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Memorandum for the Nottinghamshire Supporting People Team (SPP 31)
The key points of this submission are:
1. That the Supporting People programme in Nottinghamshire has been a hugely successful programme of investment in the provision of support for vulnerable people who would otherwise fall outside of statutory services. 2. That we believe and can evidence that the programme in Nottinghamshire has delivered on its key objectives and on the objectives of the national strategy - in terms of keeping people that need services at the heart of the programme and enhancing partnership with the third sector. 3. That we think it is too early to come to any firm judgements about the impact of the changes that have now been put in place but we have every reason to believe that they will be both an opportunity and a threat. 4. That far too little attention has been given to the significant reductions in grant that authorities like Nottinghamshire have experienced and we think that these reductions (in pursuit of greater equity) will inevitably have negative implications for services and the vulnerable people they support.
1. A Successful Programme
1.1There are many ways in which success can be measured - here are just three ways to illustrate how the programme has been successful in Nottinghamshire:
Access to quality assured services - The SP programme in Nottinghamshire is now able to support the provision of over 200 different services which are accessed by over 21,000 people. These services cover all service user groups and are available across the whole of the county. All services are monitored for their quality on a regular basis and through this monitoring, standards are maintained and outcomes for service users enhanced. There is ample national evidence (e.g. the study of effectiveness of Floating Support) that demonstrates the success of these services in providing a stepping stone back to a more settled and stable way of life.
Individual Case Studies - Here are two case examples which we think illustrate the success of the programme for the people who are its direct beneficiaries: Ø John has learning difficulties - dyslexia and dyspraxia - and is also a heavy cannabis user. He has a history of abuse from his parents, and his mother is now terminally ill. He was not opening mail or attending appointments. Since referral to the support service he has been referred to a GP and a mental health assessment has been completed. He is accessing a drug treatment program. He has also attended a service user involvement meeting around Rights & Responsibilities and his personal hygiene issues have been addressed. Overall, his quality of life has been improved through support with mental health and drugs, he has more money as less is spent on drugs, he is less isolated, he feels safer in his property and has more confidence.
Ø Jane has moderate learning difficulties due to an accident
when she was young. She moved into independent accommodation for first time
after leaving
Service User's Views - these are often the most powerful evidence of success. Our work with service users tells us how much they value the services they receive. In their own words:
"The Project's done wonders for me. I used to run a canteen before I got ill. My biggest fear is big groups of people. We had a bonfire and I arranged it all - they've supported me through that - a year ago I never thought I could have done that "
"It's a bit like a
A longer document on the impact of the SP programme on the lives of service users, from the perspective of service users, is attached.
2. Delivery on Key Objectives
2.1 Two of the key objectives of the national strategy have been to put service user's needs at the heart of the programme and also to enhance partnership working with the third sector.
2.2 In relation to the first objective, the programme has throughout been focused on meeting the needs of the people who use services and has been able to demonstrate that through the outcome of the reviews of every service carried out early on in the programme and since then, through more detailed strategic reviews of service areas drawing on available needs data. Few other service areas can point to such a comprehensive analysis of needs data as the basis for service provision. Furthermore, no other national programme is likely to be able to lay claim to anything like the wealth of data now available on individual services and the outcomes for individual service users.
2.3 Locally this enables us to say, for example, that one provider validated last year who received Level A (the highest available level) in the objectives assessed was able to demonstrate 92% achievement of service users supported to maximise income, 85% successfully supported to manage debt and 44% achieving paid employment (where these needs were highlighted). This kind of detailed information on how outcomes are met is unavailable in many other similar kinds of services funded through other programmes, locally and nationally.
2.4 In relation to the relationships with the third sector, it is widely accepted in Nottinghamshire that the Supporting People Partnership and its governing body, the Supporting People Commissioning Body, represents one of the most successful public sector partnerships that exists in the county. All 7 district councils, the NHS, the Probation Service and the County Council together oversee the delivery of services worth £26 million p.a. A well attended Providers Forum also brings SP providers and commissioners together on a regular basis
3. Impact of Changes to the Programme
3.1 The removal of grant conditions and the inclusion of the SP Grant in the Area Based Grant from next year represent both significant opportunities and also potential threats to the investment in housing related support.
3.2 There is a widely held view that ringfencing is necessarily a 'bad thing' for local government, in that it restricts the ability of local authorities to deploy the resources they have at their disposal to meet local needs according to locally agreed priorities. In practice, the priorities of local government are no longer exclusively - or even primarily- decided at a purely local level but are determined at a national level .This is not to say that they do not have credibility with local people or that they cannot reflect local needs, just that they are linked very directly to delivering on national performance indicators in specific areas of public service.
