Memorandum from Devon's Housing Support Strategic Partnership and Devon's Joint Commissioning Body (SPP 17)

 

SUMMARY

 

Devon can demonstrate a strong set of evidence towards 'Independence and Opportunity: Our Strategy for Supporting People'

 

Devon's housing support is safer, more efficient, and easier to access than prior to the strategy's launch two years ago. Within the strategy's four themes, Devon intends to continue to place the highest priority upon the 'Keeping people that need services at the heart of the programme'. During 2009/10 Devon will increase the number of practical options for people who wish to personally plan the support they need to remain independent.

 

Devon can evidence very good progress with the themes of:

Enhancing partnership with the Third Sector;

Delivering in the new local government landscape; and

Increasing efficiency and reducing bureaucracy.

Devon has used these elements of the strategy to enhance joint commissioning and build financial sustainability into future arrangements. The strategy has provided a valuable framework for linking the housing agenda to the health and social care agenda, which has led to better quality less bureaucratic arrangements - for example joint contracts in Extra Care housing. At the same time, the strategy has helped Devon highlight the unique preventative role that housing support on its own plays in reducing dependence upon less personalised, higher cost interventions.

 

Devon proposes the following steps are taken to ensure that the successes of the programme are not lost, or services cut, following removal of the ringfence:

Authorities are required to involve local communities in decisions about the future of housing & support.

Authorities are required to maintain an effective housing support resource, which is discretely identifiable within their local joint strategic needs analysis and Local Area Agreement.

That the Key Lines of Enquiry (KLOEs) within future inspection criteria, include standards and expectations for preventative commissioning to be part of an authority's evidence of their quality and excellence.

National best practice and guidances should provide leadership and help for localities that need to develop more accommodation based support for those with higher end needs. CLG should address the need for an effective supported housing capital programme.

 

 

INTRODUCTION

 

'Devon Supporting People' is a partnership comprised of commissioners and providers that includes:

 

Torridge District Council

North Devon District Council

West Devon District Council

Mid Devon District Council

Exeter City Council

East Devon District Council

Teignbridge District Council

South Hams District Council

Devon County Council

Devon Partnership Trust

Devon Primary Care Trust

Devon Drug & Alcohol Team

Devon & Cornwall Probation Area

 

Devon Supporting People has assessed local evidence relevant to the CLG Inquiry through consideration of the four themes within 'Independence and Opportunity: Our Strategy for Supporting People'. A table showing Devon's progress and next steps towards these themes comprises Appendix One to this report.

 

Section 3 of this report analyses the evidence against each theme. The analysis goes on to indicate which strategic aims Devon has made the best progress with, and which aims present the greatest challenge. This analysis finishes with a view about the likely impact that removal of the ring fence will have for the theme.

 

Section 4 of this report is an overall conclusion, with suggestions as to the steps that might need to be taken to ensure the continued success of the programme.

 

 

ANALYSIS OF DEVON'S EVIDENCE AGAINST EACH THEME

 

Keeping people that need services at the heart of the programme

 

As a large two tier authority, Devon has been careful to avoid duplicating arrangements that are already in place for service users, carers, and public involvement generally. Wherever possible, the housing support agenda has been integrated into existing partnership board agendas. This approach has ensured consultations are a proper fit with the wider care group strategy, and if necessary investigated in more detail by sub groups working on behalf of partnership boards. Where the service user need or care group type does not easily fit within any partnership board agenda, specific arrangements have been commissioned through consultancies or special interest third sector organisations.

 

In this theme, Devon can evidence good progress with 'Challenging barriers to joined-up interventions', and 'Developing more integrated assessments'. For example, Devon has introduced a new mobile response service for older people that have community alarms. This service has addressed a strong concern of older people living independently, and has been possible to deliver through the joint planning of health, housing providers, and the South West Ambulance Service Trust.

 

In this theme, Devon can evidence an ongoing challenge with 'Developing better communication and consultation with service users', and 'Putting the service user in charge'. Devon has worked closely with service users who are asking to have direct payments for their housing support, and arrangements are being developed to make this option more readily available.

 

In respect of the removal of the ring fence and this theme, opinion varies. On the one hand care groups can see advantages in service activities being more flexible and open to personalisation. On the other hand, care groups recognise that budgetary pressures could result in the prioritisation of critical and substantial needs, over the housing support that is helping people to live independently.

