PAPER B Strategic Rev. of Floating Supp. Project Board SP Core Strategy Development Group SP Commissioning Body 23 March 2006 5th April 2006 12th April 2006
Strategic Review of Floating Support – Future Distribution of Funding for Housing Related Floating Support Services in Leicester
Summary This paper outlines the proposed future distribution of funding for housing related floating support services in Leicester. It also outlines the third and final stages of the Strategic Review. Recommendations It is recommended that the SRFS Board a) Agree the target allocations of funding as detailed in Table 2. b) Note the work required to finalise the Strategic Review of FS services in Leicester.
Background The CB and Project Board agreed that the structure of future floating support services in Leicester should be outcome based, with variable points of contact. The definitions of these outcomes are detailed in Appendix A. On 10th February the CB, agreed that, future funding distribution should be based on a combination of Leicester’s current unit costs and national supply (baseline figures) and judgemental adjustments to account for national and local priorities and for local demographic and prevalence factors. The Board also agreed that where there was no needs information for housing related support available then there should be no increase to the funding currently available to those groups. Proposed Distribution of funding for Floating Support in Leicester Table 1 below outlines the effect of combining Leicester’s SP unit costs with national average supply for floating support into baseline figures. As agreed these have been used for consideration of future allocations of SP funding to the three agreed outcome based service areas split into differential focuses, based around groupings of current client groupings.
Table 1 – Unadjusted allocations to different outcomes based upon Leicester’s current unit costs and national average supply levels Area Focus Percentage Unadjusted Allocation Allocation (£s) Prevention General Prevention Services (aiming To prevent tenancy breakdown) 26.04% 1,228,142 Anti-Social Behaviour 0.00% 0 Support Post-Crisis Resettlement from Hostels 5.89% 277,892 Family Support after Homelessness 6.62% 312,239 Support after Domestic Violence 3.42% 161,315 Support after Offending 2.12% 99,881 Support for Refugees 1.83% 86,463 Support for Travellers 0.00% 0 Support for Young People in their first tenancies 4.85% 228,976 Support for Teenage Parents 1.32% 62,448 Post-Hospital Support for People with Mental Health Problems (bed blocking) 0.00% 0 Long-term independence Support for Older People 18.07% 852,091 Support for People with Mental Health Problems 14.53% 685,195 Support for People with Learning Disabilities and Learning Difficulties 9.28% 437,863 Support for People with Substance Use Problems 3.77% 177,749 Support for People with HIV / Aids 0.00% 0 Support for People with Physical and / or Sensory Disabilities 2.25% 106,272 TOTAL 4,716,526
It is acknowledged that for some client groups there will be a split between individual service users and even whole schemes that could fall within short-term and long-term (e.g. substance use and homelessness). The exact make up of services needed will form part of the final, impact analysis stage. The figures in both tables are based on the current expenditure within floating support in Leicester, with the additional need to make £500,000 per annum savings. Table 2 shows the overall movements in funding from the baseline allocations between the three outcome based service areas following adjustments for national and local factors (as described in paragraph 3.2 above).