3.3 In this context, a ringfenced grant can be hugely beneficial in helping to focus resources directly on an issue - like housing related support for vulnerable people - which might otherwise have difficulty "making its case" within the competing priorities of local government. While it may be that a ringfenced grant makes no sense in the context of the 'must-be dones' of local government performance ( why ringfence when the requirement to deliver is so clear ?) but where the obligations to fund services are less clear, then the ringfence is an effective way of supporting minorities whose voices are seldom heard.
3.4 Within our team , we are concerned that the already depleting resources available to fund the services of often marginalised groups will be further depleted by the pressures that will inevitably be placed upon statutory services over the coming years. Removal of the ring-fence could de-stabilise the sector as the SP programme was designed to give some stability to vulnerable service user groups via a single funding stream. With other non- housing related priorities potentially having access to SP funding, it is a strong possibility that there could be less money for the sector - notwithstanding the requirement to perform well on NI 141 and 142. We are inevitably concerned that the most vulnerable groups, who are not necessarily supported by communities and the media e.g. gypsy travellers, offenders, drug and alcohol, mental health etc are more likely to see reductions in services.
3.5 On the other hand, we recognise that the ability to fund some services which are currently 'outwith' the grant conditions - like welfare rights advice, mediation services, drop-in services, befriending - could enhance our ability to support people in their accommodation. More generally, it opens up the way to move 'upstream' with the support that can be offered, to prevent the need for some of the services we are currently funding.
3.6 Putting People First is a huge priority for the government and SP's relevance to this in terms of prevention and early intervention (which is a key PPF theme) cannot be underestimated. Our services can demonstrate that they have kept people out of hospital, residential care, prison, reduced falls in elderly, impacted on drug issues and improved access to primary care services. All of this prevention work is much cheaper than specialised services that would be needed if they were not in place. If SP services are reduced we are convinced that there will be an increase in costs for things such as primary care, criminal justice etc.
3.7 The Quality Assessment Framework used in SP is hugely valuable as a source of data and no other monitoring systems currently used by commissioners that we have seen are as robust as the QAF. Notts SP have used the QAF and validations against the outcomes in it as an opportunity to drive quality up, as we have been very rigorous in its application. Providers acknowledge this and have reflected that we have high standards but this has been important to them in development of quality services. With the lifting of the ringfence, it is vital that there is a clear understanding as to how the QAF will be used. Will it become voluntary and will it be linked to a clear definition of the services where it should be used? If the removal of the ring fence means that the QAF would not be used, quality could be compromised.
4. Reduction in SP funding
4.1 In December 2007 it was announced that over 3 years, the Nottinghamshire share of the national allocation would be reduced from over £25 million p.a to a little less than £22.5 million. Taking (normal) inflation into account, this represents a reduction of almost £5 million - or 20%. It is doubtful that any other area of government expenditure has been reduced by so much and its impact will be significant. In the context of the cashable savings that that the Districts and County Council are required to make, the huge pressures on NHS budgets and significant reductions in the budget of the probation service locally, it is not reasonable to expect partners to somehow fund this shortfall from other income streams.
4.2 Nor is there evidence that the efficiency savings that public sector organisations are expected to make can be replicated in the third sector. So while we will do all we can to manage this reduction in a way that maintains services at current levels, this cannot be guaranteed. And given the huge rise in the numbers of older people (most of our service users are older people) there is no margin for growth.
What benefits do SP funding bring to our service users?
Following are a selection of comments from service users who receive mental health support within Nottinghamshire, gathered during consultation as part of the mental health strategic review. Service Users were asked how the support they receive had helped them, and these are a selection of their comments:
Funding Support Can Empower
It's given me more confidence in myself to take the pressure of my shoulders. Cut my drinking down drastically and the support's there to give me that little push to push myself forward rather than letting someone else do it for me
The Project's done wonders for me. I used to run a canteen before I got ill. My biggest fear is big groups of people. We had a bonfire and I arranged it all - they've supported me through that - a year ago I never thought I could have done that.
It's a
bit like a
Funding Support Can Enable Good Money Management
Money management. They help me to realise what I actually want instead of buying DVDs and other silly things.
I had problems handling my money; staff have helped me budget my money.
Funding Support Can Enable Life Skills
I'm doing a training course in cooking
Helped me with shopping and day to day living skills
Helping me sort the house move out and the debts out and sorting out things like council tax
Funding Support Can Enable A Different Outlook
Has helped me to feel satisfied with what I've got
Being told the name of my worker and what he was going to do for me because I could relate to someone positive. So [support worker] has helped me to see things more positively. It makes you think I'm not the only silly buggar - it gives me a lot of confidence
They've made more independent than I used to be and raised my self esteem
May 2009 |