"Event write up - London"
Response to “Creating Sustainable Communities: Supporting Independence”, ODPM‟s consultation document on a Strategy for the Supporting People Programme 1. Introduction This report is a response to “Creating Sustainable Communities: Supporting Independence”, ODPM‟s consultation document on a strategy for the Supporting People (SP) Programme. It focuses on issues that could have a significant impact on small providers and the service users they support and raises wider issues that will potentially impact on people and groups on the margins of housing provision and society and the organisations that support them. Small providers have a key role to play in providing housing-related support services and have very particular experiences within the Supporting People framework. Key issues include: the ability of small providers to identify pockets of unmet need that will not show up within more generic statistical analyses, and to develop solutions to meet these needs; the disproportionate impact of paper-based quality and monitoring systems on small specialist services operating with a limited infrastructure; the need to build the capacity of small providers to deliver services within a contractual relationship, and to build the capacity of commissioners and contract managers to enter into productive partnerships with small providers. 2. About hact‟s Supporting People project Hact‟s mission is to develop solutions promoting people‟s well-being and enabling people to live in their homes with dignity and independence. Our focus is on current and emerging issues, particularly those concerning groups that are marginalised from mainstream housing and support provision. As a small national agency hact tests and develops solutions and shares the learning that emerges so as to influence policy and practice. Our work is supported by a range of funders and is carried out in partnership with other organisations. It is often small providers who are in touch with particularly marginalised people and groups. Some can struggle to provide effective services within a contractual framework; the best often have a „unique selling point‟, providing niche services offering very specific solutions and ways of working. 1 Hact‟s ODPM funded Supporting People project has provided a range of capacity building support for small providers, including regional events and grants to individual providers and to networks. Within this project, we have defined „small providers‟ as those where the organisation as a whole employs a maximum of 10 staff or supports a maximum of 50 service users. 3. Consultation methodology ODPM commissioned hact to undertake a consultation exercise with small providers of Supporting People services. To do this we prepared a summary paper and facilitated two consultation events specifically for small providers, in Sheffield and London. Invitations to the events were sent to: all applicants to hact‟s Supporting People grant funds, where the organisation was potentially eligible for a grant; members of the ten networks for small Supporting People providers currently funded by hact; small SP providers, particularly refugee community organisations, funded through hact‟s Refugee and Older People‟s programmes; a number of small providers and organisations with a particular interest in supporting small providers, as requested by ODPM. 30 delegates attended the Sheffield event, and 33 the London event. Each event opened with a keynote speech by ODPM (or their representative), followed by group discussions facilitated by staff from SITRA, the National Housing Federation (NHF), hact or by independent facilitators, and closed with a final plenary session. Hact has also encouraged feedback outside of the events, for example from small provider networks supported by our grants, and used our ongoing engagement and work with small organisations to gather further feedback about key issues affecting them. Discussions with and between small providers have been wide ranging. While ODPM‟s strategy report formed the starting point, not all of the issues of most concern to small providers are directly addressed within this document. The following response therefore reflects wider issues of particular concern to small providers, and specific comments about issues raised in the strategy paper. Providers‟ views are by no means unanimous. This report concentrates on key themes and majority views. As it is not possible to reflect all opinions and perspectives, hact has suggested that where delegates have a specific and/or strongly held view they respond directly to ODPM. The report does not attempt to undertake a statistical analysis, but does indicate whether responses are from „a few‟ „some‟ or „the majority‟ of delegates. Where relevant it also highlights issues 2 potentially affecting providers of particular types of services and/or specific service user groups. 4. The context for small providers Small providers largely welcome the development of the draft strategy as an indication of ODPM‟s continuing involvement within the Supporting People framework. Discussions have highlighted a number of cross cutting and contextual issues that have not necessarily been addressed in the draft document. These include: 4.1 The experience of being a small provider In many cases it is the experience of being a small provider, and in particular of coping with the requirements of Supporting People with a very limited infrastructure, that is uppermost in providers' minds. Hact‟s recent paper Added Value1 explores the experiences of small organisations within the implementation stage of Supporting People. While we do not wish to revisit these issues in detail in this response it is important to stress that many small providers continue to face practical difficulties within the Supporting People programme. We also note with some concern the increasing tendency for organisational mergers to be seen as a solution: the niche focus and approaches offered by many small providers can be diluted or even lost altogether if small organisations are forced to merge. There is an ongoing need for assistance and support to maintain a 'surviving and thriving' small provider sector. ODPM has a key strategic role to play in monitoring the impact of Supporting People on small providers more closely and capturing trends in how the SP market is shifting, particularly in the size and nature of local provision. In particular research is needed into how many small providers have withdrawn from Supporting People or been decommissioned2 and the reasons why. This research can build on the research commissioned by ODPM undertaken by Ridgeway Associates looking at small sheltered housing and almshouse providers. 