Supporting People Service Review

Service: Eastfield Supporting Independence Scheme. Service Address: Carrswood RAC, Cleeve Green, Twerton, Bath. Service ID Number: 215. Service Address: Adult Care & Commissioning, P O Box 3343, Bath, BA1 2ZH. National ID Number: 10008670. Date: Commenced March 2004, concluded December 2004. Review Officer: Simon Dicker on behalf of Bath & NE Somerset Supporting People Team.

 2. Introduction to Agency 

The ESIT team are based on the site of Carrswood RAC in Twerton. The service provides floating support to people with learning difficulties, the main referral route for the service being through the Community Learning Difficulties Team. The service does not yet have confirmation of an interim base that will be needed during redevelopment of the site over the next five years. Although it is intended to be re-established on the same site, it seems unlikely that they will remain there during the period of construction.

In the main service users have their own tenancies with Registered Social Landlords. In some cases service users being referred to the service are younger people still living at home with their parents, and using support as part of preparation for attaining a first tenancy.

The service has a clear identity and is focused on helping service users maintain supported living placements via low to medium tenancy support.

The levels of skill and experience in the team were found to be highly appropriate for this client group, staff training includes automatic enrolment on the Learning Disability Award Framework, and the service manager has NVQ awards at Levels 4 and 5. Many of the staff also bring considerable experience of working with various different client groups, including prior Learning Disability experience, and/or Physical and Sensory Impairment. It was also noted that considerable effort is made by the team in producing written material in an accessible format for this client group both in direct communication and efforts to modify policies.

Since the initial validation the team have made considerable efforts to embrace the SP framework and the review seeks to recognise and give credit for this.

2.1 Brief History

There is a historical link between the development of the ESIT floating support service, and the former Registered Home at Eastfield Avenue, now re-provided as Supported Living placements.

The service submitted Transitional Housing Benefit claims throughout 2002/3, generally at a medium support level with one high support exception. As a result it was awarded an interim contract from April 2003.

The service’s initial awareness of Supporting People requirements were found to be lower than in equivalent independent / voluntary sector peer organisations, but the service has more of an embrace of the self assessment framework following the review process, evidenced by its timely re-submission. This has helped restore some parity between our contractual relationships with internal and external providers, and the review sought to make clear we cannot offer any additional support to internal services beyond that which we are able to provide to external partners.

2.2 Capacity

Units:   26

Delivery: Across all tenures, including RSL tenancies and private family homes.

Staff Hours:       

1 x FT Manager (37 hours per week)

1 x FT Deputy Manager (37 hours per week)

4.3 FTE Senior Support Workers (160 hours per week)

2.3 Monitoring Information

** - exact percentages are unaccountable from monitoring returns, but validation and dialogues with referrers show that demand exceeds supply.

* - Staffing in excess of 100% refers to excess hours over contracted level provided in a quarter.

2.4 Existing Funding

(Figures given for April 2004 to March 2005, based on reductions from Interim Contract Value to 35% of total service cost from 1/10/04, reducing to 20 % from 1/04/05)

                                                Apr 04 – Mar 05       Apr 05 – Mar 06     

** - Increase to maintain existing overall 04/05 funding levels not yet confirmed by Social and Housing Services Finance Dept. SP funding will reduce to £33,675.30 p.a. if this is not met.

4. Legal / ODPM Guidance on group and type of service

There has been no specific guidance from ODPM on services for People with Learning Difficulties. The review sought to engage funding partners in social services and ensure that any variations in contract value recommended would be agreed via replacement funding. This was felt to be essential to ensure uninterrupted service to the client group that would inevitably follow any reductions in overall revenue.

‘Valuing People’ – “A new strategy for Learning Disability in the 21st Century” (March 2001) is a Department Of Health White Paper that sets out an evaluation of the current position for this client group, and an agenda for “Better Life Chances for People with Learning Disabilities”, with further guidance on delivering change. The review assumed this as the most recent and informative paper steering future provision for this client group.

The programme of change initiated by this White Paper was backed up by regional Valuing People Support Teams, charged with overseeing and supporting the implementation of necessary changes to Learning Disability Service provision.

