Supporting People Service Review

Service: Bath Keyring Network. Service ID Number: 217. Service Provider: Keyring. Service Provider Address: Unit 21a, Easton Business Park, Felix Road, Easton, Bristol, BS5 0HE. National ID Number: 10000278. Date: November 2006. Review Officer: Rebecca Potter for and on Behalf of Bath & NE Somerset Supporting People Team. 

2. Introduction to Agency

KeyRing provides a model of community supported living for people with learning difficulties who want their own place. The service is designed to offer low level support to people based in a network (i.e. small community) of 9 flats, the 10th given rent free to a Community Living Volunteer. The emphasis in KeyRing is on developing peer support relationships between network members to supplement and in some cases reduce reliance on traditionally delivered support.

The Bath network is city centre based and at the time of this review eight members were being supported whilst the ninth network place was vacant.  After a recent staff/organisational restructure KeyRing now delivers low level housing related support to Bath network members through the Community Living Volunteer, the Community Support Worker and the Network Manager.

2.1 Brief History

The service was last reviewed in April 2004 and as such it was one of the earliest reviews conducted by the SP team.  The service had been closely monitored since its establishment in 2003 and as a result the review was carried out with a ‘lighter touch’.  Whilst there were no comparable schemes locally to benchmark/measure unit costs against, the first review concluded that the service provided good value for money with a unit costs of £76.52 per person per week.

The service was found to be strategically relevant to the SP programme because of its emphasis on choice and promoting  independence and the QAF scores were validated at level C.

2.2 Monitoring Information

KPI 1 – The percentage of service users who were supported to live independently

SPI 1 – Percentage availability - Support

SPI 3a – Percentage staffing levels – Whilst there was a dip in Quarter 2, over the course of a year percentage staffing levels even out.

SPI 4a -  Percentage turnover – As a long term service, the turn over is very low

NB – The monitoring does not reflect the fact that there is a vacancy in the Bath network which has existed since 10th July 2006.  An applicant was due to be accepted into the Network.  However, he will  require accommodation in the city centre before he can take up network membership and securing accommodation in the city centre is proving problematic.  Other members live in flats owned by Registered Social Landlords including Somer Community Housing Trust and Knightstone Housing Association  but no firm agreements/arrangements are in place to ensure that future members will be offered accommodation in central Bath as required.  The SP Team has provided information and advice and has recommended that KeyRing approaches individual RSLs and the Homeseekers Team, (B&NES Housing Register), to try to resolve this pressing issue.

2.3 Service Capacity and Funding

* Includes Community Living Volunteer

4. Quality Assessment Framework (QAF) Outcomes

The objectives were assessed as follows:

Needs & Risks

Level  B

KeyRing meets all the criteria listed in Level C and B in the QAF.  Practice is influenced by its belief that people have the right to take risks and to receive support to safely exercise this choice.  Risks and needs are reviewed frequently and service users are fully involved in this process.

To achieve Level A, KeyRing needs to formalise arrangements with external agencies to facilitate and enable joint working, (This has been highlighted in the QAF).

Support Planning

Level B

KeyRing meets all the criteria listed in Level C and B in the QAF. Support plans are outcome focused and reviews and support plan meetings flag up members’ achievements.  The timing of reviews is responsive to service users.

As with Needs and Risk assessments, to achieve Level A, need to formalise arrangements with external agencies to facilitate and enable joint working, (This has been highlighted in the QAF).

Security, Health & Safety

Level A

KeyRing meets all the criteria listed in Level C, B and A in the QAF

Examples  of good practice include:

•       Member are involved in reviewing health and safety policies and procedures and included on the Health and safety subgroup.
•       Professionals, including community wardens and fire safety officers are invited to Members’ Network Meetings

Protection from Abuse

Level B

KeyRing meets all the criteria listed in Level C and B in the QAF.  In particular service users have an awareness of the issues involved and the peer support network model appears to lead to a culture where network members ‘look out for each other’. KeyRing has worked well with other agencies/professionals when concerns in this area have arisen.

Examples of good practice include:

•       Abuse booklet written in easy English and presented in accessible format by the Members Communication Group.  All members have copies of this.

To achieve Level A, KeyRing will need to develop a planned approach to victim support In addition they are currently reviewing their approach to dealing with perpetrators and are working jointly with Social Services on this.

Fair access, diversity and inclusion

Level C

To achieve Level B KeyRing needs to make more active links locally with organisations working with minority and discriminated against groups to promote fair access. The organisation has an awareness of this and has a ‘Diversity Action Plan’ in place.  Level B of this QAF standard requires that fair access targets should be set and monitored.

Examples of good practice include:

•       Work with service users around community inclusion
•       Service users have easy English versions of policies and procedures, Members Handbook and Contract.  These documents are also available on the website.

Complaints

Level A

Keying as an organisation continues to work hard to empower its members to make complaints. The Bath network has received very few complaints, (if any) over the last 12 months. 