 

Enhancing partnership with the Third Sector;

 

Devon Supporting People has a strong track record of engaging providers, and working in close partnership with them through the introduction of housing support contracts. The establishment of a countywide provider engagement framework by Health and Social Care during 2008, has created opportunities for bringing together providers of both care and community services into a more consistent business environment.

 

In this theme, Devon can evidence good progress with developing a culture of 'partnering' between commissioners and providers.

 

In this theme, Devon can evidence an ongoing challenge with 'Having the right level of reporting, accountability and transparency'. Devon continues to collect staffing data within performance workbooks, which a number of other authorities have ceased collecting.

 

In respect of the removal of the ring fence and this theme, providers have consistently flagged their concerns that housing support resources are at risk if the ring fence is removed. However, local Health and Social Care Strategies ('The Way Ahead') have strong commitments to community services, and the need to support people living independently.

 

Delivering in the new local government landscape

 

Devon Supporting People governance groups have responded positively and energetically to the national and local challenges. The primary care trust has increased its presence and influence towards better health outcomes for the socially excluded, and CLG's Rough Sleeper specialist advisor has commended Devon's joint working. Devon has successfully agreed a strategy for older persons housing & support, and good joint working arrangements have facilitated its implementation. Devon's housing support governance groups have been largely willing to adopt a strategic approach towards improving the alignment of resource to the jointly mapped needs of its communities.

 

In this theme, Devon can evidence good progress with managing funding and Investments, developing stronger, more effective governance, and integrating Supporting People into Local Area Agreements

 

 

 

In this theme, Devon can evidence an ongoing challenge with 'Minimising the burdens and bureaucracy for local government'. Work is underway to simplify subsidy contract processes, and to streamline processes used in performance monitoring.

 

In respect of the removal of the ring fence and this theme, the effect has already been one of stimulating the market. Many providers recognise that removal of the ring fence presents opportunities for them to redesign services in ways that improve the impact they have upon the statutory duties of partners. It is possible that the increased interdependencies between commissioners that removal of the ring fence involves, will lead to closer working, and better scrutiny of plans in advance of commissioning services.

 

Increasing efficiency and reducing bureaucracy

 

Devon's Joint Commissioning Body has supported the development of joint contracts for people that have treatment and care needs as well as housing support. 3 services are already administered on that basis, and work is in progress to establish a further 7 by the end of 2010. Innovative work towards the introduction of performance reward for the remaining 'housing support only' contracts means that by February 2010 Devon will have the means to deliver high efficiency right across its programme. Devon has made extensive use of the CLG 'Research into the financial benefits of the Supporting People programme' to promote understanding and confidence in the programme's investments. The availability of CLG's revised tool for identifying local financial benefits even more accurately is eagerly awaited, and no time will be lost in applying it to joint commissioning ventures of the future.

 

In this theme, Devon can evidence good progress with taking forward the objectives set out in the Supporting People Value Improvement Programme, and having used new technology and business processes to improve efficiency.

 

In this theme, Devon can evidence an ongoing challenge with reducing the bureaucracy and cost to providers of performance monitoring. Work is underway to simplify subsidy contract processes, and to streamline processes used in performance monitoring.

 

In respect of the removal of the ring fence and this theme, it does appear that the ending of specific grant conditions can support greater efficiency and reduced bureaucracy with regards to reporting arrangements. However, removal of standardised conditions also brings the potential for a growth in different types of reporting arrangements which could ultimately result in a greater level of bureaucracy than experienced under the ring fence. Devon's strong governance arrangements will be used to ensure that partners continue to seek consistent reporting criteria, and do not develop multiple requirements for a single provider. Regional working arrangements will be used to try and seek wider consistency where agreement can be found.

Other efficiencies resulting from removal of the ring fence are likely to be found as the new flexibilities become used to personalise services through use of direct payments and individual budgets. Development of single assessments and single care/support plans is a much more straightforward affair where the different elements of a person's package do not have to be fitted to strict external criteria. Packages can be better tailored to the specific outcomes needed by the individual, and as such be less costly for commissioners.

 

 

 

CONCLUSION

 

Devon accepts that removal of the ring fence brings a number of potential advantages for service users, providers and commissioners. However, some risks are also evident. In order to mitigate these risks, Devon proposes the following steps are taken to ensure that the successes of the programme are not lost, or services cut, following the change:

 

Authorities are required to involve local communities in decisions about the future of housing & support.

 

Authorities are required to maintain an effective housing support resource, which is discretely identifiable within their local joint strategic needs analysis and Local Area Agreement.

 

That the Key Lines of Enquiry (KLOEs) within future inspection criteria, include standards and expectations for preventative commissioning to be part of an authority's evidence of their quality and excellence.