Table 2 – Adjustments to national baseline allocations based upon Strategic Aims, local priorities, demographics and prevalence levels Area / Focus Unadjusted Planned Final Allocation Adjustment Allocations Prevention General Prevention Services (aiming To prevent tenancy breakdown) 1,228,142 112,369 1,340,511 Anti-Social Behaviour 0 63,556 63,556 Support Post-Crisis Resettlement from Hostels 277,892 100,000 377,892 Family Support after Homelessness 312,239 (50,000) 262,239 Support after Domestic Violence 161,315 261,315 422,629 Support after Offending 99,881 60,000 159,881 Support for Refugees 86,463 86,463 172,926 Support for Travellers 0 20,000 20,000 Support for Young People in their first tenancies 228,976 0 228,976 Support for Teenage Parents 62,448 (12,448) 50,000 Post-Hospital Support for People with Mental Health Problems (bed blocking) 0 40,000 40,000 Long-term independence Support for Older People 852,091 (727,391) 124,700 Support for People with Mental Health Problems 685,195 (440,000) 245,195 Support for People with Learning Disabilities and Learning Difficulties 437,863 300,000 737,863 Support for People with Substance Use Problems 177,749 177,749 355,499 Support for People with HIV / Aids 0 77,589 77,589 Support for People with Physical and / or Sensory Disabilities 106,272 (69,201) 37,071 TOTAL 4,716,526 0 4,716,526
5 5.1 5.2
Rationale for adjustments made in Table 2 The rationale for adjustments made in Table 2 are detailed below: Prevention Services (+15% over national baseline) Increases in baseline funding were made because a stated aim of Leicester’s SP Strategy is to increase the levels of prevention services and because the ASB scheme fits with the national RESPECT agenda. The allocation for ASB allows the continuation of the SP contribution to the jointly commissioned and funded service currently in operation. Post-Crisis Services Resettlement from Single Homeless Hostels (+36% above baseline) Leicester is an urban area with relatively high levels of deprivation. It also has higher than average numbers of spaces within hostel accommodation, which would suggest a need for more post crisis floating support services. Support for Families after Homelessness (-16% below baseline)
Although Leicester currently has no specific post-crisis floating support for homeless families, it has a higher than average number of hostel spaces for homeless families. Analysis of client record forms indicates that homeless families are however currently receiving floating support via the existing floating support in Leicester. Thus we are not recommending expanding services in this area, just a formalisation or targeting of what is currently being provided within this area. A small reduction from the national baseline allocation is shown due to the ASB scheme, which also goes to families at risk of homelessness being shown separately as a preventative focussed service. Domestic Violence (+162% above baseline) Leicester has higher than average numbers of refuge places and will therefore require higher than average levels of post crisis services. Further, floating support services go to women who wish to stay in their own home following an incidence of DV. Current needs data shows that there was 5,000 incidents of DV in Leicester in 2003/04. A judgement was made that the baseline funding would not be sufficient to offer a reasonable level of service given this prevalence data and the high numbers of refuge provision and the associated risk of harm to service users within this area of not receiving appropriate support. Offenders (+60% above baseline) Leicester has a local prison, which accommodates high numbers of people who originate from Leicester, who will need FS services as they re-integrate into the community. Leicester is also a Criminal Justice Intervention Programme (CJIP) and Drugs Intervention Programme (DIP) area, which seeks to direct drug using offenders out of crime and into treatment. FS services will be essential to support the work of these programmes. Refugees (+100% above baseline) Leicester is a NASS dispersal area, which increases the potential numbers of refugees settling in the City. The decrease in the overall numbers of asylum seekers being dispersed into NASS areas has been factored into the level of increase funding required. Travellers (negligible services nationally) Leicester has no specific service for travellers and there is under provision nationally. This minimal funding of £20,000 would allow the equivalent of roughly one SP funded worker to be focussed on addressing the needs within this area. Young People (no change from national average) Leicester has a larger than average population of young people. Leicester also has more than average numbers of young people in hostel and supported accommodation. It currently has no specific FS services for young people.
