Supporting People Service Review

Service: Portland Villa. Service Address:  Portland Villa, 1 Portland Road, Bath BA1 2SJ. Service ID Number: 67. Service Provider: The Morpeth Society. Service Provider Address:  2 St Quintin’s Gardens, Royal Borough of Kensington and Chelsea, London, W10 6AS. National ID Number: 100000987. Date: Commenced June 2004, Updated January 2005. Review Officer: Simon Dicker on behalf of Bath & NE Somerset Supporting People Team.

2. Introduction to Agency

The Morpeth Society is one of our smallest contracted partners.

Unfortunately the contract value is in excess of the ODPM definition of a small provider, and they have therefore been subject to the same quality assessment framework as large national providers. Because of their size, Morpeth Society were not in a strong position to adjust to the contract-culture of Supporting People, despite the service being well established and maintained at a consistent high occupancy, previous regimes would have only been concerned with spot-purchasing and individual service user well being.

Robert Cazenove, Manager of Morpeth Society, did attend some Supporting People seminars in Bath before the programme went live, but being based in London is better known to the Royal Borough of Kensington and Chelsea.

2.1 Brief History

The service enables five people with Mental Ill Health to live in Supported Housing with individual tenancies within a communal household focus, near to the Centre of Bath.

The service is in an excellent location within level walking distance of a wealth of amenities and recreation.

2.2 Capacity

Units:   5

Total Staffing hours per week as Contracted:          

Manager (London Based)    2 hours per week

Housekeeper (Non-Resident) at Portland Place:  35 hours per week      

Monitoring Information

* - These figures were accurate for Utilisation as checked at validation, but not submitted via quarterly returns, these have been requested again from the provider.

** - The service does not include an out of hour’s emergency call out, but has well publicised emergency numbers within the premises.

2.4 Existing Funding

Apr 04 – Mar 05       Apr 05 – Mar 06       

*Subject to any inflationary uplift which is yet to be agreed.

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

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.

(Mental Health and Social Exclusion, SEU Report Summary, June 2004)

The review did not identify any further ODPM specific steers for this client group under Supporting People, so recommendations have been drawn from above in reference to the role of Health and Social Care, and Getting the Basics right.

There is no national steer on legacy high support services for People with Mental Ill Health, yet in the main this group alongside Learning Disabilities represent much of the high cost individual long term expenditure for the Supporting People programme. Contracts can be renewed at the same level only when there is ample evidence they are high quality and represent value for money, though this must be within the overall limits imposed by the strategic direction for Supporting People that decides where housing related support fits as a funding stream and to what extent it will contribute.

6. Consultation with Stakeholders

The five service users at Portland Place were offered the chance to discuss the service. Some elected to be consulted via the elected house “spokesperson” who also feeds back to the organisation from the residents meetings, one wished to speak individually and others were not available for comment.

Issues were discussed in the garden of Portland Place at the wishes of the service users concerned.

Feedback from the Community Mental Health Team indicates that Portland Place provides a service that is needed and over-subscribed.

6.1 Consultation Findings

Service users reported high levels of satisfaction with the service they received and their level of involvement in the project, meeting as a household every six weeks. There were no unresolved complaints.

The property was well maintained, and also provides service users with a private garden and greenhouse.

The service users commented on how they appreciated the “housekeeper” role in this model of support, in that it provided a sense of community without the remoteness of more institutional environments, and helped to reduce isolation and anxiety.

There was also strong feeling that the service should be available to people without fixed expectation of move on, other than that determined by the person themselves.

7. Evidence and Risk Assessment

The main risks facing the project are non-compliance with QAF requirements, and monitoring submissions. The provider has restated its commitment to providing support, and indicated that it would not wish to enter into a landlord only agreement.

Failure to retain the units of accommodation at all would present a degree of risk. Although the notice period would allow time to reconfigure a floating support service to existing clients, their housing needs would have to be met as a priority under the Housing register. This would be our last choice of action, given the shortage of supported accommodation in B&NES, and will only occur if the recommendations of this report cannot be achieved by the provider.

I have discussed this with the London Borough of Kensington and Chelsea Supporting People Team and agreed that we undertake a joint accreditation of the Morpeth Society, following their reviews of Morpeth Society services scheduled for spring 2005.  This will also allow any subjective differences in the QAF assessments to be compared and resolved, reducing the risk of appeal from Morpeth on grounds of inconsistency of approach.

The Director of the Morpeth Society is based in this borough and was reported by the Borough to have begun a much closer working relationship with the authority. This is felt to mitigate some risk, encourages the opportunity to facilitate the required changes around service delivery and contractual compliance.

8. Value for Money

Total Unit Cost: per week:                                                                £80.87            

Regional Upper and Lower Quartile:                            £78.31 - £215.02*

National Upper and Lower Quartile:                             £87.52 - £261.85*

The service falls within the regional average for Supported Housing, but falls below the Lower National Quartile.

This represents the lowest level of support for an accommodation based service. The unit price of £80.87 compares well with a Peer Support Scheme Unit cost of £76.52.

* It should be noted that these figures are compiled from services not yet reviewed and as such are likely to be higher than post review contract prices.

9. Review Outcome / Recommendations and Impact

1.         The interim contract with Morpeth Society should be given 12 m notice. It will be made clear to the provider that attainment of the Minimum Quality standards would result in either:

• Invitation to tender for Steady State contract with revised service specifications (whole sector re-tendering) or…
• A further interim contract extending to such date as we retender.

2.         The Morpeth Society are invited to compile evidence to resubmit their QAF self assessment by the 1st June 2005, in order to demonstrate their fitness for a Steady State contract Where Level C is achieved the Morpeth Society will develop an in depth improvement plan for all areas measured.

3.         For any contract renewal purposes, the service should be regarded as Long Term classification, as this reflects the nature of the service and will avoid unnecessary or inappropriate move on targets for service users.

4.         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 any future service. This should then inform the choice of additional QAF objectives to be recommended by the provider and agree with the SP Team.

5.         Conditional on meeting the above recommendations, contract renewal is recommended, with Supporting People as sole funders. This would fit in line with draft eligibility matrices for the low level housing related support provided.

11. Action Plan (completed by the Provider) to address points 1 – 4 above