 

 

 

Keeping people that need services at the heart of the programme

 

Strategic Aims	How CLG expects Local Authorities/Providers to help	What Devon has done 2007/9	What Devon Plans to do 2009/12
Safeguarding	Work collaboratively; to plan services at the sub-regional and regional levels Engage with, and learn from, the Individual Budget pilots and other choice led personal funding mechanisms Work with us to develop a template for charters to enable independent living. Ensure that there is effective communication with service users and to explain changes properly to service users. Consider how services will need to respond to local demographic changes within their regional housing strategies and sustainable community strategies.	Devon has revised its safeguarding policies and alert pathways, specifically with housing in mind	Safeguarding team will work closely with the Supporting People team to investigate new alerts, and the contracts team will help develop consistent service standards.
Putting the service user in charge	Included provision of housing support in the health & social care local development plan ('The Way Ahead') public consultations	Offer more opportunities for service users to be represented within groups that are developing recommendations for future service design - e.g. learning disability parliament.
Challenging barriers to joined-up interventions	Ensured that housing support provision is within the scope of the Local Involvement Networks (LINks)	Introduce more 'joint' contracts for people that have care and support needs. Devon will use Joint Strategic Needs Assessments to achieve the right level and balance of service for each care group
Getting more service users involved and empowered	Developed a single assessment framework for people that have care and support needs	Make it easier and simpler for people to have a direct payment for housing support, where they want this
Developing more integrated assessments	Drafted an older persons single assessment process for people who have support only needs	Make the pathways into housing support simpler and easier
Meeting the needs of mobile groups and individuals	Worked with CLG to pilot individual Budgets for rough sleepers	Make services more personalised by building on the Individual budget pilot for rough sleepers, and other groups
Developing better communication and consultation with service users	Widened the use of 'floating support' contracts, allowing more choice of tenure for people supported	Introduce more options for 'floating support', especially for older people not in social housing, who want to continue living independently
Exploring alternative service provision models	Developed a range of public facing commissioning strategies for differing care groups	Develop public facing housing support strategies for people with disabilities, and mental health/drug/alcohol problems
Helping service users to make the right choices	Worked with CLG to improve the data quality of the service directory	Publish improved information about housing support services, through the website and 'people that help people' packs
Enhancing the Supporting People Directory of Services

Enhancing partnership with the Third Sector

 

Strategic Aims	How CLG expects Local Authorities/Providers to help	What Devon has done 2007/9	What Devon Plans to do 2009/12
A culture of 'partnering' between commissioners and providers	Authorities: Pass on three year funding certainty to Third Sector providers, Comply with their commitments under the Compact, and with full cost recovery Continue to support innovation, challenge and benchmark processes Ensure that their providers have the level of support they need, Continuing to work with national organisations Providers: Work with local authorities to include service user views in strategy setting, service design and performance management. Support and contribute to the ongoing work to ensure that existing services represent the best possible value for money Continue to ensure that any costs arising from the authority's administrative requirements are transparent.	Devon has launched a countywide provider engagement network that includes 'Supporting People'. In addition to this, Supporting People has hosted specific housing support provider engagement events in advance of contract re-designs or renewals.	Devon will continue to include Supporting People in invites to provider engagement events during 2009. Supporting People Team will host specific provider events in advance of disability and mental health contract changes in September
Having the right level of reporting, accountability and transparency	Devon has used its housing support strategic partnership (HSSP) to consult with provider representatives over service design	Providers' voice at governance meetings will be enhanced by their direct delivery of reports, and case histories.
Support and Capacity Building	Devon has avoided use of short term contracts wherever possible	Devon will continue to use contract lengths of 3 years, in combination with performance assessments
Devon has not attempted to prescribe a level of appropriate management costs	Devon will ensure that value for money and benchmarking exercises continue to place an appropriate weighting on quality of provision
Devon has consulted on and published plans for joint contracts, to achieve reduced bureaucracy	Devon will seek more use of unified contracts and performance monitoring where people receive care & support
Devon has been well represented at national and regional partnership events	Devon is Chairing the Regional group for Supporting People during 2009
Devon's sheltered housing provider forum has played a pivotal role in preparing the sector to develop the capacity needed in the future	Devon will refer closely to the sheltered housing provider forum throughout the service redesign of older person's housing support

Delivering in the new local government landscape

 