Teenage Parents (20% below baseline) One of the schemes being commissioned as part of the Value Improvement Project is specifically focussing on the needs of Teenage Parents. It is felt that this service, with a SP contribution set at £50,000 per year should be sufficient to meet the needs of Teenage Parents within Leicester. The reduction from baseline represents the allocation that would be assigned to Teenage Parents in excess of this already agreed allocation. Bed Blocking (no specific comparative data for this type of service nationally) Needs data has been supplied which suggests a need for a FS service to meet the needs of people with mental health problems as they leave hospital. This data suggests the need for the equivalent of roughly 2 full time support workers. 5.4 Long Term Independence services Older People (85% below baseline allocation) Leicester has lower than average numbers of older people. No needs data has been supplied to support increased funding above its current level of provision. The one exception in this area is needs data supporting an expansion of SP funding to cover Care and Repair type services to BME elders. Thus without other needs data the overall allocation is reduced to the current expenditure levels with a slight increase for a specific BME Care & Repair worker. This is in line with SP Strategic Objectives (as summarised in paragraph 3.2 above). Mental Health (64% below baseline, however see below) A decrease in baseline funding is proposed because it is known that there have been reductions to funding to this group nationally. Locally some accommodation services are likely to be re-designated to floating support services, which is likely to increase the levels of FS to a level closer to the baseline level of funding. A decrease of £400,000 has been assigned which is an estimate of the effect of this, based upon the average national split between accommodation based and floating support services for this client group, compared to Leicester’s split. In addition the specific £40,000 allocation for bed blocking has been removed from this allocation, as that has been considered in a separate area. Even after these reductions, the allocation would suggest an allocation greater than the services currently specifically focussed upon this client group. However, needs data has been received, which suggests a need to increase the levels of floating support services (over and above those that may be re-designated) to this group, thus the need for this increase is evidenced. Learning Disabilities (68% above baseline, however see below) Increases in baseline funding have been proposed because Leicester has higher than average numbers of people with Learning Disabilities
and Leicester has recently re-designated a large proportion of its current supported accommodation for this group as floating support. (A similar calculation has been done with this client group, as with Mental Health above, to estimate the effect of designating more of Leicester’s services as floating support compared with how they are designated nationally). National reductions to funding for this group have been factored into the calculation. Substance Misuse (100% above baseline) Increases in baseline funding are proposed because Leicester has relatively high levels of deprivation and has high numbers of people with substance misuse problems living in the hostels in the City, as evidenced by client record form returns. Leicester is also a CJIP/DIP area, which significantly increases the numbers of people identified for treatment and subsequently requiring FS services. HIV/AIDS (negligible services nationally) Increases in baseline funding are proposed because there is known that there is a significant under-provision of FS for people with HIV/AIDS. For instance, Leicester is the only area in the East Midlands which provides FS to this group. Therefore the baseline funding figure cannot be used to inform funding allocations. Leicester is likely to have higher than average numbers of people with HIV/AIDS. There has been a significant rise in the numbers of positive asylum seekers seen in the current service. This allocation would allow the continuation of the existing service in this area at its current level. Physical/Sensory (65% below baseline) Decreases in baseline funding are proposed because no robust needs information is currently available for this overall client group, thus we would not suggest increasing services beyond the existing provision level. However, needs data for people with sensory impairment was made available and suggests needs that could be met by 1 full time support worker. Thus the allocation is based upon current levels plus the funding for this one additional worker. 6 6.1 Change from the current provision It is very hard to assess directly the change that these proposed allocations will have for specific client groups or outcome levels. This is because current services generally work across several different areas within the new proposals. For example, generic services, almost by definition will work across both prevention and support after crisis areas. In addition services work with client groups where there is no specific provision and where people can easily fall into different categories (eg refugees and homeless families). However, to put some context into the proposals outlined within Table 2 and further described above, Appendix B presents the current and proposed future allocations. Below are highlighted what could be
perceived as the major changes from the current position and comments about these changes: Decrease in generic provision to prevention services Generic services currently provide the only floating support provision to a range of areas defined as post-crisis support (younger people, travellers, teenage parents etc.). Thus it is not comparing like with like to suggest comparing current generic provision with just the prevention area within the proposed new allocations. Decrease in provision for Refugees Although the funding specific to refugees is lower than the current provision, there is a specific allocation for homeless families, which does not exist in the current set up of services. It is likely that there is considerable overlap between these client groups, as it is hard to define when a family stops being labelled as refugees and when they become a homeless family. In addition there is no current specific provision for non-refugee, ‘New Arrivals’ from abroad, who may require very similar types of support as refugees. The combination of these two areas may actually allow an expansion of services over current provision. Decrease in funding for Domestic Violence Floating Support Even with funding over 2½ times the national average number of units for domestic violence, this allocation would still represent a decrease in the funding over current provision levels. This was due to the sector being very proactive in developing services in Leicester prior to Supporting People going live as a programme, thus building up a very high level of provision within the city. The current provision is among the highest cost of all floating support within the city, so it is felt that it may be possible to procure lower cost provision, which may still be able to support as many people as the current services do now. 6.3 Evaluating levels of funding in terms of specific objectives and subdividing to client groups in no way presupposes that future contracts will be set up in this way. Part of the purpose of the impact analysis (see below) will be to determine if a generic service can meet the needs of some or all of the needs for certain groups of service users. It will also determine the extent to which tendering will need to take place for some or all of the reshaped market.
