Supporting People Service Review

Service: Sedgemoor Home Link Service. Service Address: 59 Sedgemoor Road, Foxhill, Bath BA2 5PL. Service ID Number: 10004. Service Provider: Bath & NE Somerset Adult Care & Commissioning Services. Mental Health. Service Provider Address: The Hollies, Midsomer Norton, Bath. Date: Commenced March 2007. Review Officer: Rebecca Potter on behalf of Bath & NE Somerset Supporting People Team.

3. Brief History

The service was last reviewed in December 2004.  The main outcomes and recommendations were as follows:

1.   A clearer division of budgets should be put in place by the service managers to illustrate the core and cluster services separately from its Adult Care Budget funding. This is recommended to enable greater clarity of overheads for each service, and more accurate comparison with regional and national equivalents. These budgets should then be monitored against actual expenditure for each service, as the review could not prove that there was no cross-subsidy between the two.

2.   The service should be congratulated for its engagement with the QAF. It is a recommendation of the review that Sedgemoor Home Support Service resubmits its QAF self assessment for validation in Summer 2005 at Level B across all objectives.

3.   As a recommendation from review the service should identify what key action points from the Social Exclusion report it feels it contributes to, and how that contribution may be developed in 2005. This should then inform the choice of additional QAF objectives to be recommended by the provider and agree with the SP Team.

4.   Overall, the recommendation from review is to extend the interim contract by one year, but on the basis of all 27 units as indicated in Sec 2.4. This will mean monitoring returns in respect of the whole service.

5.   Financial reapportionment of costs to each service:

The maximum Supporting People contribution to Core Units is recommended at 40% of cost in line with draft eligibility matrices, the contribution to the Cluster Units is recommended at 60% of cost. The rationale behind this recommendation is that the core service enables hospital discharge, and also s117 discharge and should therefore be jointly funded with Social Services. The cluster units are long term services so should also be jointly funded with Social Services.

6.   Recommendation to classify the Core Service as Short term maximum 2 years duration, and the Cluster service as long term chargeable.

7.   The service managers should complete the following action plan to state how the above targets will be addressed.

4. Monitoring information

Sedgemoor Home Link Core

0* - No move on

KPI 2a            Percentage of service users who moved on in a planned way

All moved has been planned, the vast majority have moved on through AMOS.

SPI 1a            Percentage availability 

Rates have been consistently high.

SPI 2a            Percentage utilisation

At 96.7% over the last seven quarters, utilisation rates have been reasonable and demonstrate a continued high demand for the service.

SPI 3a            Percentage staffing levels

On the whole, staffing levels have met with the contract requirements.  However, 2006/07 Quarter 4 saw a dip due to a considerable amount of staff sickness.  Temporary staff from Springfield House were used to cover this period.

PI 4a   Percentage turnover

Turnover has been good over the past six quarters, particularly because every move has been a planned one.

Sedgemoor Home Link Cluster

KPI 1a            Percentage of service users who are supported to establish and maintain independent living

Service users continue to maintain independence with the support of the service and 2006/07 saw two service users complete their programme of support.                       

SPI 2b            Percentage utilisation

More than 26 service users had been supported in 2006/07 at any one time by the service.  Data in the workbooks indicates that a maximum of 31 clients have been supported at anyone time. However this appears to have impacted only marginally on staffing levels indicating that  the  same number of support hours have been spread across a larger number of service users. 

This is supported by the Manager of the service who has stated that utilisation has increased due to the service offering a needs led approach which allows flexibility around the number of support hours delivered to individual service users.  Approximately 30% of service users only require very low level support, (average of 1 hour per fortnight).                                                                                

SPI 3a            Percentage staffing levels

Over the last seven quarters average percentage staffing levels delivered have been 97.12%. Quarter 4 2006/07 saw a dip due to a considerable amount of staff sickness.  Temporary staff from Springfield House were used to cover this period.

SPI 4a            Percentage turnover

Turnover is quite low and the figures reflect the fact that as small numbers of users leave, these ‘vacancies’ are filled by new people entering the service.  In addition as pointed out already, because the services is offered on a needs led basis it frequently works with more than 26 individuals.

7. Strategic relevance

The review found that the service fits with the local and national context of strategic relevance in that it enables service users to develop the skills to live more independently in their own accommodation. The review found that the services continued to include the provision of general health, social and personal care including the provision of emotional support and help with activities such as cleaning or shopping.  However both services are jointly funded through Social Services to take account of this

The service contributes to five of the Supporting People 5 Year Strategy 2005-2010 objectives including:

Objective 3 - Working towards the provision of wider choice and a range of high quality services

Objective 4 – Decrease levels of homelessness through the provision of preventative services.

Objective 6 – Providing services that help to promote the health, safety and well being of individuals and of the wider community.

Objective 7 - Providing a range of options for vulnerable people which reduce the need for acute or crisis interventions

Objective 8 – Improving the provision of services for people who may be hard to reach or who are socially excluded.

Social Exclusion Unit Report Summary, June 2004

In Spring 2003, The Prime Minister and Deputy Prime Minister asked the Social Exclusion Unit to consider what more could be done to reduce exclusion among adults with mental health problems. The project focused on people of working age, and asked two questions:

• What more can be done to help adults with mental health problems to enter and retain work?
• How can adults with mental health problems secure the same opportunities for social participation and access to services as the general population?

The report sets out a 27 point action plan to bring together the work of Government departments and other organisations in a concerted effort to challenge attitudes, enable people to fulfil their aspirations, and significantly improve outcomes and opportunities for this excluded group. Action falls into six categories:

• Stigma and Discrimination – A sustained programme to try and challenge negative attitudes and promote awareness of peoples’ rights
• The role of Health and Social Care in tackling social exclusion – implementing evidence based practice in vocational services and enabling reintegration into the community.
• Employment – Giving people with mental health problems a real chance of sustained paid work reflecting their skills and experiences.
• Supporting Families and Community Participation – enabling people to lead fulfilling lives the way they choose.
• Getting the basics right – access to decent homes, financial advice and affordable transport.
• Making it Happen – Clear arrangements for leading this programme and maintaining momentum.

Independence, Wellbeing and Choice

The Government’s recent Green Paper sets out the direction of travel and a range of policy proposals for the future delivery of social care services and has sought feedback from stakeholders on these.

At the core of the Green Paper is a vision of how support for working-age adults and older people could develop, including:

•         making sure adults are treated as adults, and not made more dependent by the way services operate
•         making sure people and their families are central to assessing their own needs and choosing solutions
•         getting people better access to mainstream public services
•         putting support in early, before problems get too great
•         giving relatives and carers more support and recognition
•         letting staff work more creatively, so they can support people to make their own choices and take risks

The proposals in the Green Paper are aimed at making life better for people who use care services in a number of ways:

• Better health
• Better quality of life
• Help to make a positive contribution
• Exercising more choice and control
• Being free from discrimination or harassment
• Greater economic well-being
• Respect for personal dignity

Some other outcomes are implied in the Green Paper. It aims to make people less dependent on professionals and services, and more able to take responsibility for themselves and their families. Sedgemoor Home Link clearly has a key role to play in the delivery, at a local level, of these key national agendas.

Continued