4.2 Funding For many small providers, the most pressing issue continues to be threats to the financial survival of their organisation and service. Small providers can be proportionately more vulnerable: many operate to very tight financial margins and some are only surviving by using their reserves, which is not sustainable. A number, for example some almshouses, continue to question whether it would be better for them to pull out of the SP programme altogether. This should be of concern as it removes housing-related support provision from local strategic frameworks and quality assurance processes. The short-term nature of much current SP funding 1 Value Added: small providers and Supporting People, hact, September 2005 (available from www.hact.org.uk). 2 Milestone reports to ODPM on the outcomes of reviews and the number of providers decommissioned do not at present distinguish the size of the providers concerned. 3 brings additional problems; some providers have experienced staff leaving to go to more secure posts and it is hard to keep good work going. Hact notes that ODPM‟s document does not address problems arising from cuts in budget and uncertainty about future funding, which the Audit Commission thought was the major stumbling block for further successfully developing the programme. 4.3 Relationships and partnerships During the consultation quite a few providers raised issues to do with trust and their relationship with the local authority. This is wider than the relationship with their SP team: providers may be positive about their SP team's intentions and priorities but see them as having little influence in the wider agenda. This highlights the importance of SP being corporately owned by local authorities, and the challenges this brings for district authorities, where two tiers exist, who do not have SP budgets or dedicated staff located there. Participants also frequently raised issues about the importance, and challenges, of partnership working. They often had less concerns about the specific type of formal structure that was in place than about the quality of relationships and the resource implications. Supporting People aspires to be a partnership programme and this is welcomed. However, hact notes that for constructive and effective partnership working: the resource implications for small providers of partnership and multi-agency working need to be recognized and addressed, for example within SP funding; recognition is also needed within partnerships of the „large/small‟ dynamic, of the equal but different contributions of both parties and of ways of working that promote mutual respect and positive engagement.3 4.4 Strategic issues Providers know that a strategic approach is vital to the survival of their organisation but experience difficulties in making sense of various national and local policy initiatives, the potential impact of these on their service, and the actions that they need to take. Small providers welcome assistance in navigating their way through the changing political and policy landscape and prioritising the policies they need to focus on. 4.5 Unmet and emerging needs Providers feel that there is still a level of unmet need, often because they are turning away people that they believe need the services they offer. Hard data about unmet need is not necessarily available as local authorities are not systematically mapping need at a local level. More detailed information would inform local strategies and priorities as well as the Comprehensive Spending Review(s). Hact is not convinced Hact‟s Accommodate project is generating relevant learning about partnerships between authorities, housing associations and refugee community groups. 3 4 that the current level of information available enables ODPM and authorities to be confident that no specific groups (eg refugees, women) are discriminated against and at greater risk of exclusion through being disproportionately affected by rationing decisions. This leaves the SP programme, ODPM and local authorities open to claims of discrimination. Supporting People needs to respond to demographic changes, such as an aging population and the increase of single person households, as well as environmental, social and political changes which result in new and unmet needs. Without systematic mapping, relevant data and sophisticated forecasting, meeting new need is difficult. Needs which emerge as a result of wider changes should be factored into strategies at all levels. A good example of this is how when SP was introduced, it did not factor in the impact of changes in Government policy relating to Asylum Seekers and Refugees. It is widely acknowledged that at the time that SP was introduced, the new dispersal policy, which saw new asylum seekers dispersed to areas outside of London and the South East, had not made it's greatest impact. Although Refugee Community Organisations and specialist refugee support services were developing in new areas, these were not sufficiently established by the 'Golden' or 'Platinum' cut, and were therefore not factored into the legacy provision. With significant downward pressures on the SP budget, it also