Strategic Aims	How CLG expects Local Authorities/Providers to help	What Devon has done 2007/9	What Devon Plans to do 2009/12
Forging new relationships and making the right links	Bring together and lead the wider range of commissioners, providers and stakeholders Ensure that the remit and responsibilities of the Commissioning Body remains clear and up to date, and that the Commissioning Body is receiving timely and accurate information. Make housing support part of Devon's coordinated approach to delivering for the most disadvantaged and vulnerable people Supporting People is integrated within their future Local Area Agreement frameworks. Adhere to full cost recovery principles for service providers in commissioning services. Prepare to deliver their Supporting People programmes through their new area based grant by April 2009	Devon has strengthened and built upon the relevance of its commissioning groups for housing support, i.e. HSSP and JCB	Devon will merge its DAAT Social Inclusion group and homelessness steering group, and secure closer working with Devon Partnership Trust
Developing stronger, more effective governance	Devon's JCB has agreed a finance strategy for 2008/12, and is working to clearly defined finance principles which align housing support to the conditions applying to Area Based Grant.	Devon will regularly report progress and obstacles towards delivery of its finance strategy, at governance meetings.
Integrating Supporting People into Local Area Agreements	Devon has addressed the question of how people that are hard to reach or excluded from accessing housing support in its homelessness and older persons strategies	Older persons will begin to be able to access housing support irrespective of tenure from February 2010. Homelessness services will continue to widen their brief to work with migrant workers and gypsies and travellers
Developing new PSAs	Devon has developed a local target for improving the housing options of vulnerable people - LAA 27	Devon Supporting People's work programme has been set against the Local Authority Performance Framework. As work is carried out, housing support's contribution to local targets will be captured
Developing a Supporting People outcomes set	Devon has established a joint agency reference group for developing the performance criteria being applied to the non guaranteed element of contracts	Supporting People will manage its budget and reward high performance through means of performance assessments
Minimising the burdens and bureaucracy for local government	Devon has produced good quality outcomes reports which have been used to develop strategy - e.g. rough sleepers	Devon will use its outcomes data to gain a better understanding of improvements needed to services
Promoting and sharing positive practice	Devon has used the Capgemini research into the benefits of supported housing to influence clinicians understanding	Devon will use CLG's revised tool for assessing the local benefits of housing support at the earliest point possible
Funding and Investment

 

 

Increasing efficiency and reducing bureaucracy

 

Strategic Aims	How CLG expects Local Authorities/Providers to help	What Devon has done 2007/9	What Devon Plans to do 2009/12
The Supporting People Value Improvement Programme (SPVIP)	Make appropriate use of their local work to include and take forward the objectives set out in the SPVIP, particularly in relation to maximising value for money, and encouraging local projects where none are yet in place. Recognise the costs associated with their information requirements, and to think about whether they really represent best value for money. Benchmark service costs, to identify areas where further potential improvements could be made. Work together regionally to benchmark administrative requirements and costs, to try to minimise these costs and free-up more money for frontline delivery. Apply improvements and efficiencies and administration through application of Business Process Improvement and mobile technology.	Devon has engaged with the Essex and Thurrock Value Improvement Project, and shares elements of their plan to achieve efficiencies through rationalisation of contracts and performance reporting.	Devon's JCB incorporated the Thurrock VIP principles into its 2009/12 finance strategy, and will develop more joint contracts with greater efficiency for people with care & support needs
Reducing Bureaucracy	Devon has used information collected from providers to negotiate greater efficiencies	Devon will use the Supporting People management information suite as part of the performance assessment applied to non guaranteed elements of contracts
Using new technology and business processes to improve efficiency	Devon has used the national outcome data to gauge the impact of investment made into relieving winter pressures
Devon has invested in a regional benchmarking tool for housing support unit costs	Devon Supporting People will utilise benchmarking of unit costs as part of performance assessments, and throughout contract renewal/tender.
Devon has reviewed its Home Improvement Agency contract, and identified improvements needed to handling of management information	Devon will review guidance and deliver training to staff managing this information. Generally, HIA processes will be clarified and made simpler.
Devon has integrated a number of administration functions of the Supporting People Team, into the mainstream business activities of Health, Housing and Social Care	Devon Supporting People will continue to identify opportunities for team activities to be mainstreamed in departments and organisations, e.g. Service Improvement Plans, performance monitoring
Devon's JCB finance strategy for 2008/12 sets out the framework that will be used to scrutinise the programmes budget, and the measures that will be applied to deliver efficiency savings as they are needed.	Devon will refresh and improve the templates used for finance reporting, .

 

April 2009