased about that.
Q224 Anne Main: You may have heard
this question posed to the previous group: do you think—I
would like Councillor McCoy to answer this, since she is an elected
member—that local politicians may try and influence the
reduction in funding to electorally unpopular client groups? You
did actually refer in an earlier part of your evidence that it
was hard to defend it if it was subsumed in a bigger budget. Why
is it hard to defend, and do you think politically, you might
want to push it along, but to keep council tax bills as low as
possible, it might be difficult to defend?
Councillor McCoy: It is always
difficult to defend. As I said to your colleague, if I was just
to say, oh, it is dead easy, you would not believe me, but I think
what we have always done, and I certainly have, since it has been
in my portfolio, is that you need to demonstrate the benefits
to people outside of the service that has been provided, like
the money that is spent on the drug action team. For instance,
people will say, why are you spending that money on these druggies,
and that is their words, not mine, but we work very closely with
probation and police to be able to demonstrate the reduction in
crime. For instance, in the Tees Valley, we have the lowest crime
rates in the Tees Valley.
Q225 Anne Main: Your budget is delivering
a lower crime rate, you are assuming?
Councillor McCoy: I will argue,
as will police, probation, et cetera, that getting people into
drug reduction programmes cuts down crime, cuts down your muggings,
it cuts down shoplifting, whatever, and that is a benefit to the
whole community. Now on other issues, and I have been through
quite a few recently with the press, et cetera, is changing a
service, and people will always accuse you of doing it to save
money, and you might not be doing it to save money, you might
be doing it to deliver the service in a different way and in a
better way, but it is getting that message over. I am a great
believer in approaching the press, I am not frightened of the
press, but get the press involved so they understand the issues,
because people tend to believe what they read in newspapers, unfortunately,
and you will always have a few members who, for whatever reason,
will want to take you to task for whatever political reasons.
We are politicians, we know what that is, but it is to demonstrate
the benefits to the whole community of what you are doing, because
people do not always realise you will be old one day, you will
want this service, you will know somebody with a mental health
problem, because one in four people will have a connection with
mental health services at some point in their life, whether it
is family or not, so you need to demonstrate, and you have to
be very clear, and I am up for the job.
Anne Main: Any other views?
Q226 Chair: The witnesses we had
in our first session were representing women's refuges, services
for homeless young people, I think. They gave the very strong
impression, bluntly, that they did not trust local authorities
to protect those services. You have just spoken very eloquently
about how you, as a local councillor, would protect those services.
I am not blaming you for the whole of local authorities, obviously,
but why are local authorities not getting that message over to
services like that?
Councillor McCoy: I do not know
what authorities they came from, obviously, but I for instance
make a point as cabinet member, I sit on all of our focus groups,
Harbour, Telecare, learning disability safeguarding, whatever
the relevance is to my portfolio. I do not chair them, but I sit
on them. We have users and carers et cetera on all those boards,
to be able to demonstrate that they are important, we want to
listen, we want their input back, and whatever issues come up
I will take that away and come back, and you know what it is like,
sometimes you have to come back and say, "Sorry, that cannot
be done", but at least they have that connection. So I feel
for our authority it works, and there is that confidence there,
but I do know that the third sector, having heard about this going
into the main grant, are quite concerned, quite rightly, and I
would really make a plea, because we work so closely with the
third sector, they do not deserve to have more worries put upon
them. I mean, we work very strongly to get three year funding
packages, because we have a three year financial process in Stockton,
and if that should have to slip back to yearly, that will put
so much pressure, because as soon as they have got one year funded,
they will have to start looking again at the next year, and that
takes up a lot of energy. They have really engaged with governance,
they really have taken governance on board, which is great, because
then you can guarantee best value and best quality, so that is
my plea to you.
Q227 Anne Main: Does any other panel
member feel that it is not an easy argument to make, or that the
long-term slow burn, as somebody else described it, is not an
easy argument to make when budgets are tight, and it may be your
budget that is helping to deliver it, and you might be saving
some funding elsewhere, or necessarily investment elsewhere, does
anybody else find that argument more difficult to make?
Ms Bourne: I think it is a difficult
argument to make when, say, social services colleagues are struggling
for funding to do mainstream delivery, so that is the only time
when it is a hard argument really, when they have to meet their
statutory duties—
Q228 Anne Main: So coming up against
a statutory obligation in another section?
Ms Bourne: Yes, there is a risk,
and that is the risk, that it goes into ABG and it is not ringfenced
and there is a shortfall of budget in a mainstream, in a statutory
delivery.
Q229 Anne Main: So lots of statutory
obligations could mean that the one or two that do not have ringfences
to protect them, your concern is they would be subsumed—
Ms Bourne: That is the concern,
and that is the providers' concern as well. As we have already
said, certainly for Stoke-on-Trent, under the distribution formula,
we do not do very well anyway, so if our care budget is struggling,
et cetera, et cetera, there is more risk in a place like Stoke,
I think.
Q230 Anne Main: In which case then,
as I asked the previous group, do you think there is anything
that should be done to the tools in the CPA or anything that should
be done to ensure that you can measure what you are delivering
better, or demonstrate to make that case?