made establishing new SP provision for refugees increasingly difficult. SP needs to take account of these fast moving changes and ODPM has a role in alerting AAs to potential shifts as a result of changes made in policy in other parts of Government. Furthermore, ODPM and AAs need to create an environment where services can be developed and providers supported to innovate and reconfigure provision to meet wider changes. SP also needs to make links to other new policies and practices emerging from other parts of government. For example links need to be made with the new Sunrise pilots being developed to support the integration and settlement of refugees from NASS accommodation and support. Although some refugees supported through Sunrise may not need further support once settled, some may. The seamless transfer of support from services funded through Sunrise to those funded through Supporting People will be important in ensuring that refugees continue to integrate successfully into our society. Ensuring that these links and processes are made at the practice and the strategic level is important. 4.6 Innovation Providers also feel that the current funding, strategy and commissioning environment does not support innovation. This limits opportunities for small providers to take the initiative in developing and testing new models, or transferring „old‟ models into new settings, that could bring real benefits to service users. ODPM‟s strategy must address as a priority how it will support innovation and work with Administering 5 Authorities (AAs), providers and users to create an environment in which this can occur. 4.7 Quality The ending of the three year „reviewing‟ cycle and the move to contract management raises a number of issues. The emphasis on quality and continuous improvement embedded in the reviewing cycle is important and should continue. Providers want to keep improving but emphasise that quality costs and that it is not possible to keep driving up quality with a budget that is reducing in real terms. There is still a need to invest in expertise and in managing the delivery of this by agencies and regulators. 4.8 Time to consolidate Providers feel that there has been an at times overwhelming level of change. They want time to consolidate, „bed down‟ new systems and ways of working and implement post review action plans. 5. Responses to the consultation document 5.1 Supporting People in its Strategic Context 5.1a Outcomes focus An emphasis on outcomes was almost universally welcomed, in principle. An effective outcomes approach could be good for small organisations, many of whom feel that paper based output indicators fail to capture either the individual nature of their service or service users' actual experiences. The key concern raised by providers is how service and service user level outcomes will link to local area and strategic outcomes as they are very different types of measure. Participants stressed the need for outcome measures to be negotiated locally between SP teams and providers, to reflect other agendas (eg mental health strategies), to be joined up for services with varied funding streams, to include „distance travelled‟ and other qualitative measures such as case studies, and to be realistic. Participants also identified specific issues for small providers. It will be important to take heed of proportionality and appropriateness of outcome reporting requirements and to avoid a „plethora of paperwork‟. Statistical anomalies will also need to be allowed for: one failed outcome can easily skew the figures for a small provider. Some small providers identify that they lack skills, experience and confidence in working from an outcomes perspective and that they will therefore need support to develop their capacities in this area. Participants also noted that some SP teams will need to develop more in depth skills in quality monitoring in order to capture service users experiences and perspectives. Hact supports the emphasis on outcomes. Further work is needed in clarifying outcomes that are meaningful to government, providers, SP teams and service 6 users. A common understanding, language and methodology needs developing, as does the related IT and monitoring framework. The experiences of how outcomes defined in Local Area Agreements (LAAs) are cascaded through to service delivery and into outcomes for individuals will be important to capture to inform this debate. 5.1b User focus Participants, and hact, feel strongly that maintaining and developing the user focus of SP is predicated upon the provision of individual, consultative, person-centred support provided by a skilled and trained staff team supported by skilled and trained managers. This forms the bedrock on which to build a range of opportunities for individuals and groups to participate and influence the design and delivery of services, work which also needs the support of skilled staff. The best way for Supporting People to promote a user focus is to ensure that providers are funded and supported to operate in this way. Ongoing work is needed to develop culturally sensitive services. Specialist BME agencies note that mainstream services need to challenge themselves further – for example employing one worker who speaks the language, though a start, is not in itself sufficient. A dual strategic focus is needed to drive up the sensitivity of mainstream services and support specialist provision. The ODPM can also encourage SP teams and providers to develop better relationships and partnerships with BME and Refugee Community Organisations, bringing a greater awareness of the needs of local communities and also unlocking the considerable resources and assets that already exist. There has been an ongoing debate recently about whether SP reviews of provider services should be published as public documents. Hact‟s view is that publishing reports would be in service users‟ interests: it would highlight and