Examples of good practice include:

•       KeyRing has a Member Complaints Officer who is informed of a  compliant, (with complainants permission), and can then support the complainant as required.  The MCO reports back to the National Forum on an annual basis.
•       How to Complain Booklet – clear, accessible info for members about how to complain
•       Pre-addressed complaints/suggestions postcard included in members packs which are easy to fill in and send into the KeyRing office

 7. Evidence and Risk Assessment 

Failure to fill network vacancies because of difficulties involved in securing affordable accommodation in central Bath. In Bristol, prospective KeyRing members are given priority on the Housing Register. There are no such agreements in place in Bath and this is clearly a disadvantage as  long-standing vacancies mean that a potential service user is unable to access the service.  This adversely affects value for money.

As KeyRing services continue to develop and expand it has been necessary to recruit additional staff and revisit the allocation of Networks to ensure they continue to be managed effectively. Most recently, The Bath network will no longer be managed by the Bristol Supported Living Manager.  The effect of this change remains to be seen but should be closely monitored by KeyRing.

8. Value for Money

There is a lack of benchmarking information for comparable services nationally. On a local/regional level, unit and hourly costs at the three KeyRing Networks in Bristol and Bournemouth are slightly cheaper than in Bath.  Factors which may account for this include the possibility that the two members of Bristol based staff have higher travel costs when working in Bath.  Also the rent for the CLV’s flat is higher in Bath than in Bristol.

KeyRing appears to be relatively expensive when considering price and the fact that it caters for people who on the whole have low level housing related support needs. (Local floating support services for people with learning difficulties and/or mental health problems range in unit cost from £38 pw to £56 pw with hourly costs ranging from £11.78 to £22.4).  However, outcomes for service users are good and feedback from KeyRing members and other stakeholders suggests that KeyRing is good at encouraging community involvement and in empowering service users. The support is also very flexible; the CLV by definition lives in the community and certainly in Bath is very responsive to the needs and wishes of service users. KeyRing also dedicates a lot of resources, (advocacy and support), to enable member involvement at an organisational level and this has contributed to the high QAF scores.  It is clearly making a contribution towards both local and national strategic agendas as discussed above in Section  3.

One observation would be that management input appears to be on the high side accounting for 1 third of staff time in the Bath Network. This is despite a recent strategic review ( 2005) in which restructuring took place which led to some regional mergers and a change in the management structure.

The existence of the void for the last six month has also adversely affected VfM since SP has continued to pay the full monthly contract price.  The void has had the effect of raising the unit price to £90.21 per week.

9. Review Outcome / Recommendations and Impact

1. The Review found that KeyRing is working at a high level as assessed by the QAF.  it is recommended that they identify 2 supplementary objectives to work towards for their next assessment.
2. KeyRing has a good track record in service user involvement at a local, regional and national level and members feel that they make a genuine difference.  However, they are currently not given the opportunity to be involved in new member selection or the staff/management restructuring.  It is recommended that these opportunities be developed. 
3. KeyRing’s policies and procedures are all presented in accessible formats as far as the use of easy English is concerned and members are involved in reviewing them.  It is recommended that KeyRing shares its expertise with other providers locally. 
4. It is recommended that KeyRing works to fill future network vacancies more quickly.  This will involve a whole package of measures and may include working in partnership to set up protocols with local housing providers to ensure that new members can be suitably accommodated in a timely manner; reviewing the referral and assessment policies and procedures to ensure new members can be identified more quickly, (Is it necessary/useful to keep a waiting list/interest register?) Reviewing how KeyRing publicises it service and any vacancies, (does everyone get to know about vacancies?).
5. The Commissioning Body will need to consider whether SP should suspend/reduce payments when a vacancy persist, and also recommend a reasonable length of time for a vacancy to be fully funded.
6. An action plan should be developed to raise KeyRing’s profile among ‘hard to reach’ groups including BME, socially excluded etc.  Targets should be set and monitored, (although it is accepted that local turnover is low)
7. Ensure that staff on the ground are aware of all training opportunities including the  joint B&NES/PCT training held at St Martin’s Hospital. This is both useful and free.
8. All staff should be encouraged to attend the Vulnerable Adults ‘Alerters’ course run jointly by B&NES and the PCT.
9. The service is relatively expensive, particularly when compared to other low level floating support services and it is recommended that KeyRing explores options of achieving value improvement.  One option would be to increase the capacity of the service.  For example, in some networks, couples are counted as being 1 full member and it seems reasonable that where service users require very low levels of support another low support package/unit could be offered.
10. Information sharing

This report is a public document and will be placed on the Bath and North East Somerset Website.  KeyRing must share the Review recommendations and outcomes with Service Users and complete an Action Plan by March 2007.      

The Review recommends that the contract be renewed the current level, with an inflationary uplift of 2.5%.

Supporting People Annual Contract Value.                                                £38,574.31

Action Plan (completed by the Provider) to address points 1-9 above