Memorandum from Somerset Supporting People (SPP 102)

 

Summary of main points presented as evidence:

 

· The Supporting People programme provides the structure for multi-agency commissioning of housing related support services for vulnerable people.

· The eligibility criteria give clarity and definition to the tasks and outcomes that help vulnerable adults to live independently in their accommodation. It differentiates between what is and is not housing related support.

· The quantity and quality of data collected by CLG since the beginning of Supporting People is a valuable data bank that identifies service user needs and puts them at the heart of commissioning.

· The Quality Assessment Framework states the standards required of Providers not subject to inspection by the Quality Care Commission.

· Support plans are client led, encourage the involvement of other agencies to meet outcomes, and fit the 'Putting People First' agenda. The support can be disaggregated for Individual Budgets if required.

· Mapping and responding to unmet need and waiting list information has led to new services commissioned in Somerset.

· Third sector organisations are well represented in the Provider supply group and range from small charitable organisations to the large registered social landlords.

· Supporting People contributes to a wide range of national indicators in the National Outcome and Indicator set, including the two specific indicators for Supporting People, NI 141 and 142.

· Somerset has had a 23% reduction in government grant between 2003 and 2010. By working with Providers, Supporting People has achieved these savings without significantly reducing the capacity of the services.

· The removal of the ring-fence brings challenges such as the potential for funding to be channelled to fund statutory services, despite the findings of the Cap Gemini report (CLG 2008) that concluded for every £1 spent on housing related support, £1.79 was saved to more expensive services in social care, health, criminal justice, the police and emergency services.

· Removal of the ring fence brings greater opportunities for pooled budgets and joint commissioning of services. This could potentially increase the amount of funding available for housing related support, and could reduce costs for partner agencies.

· Further funding reductions are likely to affect the 'less popular' client groups e.g. people with mental health issues, drug and alcohol problems.

· The number of services in Somerset has been hugely reduced since 2003, creating efficiencies by amalgamating services into one contract and agreeing a block gross capacity.

· Removal of the grant conditions enables commissioning models to be based on outcomes, giving providers greater flexibility in the duration and intensity of support according to individual assessed need, and promoting partnering arrangements to achieve more efficient working. New contracts will promote the personalisation agenda.

Somerset Supporting People Response to the Communities and Local Government Committee Inquiry into Supporting People

 

 

Submission of Evidence

 

Evidence from Somerset Supporting People is submitted under the headings of the four key themes of Independence and Opportunity: Our strategy for Supporting People (2007).

 

1. Keeping people that need services at the heart of the programme

 

1.1 The Supporting People programme in Somerset provides the structure for a multi agency approach through the Core Strategy Group and the Commissioning Body. There are a number of Provider groups who send representatives to the Countywide Provider Group. They then send two representatives to the Core Strategy Group. There are also service user groups and together with service user consultation, the commissioning of services is a collaborative process that is service-user needs-led.

 

1.2 The four key themes for the Somerset Supporting People strategy are prevention, independence, accessibility and fairness. Over 12000 vulnerable people per year receive Supporting People funded services in Somerset.

 

1.3 The Supporting People eligibility criteria have given clarity and definition to commissioners and Providers that focus on the tasks that prevent homelessness, or maintain people's ability to stay living as independently as possible in their own homes. Over time it has led to a move away from housing as the criteria and more to people's support needs. The eligibility criteria make monitoring easier and have raised standards of provision of housing related support.

 

1.4 The quantity and quality of data that has been collected by CLG since 2003 is used to monitor performance and to benchmark services both within Somerset, with similar size authorities and nationally. Client record forms and outcomes forms help commissioners to better understand service user needs, and to put these at the heart of commissioning decisions. Working with providers on their own service statistics drives improved performance. An example is improved move-on times by an accommodation service and a floating support service working more closely together.

 

1.5 In Somerset the number of service users benefiting from Supporting People funding in a year is over 12,000. Client record forms provide evidence that access to the services is fair and equitable:

 

· All age ranges are represented. 38.7% of clients are under 25 years old, 40.2% are aged 25 - 49 years, and 19.7% are over 50 years.

· Males and females are equally represented.

· Referral sources to a service are varied and 21.4% of clients self-refer

· Ethnic origin of clients is well represented for the population of Somerset (6% are not White British).