showcase organisations with a good user focus and give potential service users information about quality issues.4 5.2 Focusing and Integrating Support 5.2a The „3 groupings‟ model Providers see this model as having some benefits and being helpful in conceptualising issues. It highlights that needs and services will be very different depending on the service user group and the explicit recognition of „socially excluded‟ groups provides more of a focus on their needs. Providers of housing related support and care welcome ODPM‟s wish to overcome the unhelpful care and support divide, create a more holistic approach and enhance the integration of different funding pots. The key issue for participants was how the model would translate into practice. For example, who would make the decisions and commission services in the „overlaps‟, how would contract management be carried out in this framework, and by who? 4 Hact notes that inspection reports by the Commission for Social Care Inspection are open documents. 7 Some small providers run very flexible services, which adapt to meet the changing needs of individual service users. These services can support people who would potentially move between two or even all three of these groupings. If services for each grouping are commissioned by different parts of a local authority, would this also mean that each would have different performance and monitoring requirements? If this were the case it could increase the bureaucratic demands on small providers to an impossible level. Some small providers thought the model could develop better expertise in commissioning for each of these 3 groupings but others had concerns that some of the proposed new commissioners, eg DATs, have no specific housing knowledge or expertise. Providers very much wish to support suggestions that could make for more rational and holistic services for users, overcome difficulties accessing other funding and reduce cumbersome split funding and monitoring arrangements. However, they are cautious about local authorities' willingness and/or ability to protect non-statutory services and to keep the current level of funding in housing-related support (see section on the SP ringfence, below). 5.2b Assessment processes ODPM‟s report refers to the importance of ensuring that assessment of the need for housing-related support is included in single assessment processes. A related issue is the introduction of common SP assessment processes which are being developed in a number of authorities. Small providers in these areas have a number of concerns. These centre on practice issues (whether those carrying out assessments will have knowledge about the needs of all service user groups) and on the potential implications for small providers and the service user groups they support. Hact particularly highlights the fact that quality support requires ongoing assessment, While common assessment systems can offer a „gatekeeping‟ function and/or prevent service users from having to constantly give the same information to a range of providers, they cannot be seen as a substitute for in depth and continuing assessment by support providers. We also have concerns about the potential danger of these approaches reducing access by marginalized groups or individuals who may be alienated by „official‟ access routes and/or by very bureaucratic processes. Rather than each authority developing systems in isolation and so reinventing the wheel, it will be important to learn from those that have already started developing a common process, such as Liverpool. 5.2c Balance between accommodation based and floating support services Small providers expressed some uneasiness about what they saw as an emphasis on developing floating support at the expense of accommodation based services. While supporting the wishes of those who want to stay in their homes, there was a concern that some authorities could have a bias towards floating support as being easier to commission, remodel and even decommission. 8 Hact very much supports finding a balance between accommodation based and floating support services that reflects service users needs and wishes. However, commissioning decisions need to be based on comprehensive evidence about what will best meet needs and wishes and the effectiveness of different models. They should not be driven solely by cost implications or a wish to reduce commissioning risks. We also stress the need for a clear recognition of the role that accommodation based services play in promoting mutual support and reducing isolation and note that models that have been built up over many years, that work well and are evidence based, need to be protected. There is also a need to address the difficulties that small providers face in accessing capital funding to remodel outdated buildings. We welcome the ODPM funded Hostel Capital Improvement Programme and suggest that this is broadened out to include other types of services. We also suggest that other models are explored with small providers, such as loan financing. At times floating support will clearly be the desired and most suitable alternative. However, here small providers have some concerns as to whether Supporting People is potentially moving to an over-reliance on large housing providers for generic floating support, leading to a lack of specialisation and a loss of expertise. 5.2d Incentivisation The theme of „incentivisation‟ identified in the strategy document need to move beyond incentives for local authorities and look at how providers are also incentivised to deliver high quality value for money services. Significant issues include: how local authorities incentivise good services: budget cuts do the opposite; how small community organisations that could offer services for specific groups (e.g. refugee community organisations) can be encouraged and supported to enter the SP „marketplace‟; how the sector is supported and incentivised to innovate. Participants suggested the following as incentives for small providers: ensure prompt and detailed feedback is given after service reviews are completed; the awarding of a quality mark that reflects QAF standards; accreditation certificates; showcasing excellent providers; offering flexibility / „cutting red tape‟ for providers who have demonstrated that they run good services. 