Third & Final Stage of the Strategic Review The timescales for the final stage of the strategic review were unable to be determined until the first 2 stages of the review were complete. This was due to the range of options being consulted upon and the likely difference in time scales they would take to implement. Now that the future structure has been determined (outcome based with variable
points of contact), and the financial allocations have been proposed, the final stage can be fully planned, consulted upon and taken forward. 7.2 A meeting has been arranged for early April 06 for the SP Project Team to consider and recommend the final contract composition, undertake an initial impact assessment and plan for final stage consultation and communication. When determining the proposed contract composition consideration will be given to local procurement rules, maximising existing provision (where appropriate and within procurement rules), minimising service user disruption and risk management issues. The initial impact assessment will be undertaken on the SP Team. This will evaluate the impact on service users, existing providers, referral agencies and inform a change management plan. A consultation event with stakeholders will be undertaken before a final plan to implement new contracts is signed off. All stakeholders will need to be briefed fully and sensitively on decisions made to date, invited to contribute to the impact assessment and provide views on appropriate timescales. The timeliness and clarity of the consultation events and future communication will be paramount to minimise anxiety amongst existing providers (and possibly service users if they are being made aware through providers). Attention will be given to reminding all stakeholders of the original objectives and gaining support to manage the contract changes. Timescales It is proposed that an updated project plan is produced for project board approval shortly after the planning meeting in early April. Consultation events will be planned in as quickly as possible to ensure stakeholders receive a timely update and opportunity to inform the impact assessment. It is anticipated at this stage that contract changes/awards can be achieved within the 06/07 financial year but must be implemented at a pace that is manageable by the team and existing provision.
Appendix A Definitions of Outcome Based Floating Support Services Preventing Crisis (short-term) Preventing loss of home through support (budgeting, networking etc.) Preventing tenancy loss from eviction due to ASB (generally higher need) Support after Crisis (short-term) Prevention of repeat homelessness (i.e. working with people moving on from hostels and / or supported housing) Prevention of re-offending Prevention of losing first home (eg for teenage parents & young people with support needs) Community Integration (i.e. Refugees) Surviving Domestic Violence Preventing bed-blocking Sustaining Independence (long-term) Enabling people to live in the community (e.g. LD, MH, Older People, HIV / Aids, Physical & Sensory Disabilities) Supporting People with Substance Use problems It is acknowledged that for some client groups there will be a split between individual service users and even whole schemes that could fall within shortterm and long-term (e.g. substance use and homelessness). The exact make up of services needed will form part of the final, impact analysis stage.
Appendix B Current Floating Support Provision and Proposed Future Funding Allocations
Current Allocations by Client Group Primary Client Group Current Allocation
Generic 2,190,829 ASB (Homeless Families) 63,556 Single Homeless 428,534 Domestic Violence 547,275 Offenders 161,727 Refugees 250,000 Older People 99,700 Mental Health 163,960 Learning Disabilities 736,607 Substance Use 479,678 HIV / Aids 77,589 Physical / Sensory 17,071 5,216,526 Proposed Allocations by Objective and Specific Focused Area Area / Focus Proposed Allocations Prevention General Prevention Services (aiming To prevent tenancy breakdown) Anti-Social Behaviour Support Post-Crisis Resettlement from Hostels Family Support after Homelessness Support after Domestic Violence Support after Offending Support for Refugees Support for Travellers Support for Young People in their first tenancies Support for Teenage Parents Post-Hospital Support for People with Mental Health Problems (bed blocking) Long-term independence Support for Older People Support for People with Mental Health Problems Support for People with Learning Disabilities and Learning Difficulties Support for People with Substance Use Problems Support for People with HIV / Aids Support for People with Physical and / or Sensory Disabilities TOTAL
1,340,511 63,556 377,892 262,239 422,629 159,881 172,926 20,000 228,976 50,000 40,000 124,700 245,195 737,863 355,499 77,589 37,071 4,716,526
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