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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[1] - 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[2] 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[3]. This attempted to quantify the benefits of investment in supporting people services through consideration of avoidance of costs elsewhere in the system (e.g. 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 [4]), 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 [5]. 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 "[6] 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[7], 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 [1] 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); [2] http://www.audit-commission.gov.uk/Products/NATIONAL-REPORT/8864D8E9-48F5-4a64-9FAB-87B049E05B2E/SupportingPeople13Oct05REP.pdf [3] http://www.communities.gov.uk/publications/housing/supportingpeoplefinance
[4] http://www.communities.gov.uk/documents/housing/pdf/floatingsupportresearch.pdf [5] Evaluation of the Individual Budget Pilot Programme http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_089505 [6] http://www.communities.gov.uk/documents/housing/pdf/supportingpeoplefunding.pdf [7] http://www.communities.gov.uk/documents/localgovernment/pdf/706552.pdf |