· 96% of referrals come from within the South West.

· Within the full range of client groups 26% are single homeless with support needs, 12.16% have mental health problems and 9.94% are women at risk of domestic violence.

· 56.5% of clients are in a supported housing service and 43.4% receive a floating support service.

 

1.6 Support planning is increasingly client led and is meeting strands of the government's 'Putting People First' agenda. In Somerset the outcomes form submissions are showing positive feedback for clients, for example in short term services:

 

· 68.62% clients moved on in a planned way.

· 63.01% achieved greater independence.

· Of the 65.64% who needed support to develop confidence and have greater choice a success rate of 85.47% was achieved.

 

1.7 Through the support planning process there is growing integration of services working together. For example The Somerset Drug & Alcohol Action Team (DAAT) and Somerset Supporting People jointly commissioned work on the housing and support needs of drug and alcohol misusers in Somerset. The report shows clear links between a person's security of tenure, availability of housing related support and their success in accessing and being retained in treatment.

 

The information gathered formed the basis of recommendations within the report 'Assessing the housing and support needs of substance misusers in Somerset' (April 2006), which sets out the shared objectives and strategic direction between Somerset DAAT and Somerset Supporting People for the development of supported housing services for substance misusers. Providers for the following client groups are meeting to develop a protocol and map tolerance levels in their services:

· Single Homeless

· Drug & Alcohol

· Rough Sleeper

· Offender

· Young People at Risk

· Young People Leaving Care

 

Similar joint work has taken place in Somerset with the Probation service and Supporting People mapping the housing support needs of offenders and ex-offenders. Research shows there is a clear link between stable housing and reduced re-offending.

 

1.8 The Quality Assessment Framework has raised standards in the sector. As well as setting standards, they are applied consistently across all services and provide an audit trail. Somerset has adopted the new framework and all Providers will re-assess against the new standards in 2009. Contract renewal or new contracts will only be issued subject to a Provider giving evidence that they are meeting the minimum standards across all areas. In some areas, for example Safeguarding vulnerable adults, Providers will be expected to reach beyond the minimum standards.

 

1.9 To map unmet need in Somerset, Providers complete quarterly return forms showing the number of clients who have been refused a service and the reason for refusal. They also submit evidence of number of clients on their waiting lists. This is helping to build a picture of unmet need in Somerset so that services can be commissioned or remodelled to improve access.

 

An example of using evidence of unmet need was when an official street-count in 2007 established there were 10 people sleeping rough in Taunton. Taunton Association for the Homeless (TAH), working in partnership with Taunton Deane Borough Council and Somerset County Council, secured £250,000 of central government funding to refurbish one of its existing projects to provide 7 self-catering move-on bedsits for ex-rough sleepers; and six hostel bed-spaces for rough sleepers who find it difficult to settle in mainstream hostel accommodation. The project opened on 8 December 2008.

 

£127,000 from Supporting People funds the service which enables those Rough Sleepers to secure more permanent accommodation through the completion of a structured support plan. To date there has been 22 Rough Sleepers in the Hostel (with an average stay of 23 days before moving on) and 8 within the move on accommodation. Of those who have left, almost half have done so positively, moving on to more permanent accommodation.

 

2. Enhancing partnership with the third sector

 

2.1 65% of Supporting People funding in Somerset goes to third sector organisations, i.e. charitable organisations, registered social landlords and voluntary not for profit organisations, a total of £11.8m.

 

2.2 62% of the capacity of Somerset Supporting People contracts is with third sector organisations (6822 clients).

 

2.3 Somerset Supporting People has signed up to the Compact with the third sector. There is a commitment to support and build capacity in the smaller voluntary organisations. In some cases the Supporting People funding is the sole source for the service delivery, and Somerset Supporting People works with these providers to help them to ensure their sustainability and resilience to changes in the landscape.

 

2.4 Somerset aims to commission services with third sector Providers with a contract length of 3 years with 12 month extensions whenever possible. This will help reduce uncertainty for the sector providers and also help with sustainability, financial planning and staff retention.

 

3. Delivering in the new local government landscape

 

3.1 There are two Supporting People indicators (NI 141 and 142) in the National Outcome and Indicator set. Both are reported as percentages rather then actual numbers of clients in a service, which can mask the true extent of the performance. In Somerset NI 142, (Number of vulnerable people who are supported to maintain independent living), is in the supporting tier of the Local Area Agreement and a target of 95.49 % has been set.