The influence of this paper with regard to Housing for People with Learning Disabilities is summarised below:

• It is 30 years since such a government paper has been produced which gives firm direction for services for the years ahead.
• The attitudes, the aims and principles that should guide services are formally stated: inclusion, being part of the mainstream, promoting independence, enforceable civil rights, challenging discrimination.
• Housing has an important place in the guidance for the first time: improving choice, having a say in where and how you live, involving and supporting carers. It provides a good platform for raising standards.
• Every local Board has been asked to produce and implement a housing strategy for learning disability. This offers an opportunity for a strategic approach with enormous potential for change for the better.
• There is a commitment required of housing and social care and health organizations to work together on service development and improvement

In addition the following paper from “Housing Options” is derived from the aims of the White Paper includes the following reference to Supporting People:

Supporting People

“Supporting People is a new policy and funding framework for support services that was implemented in April 2003. It brings together resources from several existing programmes into a new grant to local authorities, which can be applied more flexibly to fund support services for people with learning disabilities and for other vulnerable people wherever they live. Local social services and housing authorities, working with other partners including the NHS, will be expected to establish joint arrangements for deciding how to apply the new grant and to integrate the planning and commissioning of support services with the planning and commissioning of housing, care, and health services

In practice this has been very helpful in promoting supported housing options for services but has also proved one of the sources of difficulty for both departments trying to reconcile different agendas.”

Source: housingoptions factsheets 21

The process for agreeing the funding changes at a strategic level was ultimately through the Supporting People Commissioning Body, but was also discussed and agreed as reasonable and pragmatic at a consultation meeting with the Valuing People Support Team represented by Steve Strong (Regional Advisor to the South West) in December 2004.

It is a recommendation from this review that Supporting People contribute to the development of the Learning Disability Strategy with regard to housing options of People with Learning Disabilities.

In this respect the review recommends that the future focus should be Joint Commissioning between Social Services and Supporting People, rather than any previously regarded “pooled budgets”, in order to address the complexities of satisfying the separate agendas of the two allied funding streams.

6. Consultation with Stakeholders

Consultation with stakeholders has been delayed to January 05. This comes after extensive inspection of support plans that were initiated from the first validation visit in March 05, and completed by end of April 05.

6.1 Consultation Findings

As noted above, to be conducted in January 05. Findings will be collated and shared with the service, and issues arising will be added to the ongoing action plan detailed at the end of the report.

7. Evidence and Risk Assessment

Provided that the funding split is agreed as recommended, there will be no increased risk to this service post review. It is hoped that the overall Learning Disability strategy will recognise and formalise the role the service has to play in the continuation of Supported Living provision for People with Learning Disabilities.

At conclusion of review the service is assessed as low risk, although the review noted the uncertainty of future base.

8. Value for Money

(Based on 04/05 costs)

Overall cost per unit per week from total revenue of service:   £147.86

Cost per unit (to Supporting People) per week:                            £53.02

Cost per unit (to Social Services) per week:                                 £94.84                     

Regional Upper and Lower Quartile:          not available                       

National Upper and Lower Quartile:           not available    

(Based on 05/06 costs assuming total overall revenue maintained)

Overall cost per unit per week from total revenue of service:   £150.52

Cost per unit (to Supporting People) per week:                            £30.10

Cost per unit (to Social Services) per week:                                 £120.42

9. Review Outcome / Recommendations and Impact

The review recommends contract renewal at the following value:

Supporting People Annual Contract Value, commencing 1/4/05:

 £39,981 per annum, net of any inflationary uplift for 05/06, conditional on Adult Care expenditure below.

Required contribution from Adult Care Budget, commencing 1/4/05:

£163,533.36 per annum net of any inflationary uplift for 05/06

Block Gross Contract renewal is recommended at three years from 1/4/05 – 31/03/08, subject to approval for joint commissioning as detailed above.

10. Action Plan (completed by the Provider) to address points 1 – 5 above

1.         The service needs to collate their existing evidence at Level B into a file that clearly demonstrates competence across all six objectives at Level B, and shows written targets with timescales that describe how they plan to reach a Level A award.

            Action: AS to agree timescale for 05/06

2.         The service needs assurance via its line managers of their interim base during reconstruction of the Carrswood site.

            Action: JH to raise this issue and identify solution by end of 05.

3.         The service has good strategic potential to develop guidance and good practice on working with younger people with Learning Disabilities in attaining tenancies. It is recommended that this be included in the overall Commissioning Strategy for People with Learning Disabilities currently under development.

            Action: MM to liaise with SP Team over strategy development and service level tiers, to ensure that SP funding is reflected in shared strategic aims.

4.         The service also displayed strengths in partnership working with other organisations providing low level housing related support to this client group, as exampled in the “Keyring” network.

            It is a recommendation from this review that ESIT continue to receive referrals in respect of any individuals needing an increase in support hours over and above the Supporting People contribution, as examples of helping resolve Vulnerable Adult issues to sustain independence was also evidenced through the review.