5.2e Cross authority working Small providers have considerable concerns about local connection criteria still being used by a number of authorities to restrict access to services in a way that they feel is impractical and unfair to individuals. Although ODPM has written to authorities discouraging them in using local connection criteria, this practice still occurs. 9 Restricting access to particularly mobile groups does not support the social inclusion agenda Supporting People and the ODPM is promoting. Providers would like to see ODPM take action against authorities who continue to restrict access to vulnerable groups in this way. There is also a broader concern about the lack of co-ordination and joined up thinking between some authorities. In particular, there has been limited uptake of opportunities for authorities to jointly commission and „share‟ provision for service user groups with specialist support needs. Incentivising such approaches is a key challenge. 5.3 Funding 5.3a The ringfencing of Supporting People funding Nearly all participants have significant concerns about the possibility of lifting the current ringfence around SP funding. Many thought there was a high risk of authorities‟ statutory responsibilities „pulling‟ funding away from services for nonstatutory groups (ie those in the „risk of social exclusion‟ grouping) and from lower level support services for individuals in statutory groups (eg learning disability) whose needs do not meet statutory eligibility criteria. Some participants were more confident of their authorities‟ current commitment to these services, but noted that the financial or political landscape could change. As to the question of whether lifting the ringfence would encourage authorities to put in more funding from other sources, responses again depended on the authority concerned but in the main providers felt this was unlikely. Given the level of uncertainty, and their tight financial margins, small providers feel strongly that at least for the foreseeable future the ringfence must be kept for „socially excluded‟ groups. Preventative and lower level support services for people in statutory groups but without statutory rights to a service also need protection. In respect of support and care services, joint funding is seen as having the potential to promote more holistic services. On balance providers were supportive of taking funds for this grouping out of the SP pot and combining it with social care funds as long as funding for SP services for people in these groups who have no statutory right to a support service remains ringfenced. We note that underpinning small providers‟ responses is whether they believe their local authority has a commitment to the importance of housing related support services and, where this is the case, they trust the authority to resist short-term, expedient decisions in the event of inevitable budgetary pressures. One way of taking this issue forward would be to explore what is happening to Supporting People funded services in excellent rated authorities, where the ringfence is already lifted. Are services „surviving and thriving‟ in these authorities and if so, can the processes that support this be identified, disseminated and replicated? 10 If, however, there are very strong drivers to lift the ringfence before such work can be undertaken, protection mechanisms will need to be put in place. As discussed below, further work is needed before we can have confidence that the ODPM suggested approach of using Local Area Agreements will provide the necessary protection. Another option could be for local authorities‟ current powers to promote well-being becoming a duty, as proposed by the Chartered Institute of Housing. SITRA‟s proposal for authority based benefits realisation work could also highlight the potential financial benefits of SP preventative work and contribute to a greater awareness of the importance of SP funded services. 5.3b Local Area Agreements The suggestion to tie SP funding into agreed outcomes for Local Area Agreements particularly for socially excluded groups, needs further exploration and should be approached with caution. Participants and other commentators have noted that LAAs are new and their effectiveness is still untested. It will take time to be confident that this new approach can give robust protection to vulnerable groups of service users. LAAs rely on Local Strategic Partnerships as the key delivery mechanism and small providers report that they are rarely linked in with their LSP at any level. Where they have had some involvement, the experience has often not been empowering: providers have not felt that their voice was heard and have struggled with the number of meetings and the level of bureaucracy involved. This is a serious concern and will need to be looked at in those areas where the pilots are happening and Supporting People money is being pooled. 