Ms Bourne: Certainly I think CAA,
Supporting People going into the CAA I think is okay, I think
that will be okay. I think it is important that colleagues in
the Audit Commission get the right questions to ask, so that they
know where to target their questioning, but mostly, I think it
is about talking to the users of the service and to the customers
again. As long as they are going out and talking to customers
and asking customers about the cost benefits, they can see for
themselves, as my colleague here very eloquently talked about
the person in the drug rehab service, it makes a difference to
people's lives, and it is about talking to those people to find
out what those differences are.
Q231 Anne Main: So face to face really?
Ms Bourne: I think certainly a
lot of people in the social exclusion field, drug abuse, mental
health, those complex needs, domestic violence, they value people
actually taking the trouble to listen to them and to hear the
story really, so I do think it is very important.
Councillor McCoy: Could I make
just a quick point?
Q232 Chair: Only if it is additional.
Councillor McCoy: It is very brief,
just thinking about your question about the long-term projects,
and at one time nobody was interested in doing anything that contributed
to prevention, because it did not tick a box. It is so important
that we recognise that some things that are in place are actually
in there as a preventative measure, and we might not see the benefits
for ten or twenty years, but they are just as important.
Q233 Mr Betts: Moving on to another
potential change that might follow from the removal of the ringfencing,
some authorities have made the decision that as there is now no
longer a ringfenced pot of money, that the Supporting People services
will be effectively absorbed into the mainstream commissioning
and the specialist teams that commission the work will be disbanded.
Are either of your authorities going down that route? Would you
have concerns if that was happening?
Ms Nixon: We are not at that point
yet. What we are doing as a council, we are reviewing all of our
services to look at efficiency in transformation projects, so
we will look at Supporting People in the light of that. Certainly
from my point of view as an officer, I have found that independence
really important, and I think the commissioning body may need
to get that focus. I think it is fair to say from Stockton's point
of view, the Supporting People staff, they also commission other
independent living services, so there is some joining up of the
services anyway, so I suppose we are kind of a bit of a hybrid.
Mr Meakin: I think it would be
easy to forget, I think Supporting People has been an extremely
successful programme, and one of those successes has been about
building a skills base in local authorities and within partnerships
for commissioning services around a needs-based approach, particularly
all the work that Supporting People teams went through in reviewing
services very thoroughly in those first three years of the programme,
up to 2006. In Stoke, the Supporting People is based in the housing
services function rather than the social care. I think that has
served the city well in the context of the programme locally,
and I think there would be some risks involved in moving that,
or integrating teams at this stage, because clearly, housing issues
are not necessarily top of the agenda in health and social care
and you need to move to a place where housing is at the forefront
of people's minds in those arenas, because clearly it is very
much an enabling thing in people's lives. Having adequate housing
and being supported in that prevents people from, you know, losing
health if they have it, and helps them to maintain their position
in society.
Q234 Mr Betts: Just moving on to
another potential change, authorities, as has been mentioned several
times, have to focus on cost-effectiveness; many of the Supporting
People services that we have made reference to, or certainly that
we visited the other day, have sort of grown over a period of
time, often with third sector voluntary organisations developing
them, and then the council giving support to something that is
growing, as part of a partnership process. I think the concern
that if we go to tendering, that it will be the organisation that
can deliver the service the cheapest, also you will get what you
tender for and changing that and developing it and altering to
adjust the services will be much more difficult once you are in
the straitjacket of a tender that has been adopted.
Ms Nixon: I think for us, when
we have worked through and extended commissions, we have done
it very much in partnership, because over a period of time, you
have obviously worked with providers to the quality assessment
framework, so you are pitching your service at a high level, you
are working through the costs, and often we have found, we have
had service providers come to us and say, we can actually do this
a little bit differently, and we are able to support another two
service users for the same cost because we are going to do this,
provided we are happy with it, because they know the pressures
that we have been under financially. So we have been able to work
together to drive up efficiencies as well as improve levels of
service.
Q235 Mr Betts: Would a more rigid
tendering regime alter that ability, that flexibility?
Ms Nixon: I think it probably
would. I think for us, obviously, you have to do some benchmarking
around value for money, and when we are looking at services, we
are doing some cost comparators, but because a lot of services
are quite bespoke, sometimes it is quite difficult, you are comparing
apples and pears, so I think you have to get a performance scale
of cost, quality, feedback from service users, and then evaluate
the service on all of those things.
Mr Meakin: I agree with much of
that. I think whether or not a procurement process can be flexible
depends very much on the skills that have been putting it together.
I think procurement can be very flexible and can encourage innovation,
and when it is done right, it does not necessarily set the terms
for the perpetuity of the contract. My experience is, as of my
colleague, that providers do come forward with suggestions and
are very willing to listen to the suggestions of partners as well.
I think the infrastructure of Supporting People in terms of the
commissioning bodies, the core strategy groups, the inclusive
forum, the service user forums, the providers forums that exist
in most authorities still have been a very sound basis for having
those conversations that are about the needs of customers and
not about the needs of services, and then services have been able
to respond to that very positively, and put themselves in a very
good position when it does come to tendering for services that
they will be best placed to take advantage of those opportunities.
Chair: Thank you very much indeed.
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