 

3.2 Somerset Supporting People is also mapping services to other national indicators to show the breadth of outcomes achieved, and is included in other local area agreement delivery plans, for example NI 139 (People over 65 who say that they receive the information, assistance and support needed to exercise choice and control to live independently). Other relevant indicators are those concerning housing, older people, offenders, substance misusers and care leavers.

 

3.3 The removal of the ring-fence of the Supporting People grant will present both challenges and opportunities. The main challenge is seen as the significant potential risk to a non-statutory funded programme. Supporting People must demonstrate that public funding is being wisely spent on services that save on more expensive statutory services. The Cap Gemini report (CLG 2008) showed that £1 spent on housing related support saves £1.79 for other agencies such as social care, health, police, criminal justice, fire and rescue services. A local model being developed by the CLG will help councils make informed decisions, and this is something that Somerset is keen to be involved with.

 

3.4 A challenge when there are limited funds is the potential for reducing funding to less popular client groups, for example people with mental health issues or drugs and alcohol problems. The needs of these vulnerable groups are often met only through Supporting People funds, particularly in preventative work that avoids crises.

 

Analysis of short term outcomes forms for all client groups show that in Somerset

 

· 35.98% needed support to manage their mental health (32.80% national) with a success rate of 78% (national 72.10%).

· 27.82% of clients needed support to manage their substance misuse (27.40% national) with a success rate of 63.35% (55.60% national).

 

3.5 The removal of the ring-fence could lead to increased funding for housing related support services, for example through pooled budgets and joint commissioning. Somerset Supporting People already jointly commission services with Adult Social Care. To ensure accountability there are clear boundaries between what is housing related support and what is care, and the Provider is commissioned to deliver shared outcomes. Joint working leads to efficiency for both commissioners and providers, for example joint contract reviews, and streamlining back office costs.

 

4. Increasing efficiency and reducing bureaucracy

 

4.1 The Supporting People grant in Somerset has reduced from £21,430,845 in 2003 to £16,477,891in 2010, a reduction of 23%. During this time the number of clients being helped through Supporting People has remained constant due to close co-operation with our partners in finding efficiencies and increasing capacity. The majority of Providers have also received annual inflation awards.

 

4.2 The number of services at the start of the Supporting People programme has substantially reduced, and contracts are now awarded as block gross. An example of this is in sheltered housing where small schemes were amalgamated under one contract with the Provider, and a block gross capacity negotiated based on the average number of tenancies and voids in a year. The efficiency has been achieved by close working with providers to agree the changes and has significantly reduced the administration and bureaucracy on both sides for managing the contracts and payments. The process of reducing the number of contracts and streamlining them is ongoing as an efficiency measure.

 

4.3 The aim for the future is for Somerset to commission more outcome-based services that are flexible in the duration and intensity of support that is provided to clients based on their assessed need. The removal of the Supporting People grant conditions will encourage providers to find more innovative ways to meet those outcomes. This will benefit the service user when their needs are assessed and they can agree an individual support plan. It will also enable Providers to find ways to improve value for money.

 

4.4 An example of Somerset Supporting People continuing to find more efficient ways of working is the re-commissioning of the Home Improvement Agency contracts. The aim of this approach is to commission a countywide service with improved access to services that will drive efficiencies and reduce bureaucracy.

 

A multi-agency group of stakeholders has met on a regular basis for the past 12 months. They have carried out a market test analysis and an options appraisal, and written a service specification based on outcomes. Funding for thee years has been secured from Supporting People, Adult Social Care, the district councils and the Primary Care Trust. Somerset County Council Children and young people's services and the Fire and rescue service have been invited to contribute to the service specification where appropriate to meet their agency objectives, and become joint commissioners in the process. The commissioners have agreed to a partnering approach in the new contracts and a tender process is ready to commence. Performance monitoring will be across a range of agency objectives. The new service should provide a seamless service for the client to help them remain safe and well in their own home.

 

4.5 Somerset Supporting People is consulting with Providers to explore new ways of working that will meet the Government's personalisation agenda. A Providers conference is planned in July 2009 to highlight the issues and to hear from other authorities of their experience of introducing Individual Budgets.

May 2009