5.3c Individual budgets Many delegates are hopeful of the potential of individual budgets to promote choice and control but had questions and concerns about how the system will work in practice and how to enable vulnerable people to take calculated risks. Some saw the risks as unacceptable for particular service user groups (eg young people with chaotic lifestyles, and people with a drug dependency) and for the services supporting them. Providers also noted that the choice agenda may not be priority for some people in some situations, for example a serious emergency. Providers had questions about the practicalities: whether they would need to reorganise services, and how to 'cost up' services on an individual basis. They also had particular concerns about the implications for small organisations if there are lots of fluctuations in demand for a service: plus or minus just a few service users could be critical. More information is needed: in the first instance learning from the pilots will be important and efforts need to be made to include an exploration and evaluation of potential impacts on small providers in these pilots. Hact sees individual budgets as potentially offering greater choice and control to service users and we welcome opportunities for their implementation. However, we also note that individual budgets are not the only way to promote choice. Further work is needed on how to develop the choice agenda for groups and services where individual budgets are not appropriate, applicable or wanted by service users. 11 Maintaining and developing a diversity of provision is perhaps the most crucial issue. Providers have lots of ideas to share and welcome opportunities and support to develop the choice agenda and share good practice. 5.3d Distribution Formula Providers‟ views on the idea of carrying out an element of distribution had at least some relationship to whether they are based in an authority that expects to win or lose. However, irrespective of the local position many providers feel that there is an issue of equitability involved and that a way has to be found of increasing funding to areas in particular need. This would ideally be done through accessing additional resources, but these providers thought that in the end some degree of re-distribution may be necessary. Their concern was how any required changes will be managed by ODPM and local authorities. This opinion was not universal – other providers feel that redistribution rewards authorities who they believe were incompetent or didn't make an effort 'pre-THB' to address needs and provide services. Providers also had a range of questions about the actual formula which were outside the scope of this report. A few noted that it would have been helpful if hact had also produced a consultation report on ODPM‟s „technical‟ paper. Although not hact‟s intention to produce a summary, this request highlights the need for complex consultation documents to be made more accessible in both language and length to small organisations to facilitate greater engagement in these discussions. While not having a specific view about whether any redistribution should happen, hact stresses that after three years of no inflationary increases in the overall fund, providers contracting with authorities due to lose funding could face further cuts. The threat of this is already a destabilising factor and for many small providers the reality would make their services unsustainable. 5.4 Administering the Programme 5.4a Administrative burden It is particularly important that any new directions taken reduce, or at least do not increase, the administrative burden on small providers, and that consideration is given throughout to ensure the proportionality and appropriateness of administrative and reporting requirements. Hact particularly welcomes ODPM‟s call for local authorities to understand the cost implications of the administrative requirements placed on providers and ”to make sure that providers are being clearly remunerated for the work they will be required to do”. Likewise we fully support ODPM‟s expectation that authorities consider support for providers, particularly voluntary and community sector (VCS) providers, and “ensure that they apply best practice in working with the VCS, including maintaining and observing their local compact”. 12 5.4b Future monitoring Anything that reduces bureaucracy would be particularly welcomed by small providers. Key issues were identified by participants: Most saw QAF as being useful to set standards and as having brought about some improvements, although some felt a good framework had been badly implemented and others thought the whole experience had been disproportionately onerous for the size of their service; Should QAF continue? Providers had mixed views. Their key concern was that whatever the future system is, it needs to be proportionate and manageable; There should be a lighter touch for good providers; If a different system is introduced, there will be training implications; A baseline of information now exists. It would be a good idea for future systems to be based on SP officers talking with service users in a systematic way and following up key issues with staff. This means different skills; Providers working across more than one AA are concerned that different authorities will take very different approaches. Hact sees QAF and the quality drive as one of the key successes of Supporting People. QAF was developed by and for the sector and we need to hold on to the benefits it has delivered. It‟s implementation has undoubtedly been a struggle for many, but important foundations have been laid for further work and improvement in this area. QAF is now a known and largely respected approach and hact believes it needs to underpin future quality and monitoring systems. 5.4c Procurement / good commissioning practice Hact sees procurement is perhaps the most significant „new‟ issue facing many small providers as SP moves into its next phase. There are particular concerns about small organisations being unable to continue within the programme and/or to develop new services if the procurement methods used by an authority are disproportionately complex and onerous. This will then have a knock on effect on diversity of provision and reduce choice for service users. It is important that authorities are actively encouraged to adopt proportional approaches and provide support for small providers to develop their skills in tendering. Some SP teams report that they and/or their procurement teams believe that the legal framework within which they must operate requires them to use procurement methods that will be very onerous for small providers in particular. ODPM has a role to play in reinforcing positive approaches to procurement that support small organisations and showcasing examples of positive practice. It will also be important to explore „disincentives‟ for local authorities in contracting with small providers and ways to overcome these. For example, small providers‟ services may be of an equivalent cost or even cheaper than those of larger providers but require extra support time from SP staff. If the SP team‟s administration grant is particularly stretched this may create incentives to contract with larger providers. 13 Small providers may also be viewed as ‟risky‟ to contract with. For example they may lack the financial resilience of larger providers and so be seen as less able to cope than larger providers if future difficulties arise. Incentives and support for small organisations to work in partnership with authorities and other providers to develop creative models for procuring services is an important way forward. Evaluation is also needed of emerging models such as consortia and their impact on small providers. 5.5 eSupporting People Hact is very aware that IT based approaches will increasingly underpin business operation. However, any IT strategy is not just about designing a system but also taking account of those who will be using it, including service users and small providers. Issues of skill, capacity and cost must all be considered throughout the design and implementation stages of any IT project. 6. Key Recommendations This section summarises key recommendations made by small providers and by hact. Impact of SP and related policies on small providers Ongoing research by ODPM is needed into the experiences of small providers within the SP framework; Evaluation and research commissioned by ODPM that looks at any aspect of Supporting People should include a focus on the impact on small organisations; Issues of proportionality and impact on small providers needs to be central to all new initiatives as the SP programme develops; The potential impact of Individual Budgets upon small providers needs to be explored within the current pilots. Support for small providers Capacity building support will continue to be needed as SP develops. This will include support with organisational issues, ensuring that the ChangeUp initiatives benefit small providers, and support with key SP issues such as the developing outcomes framework, which may need to be provided outside of the ChangeUp initiative; ODPM needs to encourage procurement approaches that are proportional, and the provision of appropriate support to small providers, by showcasing positive practice; Exploration and evaluation is needed of developing consortia and subcontracting models and the experiences of small providers within these. 14 Unmet need Greater focus is needed by ODPM and AAs on mapping all needs but particularly unmet and emerging need; ODPM needs to alert AAs to potential shifts in need arising from other policy drivers across government; ODPM and AAs need to create an environment that encourages innovation and enables new specialist and community based organisations to enter the SP marketplace. User focus Funding levels need to be sufficient to enable small providers to employ a skilled workforce and provide them with appropriate levels of training, support and management that delivers a greater user focus; Reports of SP reviews of providers should be published and made accessible to service users; Ongoing work is needed to develop culturally sensitive services by challenging the mainstream, supporting small BME providers and developing partnerships with BME communities; Improving user choice should not be restricted to the introduction of Individual Budgets, but also focused on ensuring that there is a choice of provision locally by maintaining a healthy and vibrant small providers sector. Future funding arrangements The ringfence of SP funding for socially excluded groups and for individuals without a statutory right to a support service needs to stay in place until protection mechanisms have been identified and tested and an assessment made of each authority‟s capacity to implement these; Separating out and lifting the ringfence for services for people with care and support needs should be explored further with a view to improving commissioning across the support and care divide; Action is needed to overcome the destabilising influence of financial uncertainty: for example through clear information and the offering of three year contracts; Small providers need more confidence in LAAs before funding is aligned or pooled, specific evaluation of the impact of these new arrangements on small providers and the service users they work with is needed. Quality and monitoring The strategy needs to stress the importance of supporting and investing in the ongoing improvement in quality of housing-related support services; QAF should underpin future quality monitoring systems, with a „lighter touch‟ for demonstrably good providers and proportionality for small organisations; An outcomes based approach is welcomed, though further work is needed in reaching a common approach across the sector and demonstrating how outcomes relate from the national to the local and service specific level; 15 Quality measures need to be sensitive and include qualitative measures and detailed service user feedback. Some SP teams need to build their capacity to assess services in this way. 7. Further Information We are pleased to have provided this response and to have undertaken a specific consultation with small providers with the support of the ODPM. For further information and discussion on any aspect of this response please contact Judy Lowe, Supported Living Programme Manager, on 020 7247 7800 or by email firstname.lastname@example.org Hact February 2006 16